National Project Implementation Plan - NVBDCP
National Project Implementation Plan - NVBDCP
National Project Implementation Plan - NVBDCP
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e available within 24 hours. In other PHC blocks, an RDK will only be used<br />
for patients at high risk. This selective use of RDKs will make diagnosis of<br />
PF malaria more cost-effective. The proposed changes will have important<br />
implications for the commodities to be procured by the program, especially<br />
RDKs, and ACTs, and in terms of training, M&E, and quality assurance.<br />
3 Supporting innovations in malaria surveillance<br />
In surveillance, the project will support efforts to de-emphasize the<br />
collection of blood samples through outreach workers through house to<br />
house visit –i.e., Active Case Detection (ACD). Such collection will be<br />
restricted to high-risk areas with weak curative services, and when there is<br />
suspicion of an outbreak. In project districts, surveillance will be primarily<br />
based on the examination of blood samples from suspected malaria cases<br />
i.e., Passive Case Detection (PCD). In the initial phase, States will set<br />
tentative annual targets for the number of patients to be tested in PCD (e.g.<br />
at least 10% in highly endemic areas); when more experience has been<br />
gained <strong>NVBDCP</strong> will prepare norms adapted to different epidemiological<br />
situations. In the initial phase, blood slides will be collected from all patients<br />
suspected of malaria, whether or not an RDK test is also given. This will<br />
ensure continuity in surveillance and support quality control of the two<br />
methods of confirmatory diagnosis. After two years, the policy of blood<br />
slides on all fever cases where RDK is performed will be reviewed. By then<br />
it is likely that RDKs sensitive to PF as well as PV will be available. In<br />
addition, the project will support introduction of a sentinel surveillance<br />
system in the <strong>NVBDCP</strong> to monitor hospital admissions and deaths<br />
attributable to malaria at selected representative sites including those from<br />
government and in the private sector, and periodic surveys of health<br />
facilities and households in endemic areas.<br />
4 Monitoring of anti-malarial drugs and insecticides efficacy<br />
The project will support nation-wide actions to update and strengthen<br />
monitoring of therapeutic efficacy of anti-malarial medicines, insecticide<br />
resistance and quality of medicines to contain the problems of drug and<br />
insecticide resistance and ensure their efficacy. Monitoring of therapeutic<br />
efficacy of SP and ACTs will be undertaken so that effective drugs are used<br />
in the treatment of malaria. To maintain the use of effective drugs and get<br />
the desired impact, at least five units will monitor the quality of medicines<br />
and insecticides at different sites in the country. One unit in each State will<br />
be responsible for quality assurance of diagnosis. In addition, there will be<br />
an independent inspection agency monitoring the quality of pharmaceuticals<br />
by testing random samples.<br />
5 Enhancing effectiveness of existing vector control<br />
The project will support improvements in the effectiveness of its vector<br />
control operations in high Pf high burden districts by introducing microstratification<br />
of districts according to revised national guidelines based on<br />
epidemiological and ecological data, to delimit areas and populations which<br />
would be targeted for selected interventions, i.e. IRS or LLINs.<br />
Furthermore, the program will systematize insecticide rotation for IRS to<br />
lessen the risk of insecticide resistance and ensure the implementation of<br />
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