Lok Sabha Question No. 107 (STARRED), answered on 2018-02-09
Subject: Rise in Dengue/Malaria Cases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: K. MARAGATHAM, KRUPAL BALAJI TUMANE

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

## LOK SABHA STARRED QUESTION NO. 107 TO BE ANSWERED ON THE 9 TH FEBRUARY , 2018

## RISE IN DENGUE/MALAR IA CASES *107. SHRIMATI K. MARAGATHAM: SHRI KRUPAL BALAJI TUMANE:

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

- (a) whether cases of dengue and malaria have risen in the country over the l years, if so, the details thereof and the reasons therefor;
- (b) the det ails of the number of cases and deaths reported in the country durin last three years and the current year, State/UT - wise;
- (c) whether ICU healthcare resources are overburdened and nearly a fifth of resources are consumed by dengue/tropical fe ver etc., if so, the details thereof an the corrective measures taken by the Government; and
- (d) the details of various schemes launched/reviewed and funds allocated b Government for controlling such diseases in various parts of the country including Jharkhand along with the outcome of review and the other measure taken/proposed to be taken by the Government in this regard?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE ( SHRI JAGAT PRAKASH NADDA )

- (a)to ( d) : A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 107* FOR 9 TH FEBRUARY , 2018

(a)  &  (b):      Malaria  has  been  declining  in  the  country  over  the  last  th (2015- 2017).  However,  Dengue  is  spreading  in  various  parts  of  country  a transmission is governed by many ecological factors. Also, unpla developmental  activities, improperwaterstorage , population  movement,  improper solid waste management etc pla y crucial role in the upsurge of Dengue.

The state - wise number of cases& deaths due to Dengue reported duringlast three years and current year (till 28.01.18) in the country is at Ann - 1 and of Malaria during last three years is at Annexure - 2.

(c)& (d): Majority of Dengue and Malaria cases do not require hospitalizatio are treated at various health facilities. Dengue fever in normal condition to  be  a  self - limiting  viral  disease.  However,  in  certain  clinical  conditions cases may h ave severe manifestations or complications, for which such patie need  to  be  closely  monitored  requiring  hospitalization.  The  Government launched  a  National  Programme  viz.  National  Vector  Borne  Disease  Contro Programme (NVBDCP) under National Health Mission (NHM) for prevention and control  of  these  diseases.  Besides,  another  national  programme  viz.  Inte Disease  Surveillance  Programme  (IDSP)  is  implemented  under  NHM  in  all States/UTs  including  Jharkhand  with  the  objective  to  detect  and  respon o epidemic  prone  disease  outbreaks    including  outbreaks  due  to  vector  bo diseases. To prevent the spread of such outbreaks, States/UTs are provided additional manpower, training of identified Rapid Response Team (RRT) member for outbreak investiga tions, strengthening of laboratories for detection of epid prone  diseases,  IT  equipment  for  data  entry,  analysis  and  data  transfe provision of funds for operationalization of the programme.

Various  steps  taken  by  Government  of  India  (GoI)  for  pre vention  and control  of  Dengue  and  Malaria  in  the  country  including  Jharkhand  is  give Annexure- 3.

The  details  of  funds  allocated  by  the  Government  for  controlling  Ve Borne Diseases including Dengue & Malaria are at Annexure - 4.

