National Project Implementation Plan - NVBDCP

At least 80% of houses in identified Kala-azar endemic areas covered
uniformly and completely with effective insecticide spray.
3.3 Project Strategies
3.3.1 Malaria Control
1. Phased implementation of new policies focusing on high burden districts;
a. The NVBDCP has introduced new drug policy (2007) for malaria diagnosis
and treatment.
b. Apart from 106 districts in North-eastern States, Jharkhand, Orissa, West
Bengal which are already covered by GFATM support for malaria, 93
districts in the country with high Pf malaria incidence have been selected for
the proposed project. Selection criteria was based on Pf more than 25%, Pf
cases more than 1000 per district, Slide falciparum rate (SFR) >0.5 (Data
from 2004-05-06 formed the basis for selection of districts).
c. Implementation is proposed in 50 districts in first phase accounting for 60%
of national Pf cases in 6% population, another 43 districts in second phase
i.e 3 rd year onward accounting for additional 10% of Pf cases and 30 %
population.
2. Improved access to malaria case management;
a. All project districts will first be stratified according to the risk of Pf malaria
in each PHC block/ sub centre.
b. In PHC blocks with Slide Falciparum Rate (SFR) >= 2%, all reported fever
patients will have an RDK for Pf, except in areas where a microscopy result
can be available within 24 hours.
c. In other PHC blocks, microscopy will be used as the first diagnostic
procedure and RDK will be used for inaccessible locations for high risk
patients and during e emergency. Such selective use of RDKs will make
diagnosis of Pf malaria more cost-effective.
d. All confirmed Pf malaria cases will be treated with ACT.
3. Supporting innovations in malaria surveillance;
a. Active case detection is proposed at the time of an outbreak. Options for
active case detection will be used e.g. as a part of fever surveillance in
partnership with IDSP. Active case detection will also be considered in high
risk P falciparum areas that are inaccessible.
b. In project districts, surveillance will be primarily based on the examination
of blood samples from suspected malaria cases i.e., Passive Case Detection
(PCD).
c. In the first phase, States will set tentative annual targets for the number of
patients to be tested in PCD (e.g. at least 10% in highly endemic areas);
when more experience gained in implementation, NVBDCP will prepare
norms adapted to different epidemiological situations.
d. In the first phase, blood slides will be collected from all patients suspected
of malaria, whether or not an RDK test is also given. This is important since
the RDK to be used is only specific for falciparum malaria. This will also help
to ensure quality control of the two methods.
e. It is likely that by 3rd year RDKs sensitive to Pf as well as Pv will be
available. At this time the recommendation on microscopy for diagnosis of
malaria will be reviewed and appropriate strategy adopted.
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