Lok Sabha Question No. 2910 (UNSTARRED), answered on 2016-12-02
Subject: Surveillance System for Mosquito Borne Diseases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: CHANDRA PRAKASH JOSHI, MANOJ KUMAR TIWARI, (SMT.) RATNA DE(NAG), V. PANNEER SELVAM

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2910 TO BE ANSWERED ON 2 ND DECEMBER, 2016

## SURVEILLANCE SYSTEM FOR MOSQUITO BORNE DISEASES

## 2910. SHRI CHANDRA PRAKASH JOSHI:

SHRI MANOJ TIWARI:

DR. RATNA DE (NAG):

SHRI V. PANNEERSELVAM:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the Government has upgraded the Surveillance System for Mosquito Borne Diseases in the recent past;
- (b)if so, the details thereof;
- (c) if not, the reasons therefor; and
- (d) whether such steps will help to improve the health parameters in the country and if so, the details, thereof?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

(SHRI FAGGAN SINGH KULASTE)

- (a) to (c): Yes.The disease surveillance has been upgraded under the programme by adding sentinel  surveillance  for  Malaria,  Dengue,  Chikungunya  and  JE  and  special  surveillanc Lymphatic Filariasis and Kala - azar.

## Mal aria:

Considering the importance of active surveillance the Government of India, in Jan 2011, as an interim measure, provided 100% support from National Health Mission (NHM) fo 9655 contractual MPWs (M) in 235 identified backward districts, having hig h disease burden (malaria and kala -azar) initially for one year and later extended upto September 2014.

Sentinel  Surveillance  for  management  of  severe  cases  and  preventing  deaths  due malaria  has  been  strengthened  by  identifying  more  sentinel  sites and  to  make  all  of  them functional. Presently 419 sentinel sites for malaria have been identified and made funct the country.

Considering the malaria elimination target, electronic upgradation of surveillance is envisaged for faster commu nication, early detection of cases and rapid response.

Activist

Passive  surveillance  being  done  by  all  health  facilities  upto  sub - centre  level  has  been extended upto the community level through Accredited Social Health (ASHAs)/Community Health Volunteers (CHVs).

## Dengue/Chikungunya:

For disease surveillance for dengue and chikungunya and to facilitate early diag Sentinel Surveillance Hospitals (SSHs) with laboratory support have been established acro country. There is a steady increase in num ber of SSHs with ELISA facility from 110 in 2007 to 542  during  2016  to  strengthen  reporting  of  laboratory  confirmed  Dengue  and  Chikunguny cases. Besides, 15 Apex Referral Laboratories (ARLs) are also providing advanced diagno support to the system.

## JE/AES:

Number of Sentinel sites for JE has been increased from 51 in 2005 to 130 at presen Apex Referral Laboratories increased from 12 to 15 at present.

## Lymphatic Filariasis:

Lymphatic  filariasis  is  mosquito  born  chronic  disease  slated  for  eliminati on  as  per national  health  policy  2002.  The  global  goal  of  elimination  is  2020.  The twin  pillars  of elimination are Annual MDA for disease interruption with co - administration of DEC+ Albendazole.

Morbidity management for patient who have developed lymphedema and hydrocele. For lymphedema home based management through simple hygiene of limb washing, drying and up scaling of hydrocele cases in designated CHCs, PHCs and Govt. hospitals.

In lymphatic filariasis post MDA surveillance is in pla ce.

## Post MDA surveillance  is implemented in two ways

- I. Periodic surveys - Repeating a TAS is the best option for periodic surveys during pos -MDA surveillance. A series of post - MDA  surveillance surveys are being conducted to evaluate whether recrudescence has occurred. Each survey conducted approximately 2 - 3 years following the previous survey and in a similar design as the original TAS.
- II. Ongoing surveillance activities -Ongoing surveillance in implemented to detect new foci of transmission, collect data on infection trends in the general population and confirm th interruption of transmission.

Entomological surveillance by the state zonal teams has also been strengthened thr the involvement of ICMR institutions in the country and NCDC.

## ( d): Ma laria:

Upgradation of surveillance would help in meeting the target of malaria eliminati 2030  and  to  improve  the  health  parameters  in  the  country.  Under  National  Framework Malaria Elimination (NFME), the interruption of transmission of malaria and zero indigenous cases  and  deaths  due  to  malaria is  targeted  to achieved  in  15  states/  UTs  under  category  1 (States/UTs including their districts reporting an API of less than 1 case per 1000 popu risk) by 2020, in 11 states/ UTs under category 2 (States/UTs with an API of less than 1 case per 1000 population at risk, but some of their districts are reporting an API of 1/1000 or 2022; in 10 states/ UTs under category 3 (States/UTs with an API of 1 case per 1000 popu at risk or above ) by 2027.

Resistance data generated by entomological surveillance helps in deciding vector co measures and taking appropriate decision for the use of insecticide in the programme.

## Dengue/Chikungunya:

In absence of specific drug for treatment of cases and vaccine for prevention, Dengue and Chikungunya  cases  are  treated  symptomatically.  Government  of  India  monitors  the  situat through laboratory confirmed cases of Dengue and Chikungunya through identified laborat network (SSHs & ARLs) as repor ted by the States. This helps in early response to the situa and to initiate public health measures for containment.

Network  of  laboratory  also  monitors  Dengue  virus  activity  during  the  inter - epidemic period  and  alert  programme managers  for  effective  remedial  measures  in  areas  with  viral activity.

## JE/AES:

On the basis of the reports submitted by the Sentinel sites, the preventive and measures are initiated by the States for containment of JE and also it helps in case management due to early diagnosis and early referral.

## Lymphatic Filariasis:

These steps will improve the health parameters in following ways

- I. Future generation will be free from lymphatic filariasis.
- II. Improvement in quality of life of affected populat ion by reducing the DALYs.
- III. Reduce the economic burden of the affected families which in turn reduce the econo burden of the country.