## STATE - W ISE DENGUE CASES AND DEATHS IN THE COUNTRY

| Sl. No.   | State            | 2015      | 2015   | 2016       | 2016   | 2017        | 2017   | 2018 (Prov. till th Jan)   | 2018 (Prov. till th Jan)   |
|-----------|------------------|-----------|--------|------------|--------|-------------|--------|----------------------------|----------------------------|
| Sl. No.   | State            | Cases     | Deaths | Cases      | Deaths | Cases       | Deaths | Cases                      | Death s                    |
| 1         | Andhra Pd.       | 3159      | 2      | 3417       | 2      | 4844        | 0      | 71                         | 0                          |
| 2         | Arunachal Pd.    | 1933      | 1      | 13         | 0      | 15          | 0      | 0                          | 0                          |
| 3         | Assam            | 1076      | 1      | 6157       | 4      | 5024        | 2      | 0                          | 0                          |
| 4         | Bihar            | 1771      | 0      | 1912       | 0      | 1875        | 0      | 2                          | 0                          |
| 5         | Chhattisgarh     | 384       | 1      | 356        | 0      | 433         | 0      | 0                          | 0                          |
| 6         | Goa              | 293       | 0      | 150        | 0      | 235         | 0      | 8                          | 0                          |
| 7         | Gujarat          | 5590      | 9      | 8028       | 14     | 4632        | 5      | 86                         | 0                          |
| 8         | Haryana          | 9921      | 13     | 2493       | 0      | 4413        | 1      | 0                          | 0                          |
| 9         | Himachal Pd.     | 19        | 1      | 322        | 0      | 453         | 0      | 0                          | 0                          |
| 10        | J & K            | 153       | 0      | 79         | 1      | 485         | 0      | 0                          | 0                          |
| 11        | Jharkhand        | 102       | 0      | 414        | 1      | 707         | 5      | 1                          | 0                          |
| 12        | Karnataka        | 5077      | 9      | 6083       | 8      | 17265       | 5      | 130                        | 0                          |
| 13        | Kerala           | 4075      | 25     | 7439       | 13     | 19973       | 37     | 145                        | 0                          |
| 14        | Madhya Pd.       | 2108      | 8      | 3150       | 12     | 2585        | 6      | 0                          | 0                          |
| 15        | Meghalaya        | 13        | 0      | 172        | 0      | 42          | 0      | 0                          | 0                          |
| 16        | Maharashtra      | 4936      | 23     | 6792       | 33     | 7442        | 41     | 88                         | 0                          |
| 17        | Manipur          | 52        | 0      | 51         | 1      | 187         | 1      | 0                          | 0                          |
| 18        | Mizoram          | 43        | 0      | 580        | 0      | 107         | 0      | 0                          | 0                          |
| 19        | Nagaland         | 21        | 1      | 142        | 0      | 357         | 0      | 0                          | 0                          |
| 20        | Odisha           | 2450      | 2      | 8380       | 11     | 4158        | 6      | 7                          | 0                          |
| 21        | Punjab           | 14128     | 18     | 10439      | 15     | 15320       | 0      | 0                          | 0                          |
| 22        | Rajasthan        | 4043      | 7      | 5292       | 16     | 8387        | 16     | 0                          | 0                          |
| 23        | Sikkim           | 21        | 0      | 82         | 0      | 659         | 0      | 0                          | 0                          |
| 24        | Tamil Nadu       | 4535      | 12     | 2531       | 5      | 23294       | 65     | 813                        | 0                          |
| 25        | Tripura          | 40        | 0      | 102        | 0      | 123         | 0      | 0                          | 0                          |
| 26        | Telangana        | 1831      | 2      | 4037       | 4      | 3083        | 0      | 41                         | 0                          |
| 27        | Uttar Pradesh    | 2892      | 9      | 15033      | 42     | 3066        | 28     | 45                         | 0                          |
| 28        | Uttarakhand      | 1655      | 1      | 2146       | 4      | 971         | 0      | 0                          | 0                          |
| 29        | West Bengal      | 8516      | 14     | *22865     | 45     | **10697     | 19     | 0                          | 0                          |
| 30        | A&N Island       | 153       | 0      | 92         | 0      | 17          | 0      | 0                          | 0                          |
| 31        | Chandigarh       | 966       | 1      | 1246       | 0      | 1094        | 0      | 0                          | 0                          |
| 32        | Delhi            | 15867     | 60     | 4431       | 10     | 9232        | 9      | 5                          | 0                          |
| 33        | D&N Haveli       | 1154      | 0      | 4161       | 2      | 1996        | 0      | 0                          | 0                          |
| 34        | Daman & Diu      | 165       | 0      | 89         | 0      | 59          | 0      | 0                          | 0                          |
| 35        | Puducherry TOTAL | 771 99913 | 0 220  | 490 129166 | 2 245  | 4766 157996 | 7 253  | 59 1501                    | 0 0                        |

*   As per data reported by the State Government till 9 th November.
- **  As per data reported by the State Government till 4 th October.

