National filarial control programme

National filarial control programme

1. Submitted by : Tripti sharma 02822106617 4 th year National filaria control programme

2. filariasis

3. INTRODUCTION Filariasis  is a parasitic disease caused by an infection with roundworms of the Filarioidea type. These are spread by blood-feeding insects such as black flies and mosquitoes . They belong to the group of diseases called helminthiases . Disease is endemic Major social and economic scourage is in A frica , A sia and A merica .

4. TYPES OF FILARIASIS LYMPHATIC FILARIASIS Wuchereria bancrofti Brugia malai Brugia timori SUBCUTANEOUS FILARIASIS loa loa SEROUS CAVITY FILARIASIS Mansonella

5. Filaria vectors Culex ( C. quinquefasciatus ) – vector for Bancroftian filariasis Mansonia ( M. annulifers and M. uniformis ) – vector for brugian filariasis Culex breeds in polluted water Mansonia is associated with certain aquatic plants

6. TRANSMISSION OF LYMPHATIC FILARIASIS Lymphatic filariasis is transmitted through mosquito bites. The persons having circulating microfilariae are outwardly healthy but transmit the infection to others through mosquitoes. The persons with chronic filarial swellings suffer severely from the disease but no longer transmit the infection

7. Life cycle of filarial parasite

8. Burden of Disease Lymphatia filariasis is prevalent in 18 states and union territories. Bancrftian filariasis is widely distributed while brugian filariasis caused by Brugia malayi is restricted to 6 states - UP, Bihar, Andhra Pradesh, Orissa, Tamil Nadu, Kerala, and Gujarat. The WHO has estimated that 600 million people are at risk of infection in South east Asia and 60 million are actually infected in the region (WHO-SEARO !999). There are about 454 million people (75.6%) at the risk of infection with 48 million (80%) infected with parasite are contributed only by India.

9. Economic Loss About 1.2 billion man-days are lost due to filariasis every year leading to an economic loss of Rs . 3500 crore

10. National Filaria Control Program This program was started in 1955 In 1998 the operational component was merged with Urban Malaria Scheme In 2003 -04 it was merged with NVBDCP Filariasis has been a major public health problem in India next only to malaria. Indigenous cases have been reported from about 250 districts in 20 states/Union Territories.

11. OBJECTIVES : To train professional and ancilliary personnel required for the programme . To carry survey in different parts of the country. Reduction of problem in un-surveyed area. Control in urban area through recurrent anti-parasitic measure

12. CONTROL STRATEGY Vector control through anti larval spray/ application at weekly intervals with appropriate larvicides . Biological control through larvivorous fishes Environmental engineering through source reduction and water management Anti- parasitic measures through diagnosis and treatment of microfilaria carriers and cases. Information , education and communication to generate community awareness .

13. Anti-Mosquito and Anti-larval Measures One or two round of residual insecticide spray with DDT in areas which is known to be endemic for filariasis. Anti-larval measures with temephos in prescribed dosage in water storage tanks every week and application of Mineral Larvicidal oils on water surface are practiced.

14. 15 Elimination of Lymphatic Filariasis In 1997, WHO and its Member States made a commitment to eliminate Lymphatic Filariasis (LF) as public health problem by 2020 through World Health Assembly Resolution. The National Health Policy (2002) has set the goal of Elimination of Lymphatic Filariasis in India by 2015. Later extended to 2021. Twin pillar strategies of Mass Drug Administration (MDA) for interruption of transmission i.e. no new case and Morbidity Management and Disability Prevention (MMDP) for catering the disease afflicted patients were adopted for elimination.

15. Mass Drug Administration ( MDA) M DA started as mass campaign from 2004. Initially with single dose of DEC only. In the year of 2007 with DEC + Albendazole co-administration Form 2018 Triple Drug Therapy (IDA) i.e. DEC + Albendazole + Ivermectin is launched initially in five selected districts. Since elimination target is approaching first all the left out districts which are yet to achieve elimination will be brought under IDA .

16. Twin Pillar Strategy for Elimination of Lymphatic Filariasis Annual Mass Drug Administration (MDA) of single dose of DEC ( Diethylcarbamazine citrate) and Albendazole for 5 years or more to the eligible population (except pregnant women, children below 2 years of age and seriously ill persons) to interrupt transmission of the disease. Home based management of lymphoedema cases and up-scaling of hydrocele operations in identified CHCs/ District hospitals /medical colleges.

17. Progress and Achievement In pursuit of the goals, the Government of India launched nationwide MDA in 2004 in endemic areas as well as home based morbidity management, scaling up hydrocelectomies in hospitals and CHCs. During the year 2004, only 202 districts could be covered with coverage rate of 72.6%. The number of districts was upscaled and in 2007 all the 250 known LF endemic districts were brought under MDA Accelerated Plan which include Triple Drug Therapy (IDA) was launched in the Global Alliance Elimination of Lymphatic Filariasis (GAELF) meeting held during 13 th  to 15 th  June 2018 by Hon’ble Union Health Minister and Hon’ble Minister of State.

