Integrated vector control program part 2

By V. Keerthivasan

Overview
Environmental control Biological control Genetic control Protection against bites Programs in India

Environmental control
Source reduction Involves elimination of mosquito breeding places. Comprises minor engineering methods such as filling leveling and drainage of breeding places and water management. Rendering the water unsuitable for breeding.

Environmental (cont)
Culex mosquitoes Abolition of domestic and peridomestic sources of breeding such open ditches. Adequate collection, removal and disposal of sewage and waste water.

Environmental (cont)
Aedes mosquitoes Steps involve removal of artificial collections of water such as discarded tins, empty pots, broken bottles, tiers, etc.

Environmental (cont)
Anopheles mosquitoes Filling and drainage of the breeding places

Environmental (cont)
Mansonia mosquitoes The aquatic plants to which the mosquito larvae are attached to are removed or destroyed by herbicides

Biological control
Biological control methods involve the use of small fish that feed on mosquito larvae such as Gambusia affinis and Lebister reticulatus.

Gambusia affinis

Lebistes reticulatus

Biological control (cont)

These fish can be used in burrow pis, sewage oxidation ponds, ornamental ponds, and farm ponds Biological control is effective only when used in conjunction with other methods

Biological control (cont)

Other methods of biological control
Dragonfly Crustaceans Copepods Fungi Bacterium such as Bacillus thuringiensis

Genetic control
Control of mosquitoes by genetic methods such as
Sterile male technique Cytoplasmic incompatibility Chromosomal translocations Sex distortion Gene replacement

Are being researched

Genetic control (cont)

Advantages These techniques have great potential in mosquito control They have advantages over certain chemical methods, being cheaper and potentially more efficient and above all not subject to vector resistance

Protection against bites

Mosquito net Screening Repellants

Mosquito nets
The mosquito net offers protection against mosquito bites during sleep

Mosquito nets (cont)

Characteristics of an ideal mosquito net Should be white, to allow easy detection of mosquito The top and sides of the net should be of netting The best pattern is the rectangular net

Mosquito nets (cont)

There should not be a single hole or rent in the net Size of opening should not exceed 0.0475 inch in any diameter Number of holes in one square inch is usually 150

Screening
Screening of buildings with copper or bronze gauze having 16 meshes to the inch is recommended. The aperture should not be larger than 0.0475 inch. Screening is costly but gives excellent results

Repellants
Repellants or culicifuges are used mainly for application on the skin and have a short duration of action

Repellants (cont)
Diethyltoluamide, indalone, dimethyl pthalate, dimethly carbate, diethyl hexanediol are some of the chemicals used as repellants Diethyltoluamide (deets) is the most commonly used.

Vector control programs in India

Malarial Filaria Kala-Azar Dengue

Malaria
At the time of independence, there were an estimated 75 million malaria cases and 0.8 million deaths annually Various programs were launched by the government of India to control the spread of malaria Started in 1953 as NMCP with Two rounds of residual insecticidal (DDT) (not used now) spray as the mainstay of the program.

Malaria control programmes

NATIONAL MALARIA CONTROL PROGRAMME 1953

SPECTACULAR SUCCESS
NATIONAL MALARIA ERADICATION PROGRAMME1958

URBAN MALARIA SCHEME 1971 RESURGENCE MODIFIED PLAN OF OPERATION 1977

MALARIA ACTION PROGRAMME 1995

ENHANCED MALARIA CONTROL PROJECT 1997

NATIONAL ANTI-MALARIA PROGRAMME 1999

NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME 2004

INTENSIFIED MALARIA CONTROL PROJECT 2005

Strategies of malaria control

Surveillance and case management Case detection Early diagnosis and treatment Sentinel surveillance Intergrated vector control management Indoor residua spray Insectiside treated bed nets Antilarval measures including source reduction Epidemic preparedness and early response

Strategies of malaria control (cont)

Supportive interventions Capacity building Behavioral change communication Intersectoral collaboration Monitoring and evaluation Operational research and applied field research

Filaria
National Filarial control program was started in 1955 In 1998 the operational component was merged with Urban Malaria Scheme In 2003 -04 it was merged with NVBDCP National health policy (2002), envisages elimination of lymphatic filariasis by 2015

Strategies of filarial control programme

Vector control Source reduction Antilarval operations Detection and treatment of microfilaria carriers Annual mass drug administration Single dose of anti filarial drug for 5 years or more to the eligible population Home based management of lymphoedema cases and upscaling of hydrocoele operations

Kala-Azar
A centrally sponsored programme was launched in 199091. This has brought incidence and death rate of the disease by 75 per cent by the year 2002 National Health policy envisages kala-azar elimination by year 2010

Strategies of the programme

Enhanced case detection and complete treatment Interruption of transmission by vector control Communication for behavioral impact and intersectoral convergence Capacity building Monitoring, supervision and evaluation Research guidelines on prevention and control of kalaazar

Dengue fever
There was a major out break of Dengue /DHF in Delhi in 1996 Since than many focal outbreaks have been reported from different areas of the country mainly from urban areas. In the view of major outbreak of Dengue Guideline of Preparation of Contingency Plan in case of outbreak/epidemic of Dengue/Dengue haemorrhagic fever was prepared This disease has been included in NVBDCP in 2003 -04

Reference
www.wikipedia.org
PARKS TEXT BOOK OF PREVENTIVE AND SOCIAL MEDICINE 20TH EDITION BY DR. K. PARK