Annexure- 1

## Annexure-2

## STATE-WISE MALARIA CASES AND DEATHS IN THE COUNTRY

| SN              | STATEs/UTs.      | 2015    | 2015   | 2016    | 2016   | 2017   | 2017   |
|-----------------|------------------|---------|--------|---------|--------|--------|--------|
| SN              | STATEs/UTs.      | Cases   | Deaths | Cases   | Deaths | Cases  | Deaths |
| 1               | Andhra Prd.      | 25042   | 0      | 23613   | 0      | 16913  | 0      |
| 2               | Arunachal Prd.   | 5088    | 7      | 3128    | 2      | 1538   | 0      |
| 3               | Assam            | 15557   | 4      | 7826    | 6      | 5473   | 0      |
| 4               | Bihar            | 4006    | 1      | 5189    | 0      | 3175   | 2      |
| 5               | Chhattisgarh     | 144886  | 21     | 148220  | 61     | 141310 | 0      |
| 6               | Goa              | 651     | 1      | 742     | 0      | 653    | 2      |
| 7               | Gujarat          | 41566   | 7      | 44783   | 6      | 37801  | 2      |
| 8               | Haryana          | 9308    | 3      | 7866    | 0      | 6887   | 0      |
| 9               | Himachal Pradesh | 60      | 0      | 106     | 0      | 95     | 0      |
| 10              | J & K            | 216     | 0      | 242     | 0      | 226    | 0      |
| 11              | Jharkhand        | 104800  | 6      | 141414  | 15     | 92770  | 1      |
| 12              | Karnataka        | 12445   | 0      | 11078   | 0      | 6529   | 0      |
| 13              | Kerala           | 1549    | 4      | 1547    | 2      | 1194   | 2      |
| 14              | Madhya Prd.      | 100597  | 24     | 69106   | 3      | 46176  | 3      |
| 15              | Maharashtra      | 56603   | 59     | 23983   | 26     | 18133  | 19     |
| 16              | Manipur          | 216     | 0      | 122     | 0      | 80     | 0      |
| 17              | Meghalaya        | 48603   | 79     | 35147   | 45     | 16433  | 11     |
| 18              | Mizoram          | 28593   | 21     | 7583    | 9      | 5710   | 0      |
| 19              | Nagaland         | 1527    | 3      | 828     | 0      | 394    | 1      |
| 20              | Orissa           | 436850  | 80     | 444843  | 77     | 352140 | 25     |
| 21              | Punjab           | 596     | 0      | 693     | 0      | 808    | 0      |
| 22              | Rajasthan        | 11796   | 3      | 12741   | 5      | 6837   | 0      |
| 23              | Sikkim           | 27      | 0      | 15      | 0      | 12     | 0      |
| 24              | Tamil Nadu       | 5587    | 0      | 4341    | 0      | 5449   | 0      |
| 25              | Telangana        | 10951   | 4      | 3512    | 1      | 2688   | 0      |
| 26              | Tripura          | 32525   | 21     | 10546   | 14     | 7040   | 6      |
| 27              | Uttarakhand      | 1466    | 0      | 961     | 0      | 532    | 0      |
| 28              | Uttar Pradesh    | 42767   | 0      | 40700   | 0      | 32345  | 0      |
| 29              | West Bengal      | 24208   | 34     | 35236   | 59     | 30008  | 29     |
| 30              | A.N.Islands      | 409     | 0      | 485     | 0      | 404    | 0      |
| 31              | Chandigarh       | 152     | 1      | 157     | 0      | 114    | 0      |
| 32              | D & N Haveli     | 418     | 0      | 375     | 0      | 297    | 0      |
| 33              | Daman & Diu      | 84      | 0      | 48      | 0      | 37     | 0      |
| 34              | Delhi            | 54      | 0      | 31      | 0      | 577    | 0      |
| 35              | Lakshadweep      | 4       | 0      | 2       | 0      | 1      | 0      |
| 36              | Puducherry       | 54      | 1      | 76      | 0      | 59     | 0      |
| All India Total | All India Total  | 1169261 | 384    | 1087285 | 331    | 840838 | 103    |

## Dengue

- For  improvement  of management of Dengue cases, Master  Trainers  of  29 States/UTs  have  been  trained  during  2017  in  four  training  workshops organized in collaboration with World Health Organization
- GoI provided Technical Guidelines for prevention and control, case management  &  effective  community  participation  to  the  States  for its implementation and also uploaded on NVBDCP website www.nvbdcp.gov.in.
- Periodic  reviews  were  done  at  various  levels  through  review  meetings  and video-conferences and advisories issued from time to time to States/UTs.
- States have been requested to make Dengue a notifiable disease.
- Diagnosis provided through 609 Sentinel Surveillance Hospitals (SSHs) and 16 Apex Referral Laboratories (ARLs) identified across the country and GoI supplies diagnostic kits to them through National Institute of Virology (NIV), Pune free of cost.
- Sensitization and Capacity Building
- Field Visits by Central Teams.
- Monitoring & Supervision

## Malaria

1. Government  has  launched  the  National  Framework  for  Malaria  Elimination (NFME) in India, 2016-2030 for elimination of  Malaria  by  2030  and  released National  Strategic  Plan,  2017-2022  and  Operational  Manual  for  Malaria Elimination in India, 2016.
2. Surveillance and case management
- Case detection (active and passive)- Intensified during high transmission period
- Early diagnosis and complete treatment
- Sentinel surveillance