18. Meeting for Dissemination of the Accelerated Plan for Elimination of Lymphatic Filariasis and Program Progress Review held at New Delhi. The population coverage during MDA has improved from 73% in 2004 to 87.33% in 2019 (Prov.) Intensive social mobilization during MDA, have been carried out by various States/ UTs involving political/ opinion leaders, decision makers, local leaders and community. For high level advocay - United to Eliminate Lymphatic National Symposium Filariasis held on 30th October 2019 at Pravasi Bharatiya Kendra, New Delhi inaugurated by Hon’ble Union Health Minister

19. Milestones of ELF In 1997, The World Health Assembly adopted resolution WHA 50.29, for Elimination of Lymphatic Filariasis as a global public health problem by 2020. In 2002, National Health Policy set a goal for ELF in India by 2015 (further extended to 2017). It implies that LF ceases to be a public health problem when microfilaria rate is <1% and the children born after initiation of MDA are free from circulating antigenemia . In 2004, Elimination of Lymphatic Filariasis (ELF) programme was launched covering 202 endemic districts in 20 States/UTs. Subsequently scaled up to cover all the 257 endemic districts in 21 States/UTs targeting a population of about 650 million. In 2013 validation started through Transmission Assessment Survey (TAS ).

20. The policy decision to implement global strategy of co-administration of DEC with Albendazole during MDA was approved by National Task Force on Elimination of Lymphatic Filariasis under the Chairmanship of DGHS in 2006. Accelerated Plan for Elimination of Lymphatic Filariasis 2018 launched in 10 Global Alliance Elimination of Lymphatic Filariasis (GAELF) on 13th June, 2018. Triple Drug Therapy (IDA) has been successfully implemented in 5 districts namely Arwal (Bihar) and Simdega (Jharkhand), Nagpur (Maharashtra), Varanasi (Uttar Pradesh), Yadgiri (Karnataka) on 20 th  December 2018, 10 th  January 2019, 20 th  January, 2019, 20 th  February, 2019 and 13 th  November, 2019 respectively. GoI has revised the financial norms for Morbidity Management Kits from Rs . 150/- to Rs . 500/- per kit in last MSG meeting held in February 2019. Proposal for enhancement of budget under ELF programme approved by EPC for consideration of MSG .

21. Transmission Assessment Survey (TAS) All the districts have completed more than 5 rounds of MDA by the end of 2014, and are required to be evaluated to decide whether to stop or continue MDA. Till august 2017, 94 districts with 152 evaluation units (approx. 221 million popu l a t i on ea c h) h a ve been s u cc e ss fu l l y completed t hro u gh T A S a nd qualified for MDA stoppage.

22. Morbidity Management and Disability Alleviation The process involved updating the line-listing of Lymphoedema & Hydrocele cases by door to door survey in endemic district. Demonstration and training on simple foot hygiene to affected persons and motivate them for self practice. Motivate for surgical intervention to hydrocele cases.

23. The updated report from LF endemic states/UTs indicated 8.7 lakh Lymphoedema and 3.8 lakh hydrocele cases. Since 2004, the states/UTs have reported 129572 hydrocele operations. Different states have initiated management of Lymphodema cases through demonstrating home based foot hygiene method to patients at local levels .

24. prevention Avoiding mosquito bites is the best form of prevention. The mosquitoes that carry the microscopic worms usually bite between the hours of dusk and dawn . If you live in or travel to an area with lymphatic filariasis: Sleep under a mosquito net. Wear long sleeves and trousers. Use mosquito repellent on exposed skin between dusk and dawn.

25. Role of nurse The functions of a community health nurse have been classified as follows: Administration Communication Nursing Teaching Research

26. Administration She provides direction & leadership to those whom she supervises. She is responsible for plannilg , impementation , & evaluation of a practical plan of nursing administration in the primary health centres & its assosiated subcenters

27. Communication She should maintain good working relationship with members of health team She is a link between the patient ,the family & the doctor. She participates in staff & community meetings

28. Nursin g She provides comprehensive nursing care to individuals & families. She should support to the patient & family Provides proper health education & proper administration of drug .

29. Teaching Nurse should teach to the patient & family regarding: Disease condition Risk factors Treatment Prevention Home care

30. research The nurse should have knowledge regarding current updates.

31. RESPONSIBIL I TIES OF NURSE To go for home visit in community. To find out the cases of filariasis in the community To provide proper nursing care to the patients To provides health education to the patients & family members Advise to the patients for follow-up Advise to patient & family for proper sanitation

32. Questions:

33. 1) When was the National filaria control program started?

34. 2) What are the different types of filariasis?

35. 3 ) What is the mode of transmission of filariasis?

36. 4 ) What is the drug of choice in the treatment of filariasis?

37. 5 ) What are the measures to prevent filariasis?

38. 6 ) What are the functions of a community health nurse in National filariasis control program?