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Malaria Cell

Introduction

Statistics of Ahmedabad city for distribution of households by the type of source of drinking water supply records is as follows:

68.9 % households have tap water supply within their premises

19.4 % households have tap water supply outside their premises

3.6 % receive water supply from bore pumps & tube wells

Limited water supply for only 2 hrs a day is a forcing factor for container storage practices, which are preferable breeding sites for both malaria and dengue vector species.

The city is also traversed (by 9 km.)by river Sabarmati, which with increasing urbanization, and coming up of barrages, check dams, industrialization and intensive agricultural usages, along with low rainfall in catchments area etc, has become narrowand more polluted, and has thus become a breeding ground for mosquitos. However, since August 2002 Narmada river water has been fed into the river Sabarmati and also lakes and ponds of the city and surrounding areasthrough Sardar Sarovar Dam Project's Main Canal. Downstream flow river water is regulated at Vasna barrage dam for irrigation purposes. With Narmada water reaching Ahmedabad, the environmental conditions have become more mosquitogenic with rise of water table, recharging of dry French wells and bore wells, canal and feeder canals seepages and / or pools etc.

Water scarcity and indiscriminate water storage practices have established An. stephensi and Aedesaegypti (Map - 1) as throughout year prevalent malaria and dengue proven vectors. Other vector borne diseases Japanese Encephalitis, Filariasis, Plague though not prevalent but have a great threat of outbreak particularly of late.

Malaria_Graph

Malaria Research Centre (Indian Council of Medical Research, New Delhi) has observed that nearly 10% of all malaria cases reported in India in recent years have occurred in the urban areas. Many cities and towns are endemic for malaria. During last two decades, malaria, dengue and dengue haemorrhagic fever have emerged as major health problems throughout India. Due to rapid urbanization and development, within and around Ahmedabad, malaria and other mosquito borne diseases have become a serious problem in Ahmedabad city

Mosquito breeding associated with domestic water storage practices

Storage of water is a common practice in almost every household. Main reason being inadequate supply of water almost throughout the year. Water is stored in a variety of containers, ground level tanks and underground tanks being the most common. In addition, all sorts of available pots, pitchers and containers are used to store water.

The major issues and challanges in containing the vector borne diseases morbidity and mortality are as under:

  • Rapid unplanned urbanization around Ahmedabad, growth of slums and squatter settlements, uncontrolled population growth, inadequate basic infrastructure in squatter settlements, have created the conditions conducive for the spread of vector borne diseases(malaria, dengue, chikunguniya, kala azar, filaria, Japanese encephalitis etc.) in the last few decades.
  • Due to water shortage in slums, there is an increasing tendency of storing water inside houses in earthen pots. The population at the risk of dengue has therefore increased tremendously.
  • The urban malaria scheme is faced with operational constraints such as an inadequate number of skilled staff and health facilities in slums, influx of people pursuing employment into the city and peri-urban areas often are carriers of malaria infection.
  • Due to the excessive use of insecticides and anti-malarial drugs, insecticide resistance in mosquitoes and drug resistance in Plasmodium falciparum is increasing.

Organization Structure of the Department

Malaria_Org_Structure

Roles & Functions/Objectives of Department

  • Planning, implementation and monitoring the Urban Vector Borne Disease Control Programme considering the topography, demography, disease prevalence pattern, seasonality, available resources & infrastructure.

  • Providing preventive and curative services for the vector borne diseases i.e. malaria, dengue, filaria, plague, chikungunya etc. following the operational guidelines / directives of the Programme Managers.

  • Anti-larval & Anti-adult control measures for control of the vector species i.e. by judiciously applying either or in combination of chemical, biological, engineering, environmental manipulation & management methods.

  • Propagation of community awareness, education and their participation for the containment of the vector and diseases.

  • Fortnightly active domiciliary services for malaria fever surveillance in the slums of the city.

  • Passive diagnostic and curative centers, where free malaria parasitological diagnostic services are provided and presumptive/radical treatment are given (RCH Urban Health Centers).

  • Compilation of the data from various agencies, analysis ,interpretationand reporting to the Programme Managers.

  • Entomological monitoring of the vector(s) species as per the standard methods.