## Steps taken by Government for prevention and control of Dengue and Malaria

3. Integrated Vector Management (IVM)
- Indoor residual spray (IRS)
- Insecticide treated bed nets (ITNs) / Long-Lasting Insecticidal nets (LLINs)
- Anti-larval measures including source reduction
4. Epidemic preparedness and rapid response.
5. Supportive interventions
- Capacity building
- Behaviour change communication (BCC)
- Inter-sectoral collaboration
- Monitoring and evaluation (M & E)
- Operational research and applied field research
6. Other steps to combat and to avoid recurrence of epidemics of malaria are as follows:-
13. Regular monitoring of the states and feedback to them
14. Coordination with IDSP to detect Early Warning Signals i.e. any upsurge in fever cases or any reports of malaria outbreaks. Such reports are verified, followed up and managed accordingly.
15. Regular monitoring through field visits of NVBDCP officers/ consultants.
16. Issuing advisory to the states before the monsoon season to upscale their activities and make all the necessary preparations.
17. Technical support and guidance.
18. Logistic support

## Fund Allocation under NVBDCP

| Sl. No.   | States/UTs        | 2014-15   |   2015-16 |   2016-17 |   2017-18 |
|-----------|-------------------|-----------|-----------|-----------|-----------|
| 1         | Andhra Pradesh    | 2510.00   |    864.2  |     728   |    909.95 |
| 2         | Arunachal Pradesh | 1291.00   |   1364.27 |    1183   |   1183    |
| 3         | Assam             | 3036.00   |   3260.14 |    2395.1 |   2335.1  |
| 4         | Bihar             | 4800.00   |   9695.23 |    3534   |   3673.5  |
| 5         | Chhattisgarh      | 2990.00   |    561.92 |     908   |   3364.5  |
| 6         | Goa               | 128.00    |     47.5  |     102   |    106.76 |
| 7         | Gujarat           | 2380.00   |   1159.71 |    1100   |   1259    |
| 8         | Haryana           | 363.00    |    255    |     200   |     52    |
| 9         | Himachal Pradesh  | 140.00    |      0    |      26   |     45    |
| 10        | J & K             | 155.00    |     91.23 |      94.2 |     99.62 |
| 11        | Jharkhand         | 4139.50   |   5349.94 |    3390   |   3370.91 |
| 12        | Karnataka         | 2320.00   |   1843.6  |    1759   |    970.06 |
| 13        | Kerala            | 1007.00   |    726    |     644   |    509.41 |
| 14        | Madhya Pradesh    | 2390.00   |   2150.64 |    2118   |   1657.15 |
| 15        | Maharashtra       | 2187.00   |    652.84 |    1320   |    705.8  |
| 16        | Manipur           | 1091.00   |    979.13 |    1005   |    905    |
| 17        | Meghalaya         | 1162.00   |   1108.89 |     915   |    864    |
| 18        | Mizoram           | 1248.00   |   1392.69 |    1104   |   1364    |
| 19        | Nagaland          | 1533.00   |   1314.78 |    1117   |   1117    |
| 20        | Odisha            | 5170.00   |   4425.32 |   10037   |  10177    |
| 21        | Punjab            | 550.00    |    509.29 |     402   |   1038.63 |
| 22        | Rajasthan         | 990.00    |   2146.16 |    2180.8 |   1388.65 |
| 23        | Sikkim            | 70.00     |     58.9  |      90.9 |     41.9  |
| 24        | Tamil Nadu        | 2250.00   |   1594    |    1409   |   1410.55 |
| 25        | Telangana         |           |    701.47 |     685   |    628.33 |
| 26        | Tripura           | 1459.00   |   2182.72 |    1617   |   1617    |
| 27        | Uttar Pradesh     | 3905.50   |   1783.67 |    3650   |   3343.8  |
| 28        | Uttarakhand       | 125.00    |    127.14 |     266   |    249.38 |
| 29        | West Bengal       | 3500.00   |   1645.85 |    1910   |   1600    |
| 30        | Delhi             | 584.00    |     19    |     169   |    168.17 |
| 31        | Pudducherry       | 56.00     |    108.25 |      51   |     51.83 |
| 32        | A&N Islands       | 250.00    |    611.31 |     349   |    373    |
| 33        | Chandigarh        | 96.00     |     79.49 |      77   |     60    |
| 34        | D & N Haveli      | 98.00     |     96    |     107   |    100    |
| 35        | Daman & Diu       | 72.00     |     68    |      71   |     66    |
| 36        | Lakshadweep       | 54.00     |     47    |      36   |     41    |
|           | TOTAL             | 54100.00  |  49021.3  |   46750   |  46847    |

## Annexure - 4

(Rs. in lakhs)