National Project Implementation Plan - NVBDCP
National Project Implementation Plan - NVBDCP
National Project Implementation Plan - NVBDCP
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The following table summarizes the key innovations being put in place by<br />
the project and some remaining concerns and issues:<br />
Intervention and<br />
Current Status<br />
Malaria Case Management<br />
Presumptive<br />
chloroquine treatment no<br />
longer effective for<br />
increasing falciparum<br />
malaria (Pf) prevalence<br />
Community-level<br />
diagnosis based on<br />
microscopy not available<br />
or delayed in rural and<br />
tribal areas<br />
Malaria Vector Control<br />
Mosquito control<br />
traditionally with<br />
insecticide spraying in<br />
houses (IRS).<br />
Effectiveness has declined<br />
due to vector resistance<br />
Agreed Change in<br />
Policy/Program<br />
Confirmed Pf cases<br />
to be treated with ACT, a<br />
highly effective drug<br />
regimen<br />
Rapid diagnostic test<br />
kits to be introduced at<br />
community level and<br />
used to confirm Pf within<br />
24 hours of reporting of<br />
fever<br />
Program will replace<br />
over time most IRS with<br />
use of long-lasting<br />
insecticidal mosquito bed<br />
nets (LLINs). Delivery<br />
free to villagers<br />
Comments/<br />
Challenges<br />
ACT treatment<br />
requires new training<br />
and supervision<br />
Higher commodity<br />
costs<br />
Need to assure<br />
adequate supply and<br />
storage in remote areas<br />
Need to assure<br />
quality of drugs and<br />
medical supplies in<br />
booming global market<br />
LLINs not yet widely<br />
accepted by beneficiaries<br />
in many districts– need<br />
strong behavior change<br />
activities<br />
LLIN production in<br />
India still limited. Need<br />
to develop market<br />
Kala-azar Case Management<br />
Increasing resistance<br />
to currently used injectable<br />
medicines for Kala-azar<br />
which also have significant<br />
side effects<br />
Current tests to<br />
diagnose Kala-azar are not<br />
very specific<br />
New oral drug –<br />
miltefosine – which is<br />
safer and more effective<br />
to be introduced in<br />
districts where there is<br />
high resistance to<br />
current drugs.<br />
New Rapid<br />
Diagnostic Test for Kalaazar<br />
test kits to be used<br />
to improve diagnosis<br />
Successful strategies<br />
from TB program to be<br />
used to increase patient<br />
compliance<br />
New strategies will<br />
require better<br />
implementation in some<br />
of weakest districts<br />
Miltefosine must be<br />
closely monitored as it<br />
can be toxic to pregnant<br />
women and small<br />
children<br />
Adequate supplies<br />
and logistics must be<br />
assured in difficult areas<br />
New technologies are<br />
higher in cost and may<br />
result in low quality<br />
imitators which must be<br />
kept away from program<br />
Kala-azar Vector Control<br />
Kala-azar vector, the<br />
sandfly, poorly covered<br />
DDT application to<br />
be strengthened with<br />
25<br />
New strategies<br />
require additional staff