National Project Implementation Plan - NVBDCP

Some of the recent changes in the national drug policy (2007) include:
Discontinuing the presumptive treatment for fever cases with
chloroquine
Reducing the chloroquine resistance levels for deciding use of ACT
from 25% to 10% as recommended by WHO
Giving flexibility to states to decide on extent of areas to be covered
(clusters of blocks) with ACT once chloroquine resistance levels of
more than 10% are noted
Introducing 14 day radical treatment for confirmed cases of P.Vivax
The Technical Advisory Committee (TAC) GoI has approved the use of
Artesunate combination drugs (ACT) as first line treatment to all confirmed
P. falciparum cases in 50 districts under World Bank project and districts
under GFATM support Intensified Malaria Control Project
It is pertinent to note that a large number of fever cases are treated in the
private sector where the practices are variable and the cases are not
reported to the programme.
2.1. b. Current practices in Vector control
a. Indoor Residual Spray (IRS) - At present, IRS is being carried out
during the disease transmission season (May to November) without
undertaking micro stratification. Every year two rounds of sprays
are to be carried out with DDT/ Synthetic Pyrethroids. The IDR
review (2006) has shown that both the coverage and quality is
ineffective to reduce mosquito density.
b. Bednets - Insecticide Treated Nets (ITNs) have been distributed in
the EMCP (1997- 2005) areas and NGOs were contracted to
impregnate these nets once every 6 months. The use of ITNs
however was observed to be inadequate (IDR review 2006) due to
multiple factors, such as social cultural and operational problems to
re impregnate the nets.
c. Larvivorus Fish - The use of larvivorus fish and larvicide’s have not
contributed to a significant reduction of mosquito density.
d. Environmental engineering - Has been equally ineffective in
motivating communities to improve environment sanitation
especially in municipalities.
2.2. Recommendations on Malaria Control
i) Review and update the policy for malaria diagnosis and treatment
The Joint Monitoring Mission noted that the present policy for malaria
diagnosis and treatment in public sector is not appropriate to the current
context. The key policy issues relate to the diagnosis and treatment of P.
falciparum malaria. Drug sensitivity studies show that resistance to
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