  • Capacity buildup of staff, training, seminars, workshop, demonstration etc.

  • Preparedness for any outbreaks/epidemics.

  • Supporting the operational field level research projects undertaken by the state / national level programme managers, like drug / insecticide trials & efficacy, novel product evaluations, socioeconomic surveys, knowledge and practices evaluations etc.

  • Logistics & supplies - planning, procurement, verifications etc.

  • To assist as presiding / presenting / evidence in Industrial Relations Enquiry Cases.

Initiatives taken by the Department

Disease surveillance, diagnosis and treatment :

A. Urban Health Centres (Public Private Partnership)

Fifty seven UHCs: Managed by Medical Officer, Medical Specialist (Paedtrician, Gynecologist), Laboratory Technician, Pharmacist, and for dominiciliary services Supervisors, Field Workers (Multi Purpose Health Workers), Link workers etc.

These are established under Central Government financed scheme-Reproductive Child Health (RCH) Programme, and has given an impounding thrust to the existing medical domiciliary services.

These centres are managed by the local leading NGO bodies, which motivate the communityto participate in health programs (NGOs listed in the table under Health status of the city). The proposed action plan activities under the Urban Vector Borne Disease Control Programme will be synergistically intricated with the existing RCH programme to utilize the trained manpower cost effectively.

B. Passive Case Detection Agencies

To know the true prevalence of the disease passive agencies i.e hospitals cases are retrieved and preventive actions are therein to contain the disease transmission.

Passive case detection agencies :

  • Gomtipur Ref. Hosp
  • Behrampura Ref.Hosp.
  • Kapdivav city center
  • Sabarmati Ref.Hosp.
  • Sabarmati Rly. Hosp.
  • Police welfare Hosp.
  • Rajpur-Hirpur
  • V.S.Hospital
  • L.G.Hospital
  • S.C.L.Hospital
  • Civil Hospital
  • Sola Civil Hospital
  • ROH & FW
  • Army Cantonment
  • Bapunagar Gen.Hosp.
  • University Hosp.
  • Sterling Hospital
  • Rajasthan Hospital
  • Karuna Med. Trust Hos.

C. Online diseases from private clinicians / pathological laboratories:

Since retrieving of vector borne 8thAugust 2011 around 165 private agencies are reporting to Local Health Authority about water and vector borne disease case reported to them, upon which the ring operations are undertaken to contain furthertransmission of these diseases. The reported cases of malaria vivax, falciparum and dengue cases arepresented here under:

On Line Reporting Of Malaria Cases - P VIVAX
Year Repoted Cases
Yearly 2011 (8TH Aug. onwards) 852
Yearly 2012 2297
2013 968
JAN-JUL 2013 560
JAN-JUL 2014 175
P vivax private reported cases: decline in 2014 is -69%

On Line Reporting Of Malaria Cases - P FALCIPARUM
Year Repoted Cases
Yearly 2011 (8TH Aug. onwards) 829
Yearly 2012 555
2013 291
JAN-JUL 2013 48
JAN-JUL 2014 18
P falciparum private reported cases: decline in 2014 is -62%
2013: Both P vivax and falciparum cases trend in private agencies reporting is less, like the RCH or PCD Hospital agencies.


On Line Reporting Of Dengue Cases
Year Repoted Cases
2011 (8TH August onwards) 1031
2012 1465
2013 1184
2014 (till july) 32

D. Dengue / Chickungunya Diagnostic Services:

At each Urban Health Centre and inCorporation run general hospitals facilities are provided for sampling and diagnosis ofthese two diseases. Samples collected from the city are sent for diagnosis to either NHL Medical College or BJ Medical College, which both are designated as sentinel surveillance centers by the central government.

E. Anti larval and Anti adult Mosquito Control Measures:

The measures adopted are either
(a) Biological - using biolarvicides & larvivorous fishes ,
(b) Chemical - by using NVBDCP recommended insecticides for both larval or adult control measures

Services offered by the Department

  • Diagnosis of malaria, dengue , chikungunya
  • Treatment of malaria cases and management of dengue, chikungunya cases at general hospitals.
  • Complaint redressal of mosquito nuisance.

Proactive Disclosures under RTI Act

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