National AIDS & STD control programme of India

for paramedical workers.

1. ALL INDIA INSTITUTE OF LOCAL SELF GOVERNMENT DELHI “NATIONAL AIDS CONTROL PROGRAMME “ DR.P.P.SINGH By Dr. P.P.SINGH Faculty AIILSGD Ex Medical Superintendent Cum Consultant pathologist HRH Delhi Ex. Director India Population Project 8 Delhi..

2. INTRODUCTION 1.Director General of Health Services in year 1985 formed AIDS cell in New Delhi. 2.To coordinate all activities pertaining to AIDS in India. 3.For control of transmission . NATIONAL STRATEGY;- Establishment of surveillance centers to cover whole country. Identification of High risk groups and their screening. Issuing specific guidelines for management of detected cases and their follow up. Formulating guidelines for Blood Banks , Blood Product manufactures , Blood Donors and dialysis units. IEC activities by involving mass media. Researches. Till date 62 Surveillance centers 29 Zonal Blood testing centers .

3. History. First cases was detected in USA in 1981. Hiv /AIDS continues its expansion across globe. Soon after the first case of AIDS detected in India in 1986. NAC Programme constituted in 1987. STD control has been linked because sexual transmission of AIDS in STD cases is more 5 times. Behavior changes is required amongst STD cases.

4. NACO – FOCUSSED Increasing awareness of HIV/AIDS. Screening of Blood for HIV. Testing of Individuals practicing High risk behaviours . NACO was established in Year 1992 under the MOHFW with the assistance of World Bank ( 84 million US $ ). WHO gave the assistance of 1.5 million US $.

5. The available indicates that ;- The highest Number of HIV infection – Maharashtra and Tamil Nadu and amongst inject able drug users in Manipur. 2. Predominant mode of transmission – Hetro sexual contact Blood transfusion Blood Products. Inject able Drugs Users Male account78.6% and Female 21.4% out of AIDS cases of age group of 15 – 49 years. Trend is in two ways – From risk group to general population , from urban area to rural area. ( data from ANC clinics & among children) The major opportunistic infection is tuberculosis. Thus dual epidemic of TB & AIDS is predicted. There are about 4 Million HIV Positive cases in India.

6. ALL INDIA INSTITUTE OF LOCAL SELF GOVERNMENT DELHI “PPTCT DR.P.P.SINGH By Dr. P.P.SINGH Faculty AIILSGD Ex Medical Superintendent Cum Consultant pathologist HRH Delhi Ex. Director India Population Project 8 Delhi..

7. PREVENTION from PARENT TO CHILD TRANSMISSION PROGRAMME. ELEMENTS Primary Prevention of HIV in Young people & women of child bearing age through :- Promotion & Provision of free , subsidized or commercially marketed CONDOM. Provide diagnosis of STD. Behavior Change Communication effort to reduce individual at risk. To inform about PTCT during pregnancy, delivery , breast feeding . To encourage for VCT counselor or health provider. Prevention of unintended pregnancies in HIV cases. Through RCH & FP. Prevention of transmission from HIV positive women to her child through anti retroviral (ARV) prophylaxis and safer delivery. Care and support services to HIV infected women. Including counseling on breast feeding etc.

8. Comprehensive PPTCT service include 4 prongs. Prong 1 – Primary prevention of HIV infection. Prong 2 – Prevention of unintended pregnancies among HIV infected women.. Prong 3 - Prevention of HIV transmission from HIV infected women to their infants. Prong 4- Provision of care and support to HIV infected women ,their infants and their families.

9. RATIONALE for PPTCT in INDIA. 27 million pregnancies per year. 162000 infected pregnancies. Cohort of 48600 infected newborns per year. 0.6% prevalence. 30% transmission, Most of these children die with in 2-5 years.

10. PPTCT Interventions To decrease Risk of HIV transmission to Infant. During pregnancy. Decrease viral load ( ARV prophylaxis & treatment). Monitor and treat infections. Support optional Nutrition.

11. PPTCT : Interventions to decrease Risk Avoid : During labour and delivery. Premature rupture of membranes. Invasive delivery techniques. Unresolved infections such as STIs. PROVIDE.:- Elective caesarean section when safe and feasible. Promote safer infant feeding. Replacement feeding. Exclusive Breast feeding for limited time. TREATMENT ( New prophylaxis ) A 200 mg pill is givin to the mother during labour and a spoonful of syrup to baby with in 72 hrs of birth.

12. ALL INDIA INSTITUTE OF LOCAL SELF GOVERNMENT DELHI “ NATIONAL STD CONTROL PROGRAMME “ DR.P.P.SINGH By Dr. P.P.SINGH Faculty AIILSGD Ex Medical Superintendent Cum Consultant pathologist HRH Delhi Ex. Director India Population Project 8 Delhi..

13. Introduction sexually transmitted disease (STDs) are caused by different pathogens, but can be recognized through mainly three syndromes. Urethral discharge Vaginal discharge Genital Ulcer. Recently HIV infection has been also added. HIV has overloaded 8-10 times higher in presence of STD. India has high incidence of STD in urban as well as rural area. The programme began in 1949 as a pilot project to control Venereal diseases. Recognizing STD as one of the major determinant of transmission of HIV infection . The programme has been merged in NACO. NACO after taking over the STD control programme in 1992 made it integral component of AIDS.

14. STD Organism Type of Parasite Syphilis Trepenoma pallidum Spirocheate bacteria. Chancroid Haemophilus duceyi . gram negative coco bacilli. Herpes genitalis Herpes simplex virus 1&2 Virus Denovanosis Calymmatobacterium granulomatis Gram negative bacilli Bacteria LGV ( Lymphogranuloma Venerum ) Chlamydia trachomatis Bacteria intracellular parasite Gonorrhoea Neisseria gonorrhoeae Gram negative cocci .

15. ` STD distribution ```````` Male are more infected. Syphilis ,Gonorrhea , painless syphilis , Chancre in females. Age group 21- 35 yrs. Prostitutes , Industrial workers. OBJECTIVES To reduce transmission of STD /HIV by reducing risk factors. To prevent the development of short & long term Morbidity /Mortality due to STD.

16. STRATEGIES IEC for awareness and Promotion of Health Care seeking behaviour . For safer sex and use of Condom. Adequate Management - Comprehensive case management . Increasing access to health care. To establishing 5 Regional training Centers ( Mumbai, Calcutta, Delhi, Madras & Hyderabad.) Development of 5 Regional Laboratories & 5 Regional reference centers. All medical collages as Skin Leprosy –STD clinics and STD district hospital.

17. CONTROL MEASURES:- Case detection . Laboratory Support. Treatment. Case Holding and Follow up. Special measures for High risk groups. Removal of Devdasi system. Legislation Political awerness .