This presentation deals with occasion of World Health Day "2014 Theme - Vector Borne Diseases::Small Bite Big Threat"
Topics e.g.,
Need to celebrate World Health Day, Important Vector Borne Diseases Situation in Punjab India, Dengue, Malaria & JE situation, Prevention & Control of Arthropods, Challanges in public Health are discussed
3. Dr Priya Bansal
Assistant Professor
Department of Community Medicine
Dayanand Medical College & Hospital,
Ludhiana
4. Why this theme was chosen
• 17% of all infectious diseases
• 1 million deaths annually.
• 2.5 billion people in over 100 countries are at risk
• Malaria causes more than 6,00,000 deaths every year
globally.
• Other VBDs diseases such as Chagas disease,
leishmaniasis & schistosomiasis
5. Who are affected?
• These diseases affect urban, peri-urban & rural
communities
- Poor living conditions
- Safe drinking water
- Sanitation.
• Malnourished people are especially vulnerable.
6. Economic Effect
• Vector-borne diseases play a major role in economic
downgrowth
• Countries with intensive malaria have income levels
of only one third of those that do not have it
7. Definition
• Vector-borne disease (VBD) : an illness
caused by an infectious microorganism
(pathogen) that is transmitted to humans by a
vector, usually arthropods
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11. Malaria
• Life-threatening disease
• Caused by plasmodium species
• Transmitted through bite of female anopheles
• Plasmodium - four parasite species
4/19/2014
13. Malaria-Burden
India-2011
• 1.31 million cases,
including 6,50,000 Pf
cases & 463 deaths
• 27% of population
resides in Malaria High
Transmission areas
• 58% in Low
Transmission areas
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15. Malaria Kills More People than
AIDS
• Malaria kills in one year ,what AIDS kills in
15 years
• For every death due to HIV/AIDS, there are
about 50 deaths due to malaria
16. WHO are at High Risk?
• Young children
• Pregnant women
• People living with HIV
• Natural disasters
• Non-immune travellers
moving into Endemic areas
17. Malaria
• Early diagnosis & treatment is
key
• If left untreated, disease can
lead to severe illness & death
• Artemisinin -based
combination therapy (ACT)
18. Vaccine
• No commercially available vaccine
• Vaccine against P. Falciparum is currently
under trial.
4/19/2014
19. Dengue fever
• Most rapidly spreading viral disease in the world
• In past 50 years, incidence has increased 30-fold
• Pattern changing from urban to rural settings
20. Dengue
• There are four known serotypes of dengue
virus (DEN 1 to 4).
• Recovery from infection by one provides
lifelong immunity
22. Globally
• Estimated 5,00,000 people with severe dengue
require hospitalization each year
• About 2.5% of those affected die
Dengue-Burden
23. Dengue-Burden
India-2011
• Endemic in 31 states/UTs.
• About 18059 cases were reported with 109
deaths.
• Case Fatality rate was 0.65%
• Highest Number of cases were reported from
Punjab, followed by TamilNadu, Gujarat,
Kerala & Andhra Pradesh.
4/19/2014
29. Distribution Of Japanese Encephalitis in India //
J E Cases And Deaths
Reported in 2011
Case Death
U P 3490 579
Total 7838 1137
Japanese Encephalitis
Endemic areas
30. Japanese Encephalitis
• No specific treatment
• Vaccine (SA 14-14-2) -
most effective preventive
measure
31. CHIKUNGUNYA
• Occurs in Africa, Asia
& Indian subcontinent
• In recent decades, there
have been outbreaks of
the disease in countries
32. Burden-Chikungunya
• Earlier reported in 1965
with 3,00,000 cases in
Kolkata & Chennai
• 2006- Reappeared in
16 states
• 17,472 cases were
reported by the GOI in
2011
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33. CHIKUNGUNYA
• Shares same vectors, symptoms &
geographical distribution as dengue, except for
the presence of joint pains
• No specific treatment
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35. STRATEGIES
• Needs sound knowledge of the
Bionomics
Distribution
Seasonal prevalence
Vectorial capacity
Insecticide susceptibility status
Role of arthropods in disease transmission
37. Integrated Vector
Management
• " the utilization of all appropriate
technological & management techniques to
bring about an effective degree of vector
suppression in a cost effective manner"
• Best approach to strengthen vector control in a
way that is compatible with national health
systems
38. • Evidence-based decision-making
• Monitoring & Evaluation
• Advocacy & Social mobilization
• Intra & intersectoral Collaboration
• Capacity-building
• Legislation & Regulation
Key Elements of IVM
43. Chemical Control
Oiling (diesel oil,fuel
oil, kerosene oil)
Paris green
Synthetic
Insecticides
(Fenthion, malathion,
chlorpyrifos, abate)
44. Indoor residual spraying
• Most widely used method
• Effective way to reduce
sandflies & bugs inside
homes
• 80% of houses in targeted
area need to be sprayed.
• Effective for 3–6 months,
depending on the insecticide
used & type of surface
46. Outdoor spraying
• Spraying outer
surfaces of
- Domestic animal
shelters,
- Outdoor latrines &
- Damp places
• Aerial spraying --
control mosquitoes
during epidemics of
dengue & yellow
47. Biological Control
• Introduction of bacterial
larvicides & larvivorous
fish
• Target vector larvae
without generating
ecological impacts of
chemical use
• Regular monitoring &
restocking is important
GAMBUSIA FISHES
48. Genetic Control
• "Use of any treatment
that reduce the
reproductive potential by
replacing the hereditary
material"
Sterile male technique
Hybrid male technique
Sex distortion
Gene replacement
49. Personal protection
• First line of defence
• Prevent vectors from biting
& feeding on host
• Acheived by wearing long
sleeved, light-coloured
shirts, trousers, socks, shoes
& by the use of repellents
like Benzyl benzoate,
DEET (N,N-diethyl-m-
tolumide)
50. Long-lasting Insecticidal Nets
• Most efficient & cost-
effective method
• WHO recommends
that everyone at risk of
malaria sleeps under a
net
51. Waste Management
• Empty tins, plastic
bottles, unused drums,
coconut shells & used
car tyres can serve as
important breeding
sites
52. Housing Modification
• Door & window screens
• Plaster walls & concrete
floors in good condition
• Cracks & entry points
sealed up
54. Challenges in the Control of
Vector-Borne Diseases
Emerging insecticide resistance
Major threat
Widespread use of synthetic insecticides
Lack of expertise in vector control
Expertise of entomologists is critical ; an extreme
shortage
Lack of Surveillance
In many high-burden settings, there is almost no
data
55. Entomological Skills
• WHO calls for countries to increase their
investment in training people with
entomological skills, as well as the
corresponding infrastructure
56. Sanitation and Access to
Safe Drinking Water
• Poor sanitation & lack
of access to clean
drinking water allows
many vectors to thrive
58. Role of Health Education
• Active Community participation
• Strict enforcement of legislation for wastes disposal
• Unless man himself changes his behavior & becomes
vector conscious & stops creating breeding places ,
no one can eliminate
61. 4/19/2014
Conclusion
• VBDs - greatest contributors to human mortality
& morbidity in tropical settings & beyond.
• Significant progress is being made in combating
diseases such as Malaria, Filariasis & Chagas
disease
• Dengue continue to spread at an alarming pace
62. 4/19/2014
Conclusion
• Resistance to insecticides threatens the gains
made through vector control & calls for
concerted planning & collaboration across
sectors
• Areas where VBDs overlap, integrated
management of insecticide resistance is
essential, supported by adequate capacity of
trained personnel
