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These mosquitoes are day biters & outbreaks are sustained by human mosquito human transmission. The peak biting times of the Aedes aegypti mosquito are early morning or late evening. These mosquitoes usually breed in clean water collections in containers, tanks, disposable junk material such as discarded buckets utensils tyres flower pots etc. Slide 4: During 1996, an outbreak of dengue was reported in Delhi. In view of this major outbreak of the disease a “Guideline of preparation of contingency plan in case of outbreak/ epidemic of Dengue/ Dengue haemorrhagic fever” was prepared and sent to all states. Technical assistance for investigation, prevention and control of Dengue/ DHF outbreak is provided through Directorate of NAMP and NICD Delhi. HISTORICAL BACKGROUND/PERIODICAL DEVELOPMENT : HISTORICAL BACKGROUND/PERIODICAL DEVELOPMENT Dengue Control activities are being carried out by staff appointed under NVBDCP and staff working at Primary Health Centre level. Separate Dengue Control Programme is proposed and is under consideration at National level. In the beginning, Dengue outbreaks were reported from Urban and Peri-Urban areas. But during last three years, dengue outbreaks are being reported from rural area also. Slide 6: The first major outbreak of dengue fever accompanied by dengue haemorrhagic fever was reported in Calcutta in 1963. About sixty outbreaks have been reported during the period 1956 to 1996. Because dengue infections have the potential of rapid spread leading to an acute public health problem, special attention is required to be paid for its surveillance, prevention & control. Slide 7: OBJECTIVES To reduce morbidity & mortality due to Dengue at least by 50 % in next 5 years Slide 8: SERVICES TO COMMON PEOPLE All Govt. Hospitals have been instructed to provide free treatment and laboratory facilities to the suspected Dengue patients. Slide 9: SERVICE CENTRES AVAILABLE IN EACH DISTRICT Treatment for Dengue is available at All Govt. Hospitals at Taluka and Dist. level & Medical College Hospitals Slide 10: ROLE OF OTHER SECTORS Involvement & co–operation of other related sectors is obtained through the Umbrella Societies at District levels. Slide 11: IMPACT Non availability of separate infrastructure for Dengue Control and water scarcity leads to increase in number of Dengue cases and deaths due to dengue day by day. STRATEGY OF NATIONAL DENGUE CONTROL PROGRAMME : STRATEGY OF NATIONAL DENGUE CONTROL PROGRAMME Implementation strategies Considering major outbreaks of dengue in the nation, the nation has started vector surveillance from 1999 in all districts by giving training to 2 MPWs from each district. On the basis of entomological findings, following measures were undertaken to control/prevent dengue in the States. ACTIVITIES OF NATIONAL DENGUE CONTROL PROGRAMME : ACTIVITIES OF NATIONAL DENGUE CONTROL PROGRAMME a. Fever Survey. Collection of Blood Smears to rule out malaria. Presumptive treatment with Chloroquine. Collection of Serum samples for isolation of Dengue virus if there are no malaria positive cases. Collection of Aedes Aegypti mosquitoes for isolation. Slide 14: b. Indoor/outdoor fogging with Pyrethrum Extract/Synthetic Pyrethroid Ultra Low Volume(ULV ) c. To empty all domestic & Peri domestic water containers to eliminate the Aedes breeding. d. The indoor residual spraying with Synthetic Pyrethroid. e. The State has also supplied rapid diagnostic dengue kits (Panbio) to selected districts. f. IEC: Health Education regarding seriousness of Dengue disease, its spread and measures to be undertaken is given at the time of house visits. Posters, Pamphlets are also distributed. SURVEILLANCE : SURVEILLANCE 1. Regular surveillance (a) Active. (b) Passive. 2. Rapid fever survey. : 2. Rapid fever survey. Collection and Examination of Blood Smears for Malaria. Collection of 5% Serum Samples of Dengue suspected cases for Viral isolation. Fogging. Entomological Survey for search of Dengue Vector i.e. Aedes Aegypti. DENGUE SITUATION : DENGUE SITUATION 3.Other activities : 3.Other activities Workshop for all district level officers regarding Dengue prevention and control. Arrangement for platelet count and treatment of dengue cases in Govt. Institutions. Guidelines issued to all District level officers. Health Education to community through different Medias. Visits of Health authorities from various levels. THE PUBLIC IS ADVISED TO DO THE FOLLOWING:- : THE PUBLIC IS ADVISED TO DO THE FOLLOWING:- i. To sprinkle oil in the stagnant water ii. To keep the water pots covered iii. To keep overhead water tanks tightly covered iv. To prevent stagnation of water in the broken bottles, flower pots, buckets, tyres etc. v. People are advised to use mosquito nets, Mosquito repellent oils & creams etc. EXPECTED COMMUNITY PARTICIPATION : EXPECTED COMMUNITY PARTICIPATION The community must be encouraged to take steps to protect themselves from mosquitoes by: Eliminating mosquito breeding sites Taking personal measures such as use of bed nets, mosquito repellents etc. The co–operation of the community is also important during the periodic insecticides spray. CONTD……… : CONTD……… In an event of an outbreak, the co–operation of other government departments will help to bring it more effectively under control. An inter departmental committee for outbreak prevention and control should be constituted which should meet more periodically. Panchayat members, key community representatives and NGOs should be included as members of committee. A meeting of the committee should be conducted before the expected seasonal increase of water and vector borne diseases. In districts where risk factors exist, status of control measures of DF/DHF should also be assessed. CONTD………. : CONTD………. In pockets of high risk, active surveillance of DF/DHF should be encouraged so that first case(s) is (are) immediately reported to the local health authorities. Co – ordinated efforts by government departments such as sanitation,Urban development, education etc. are essential so that risk factors for mosquito breeding can be reduced and other control measures taken up effectively. Important Health Education Messages : Important Health Education Messages Health education to the community regarding:- Emptying of all household water containers at least once in a week. To keep surrounding of the house clean & dry. Not to keep unused materials on the roof and around the house. Source reduction by community participation : Source reduction by community participation In 1992, considering the constraints of coverage of mass/selective larviciding (limited to 30% to 40% of endemic areas), organized community efforts were conducted at village level through the DHF Working Group. This group included one member from the PKK (Women Empowerment Welfare Group). This programme called Bulan Gerakan “3M”, has three components: : This programme called Bulan Gerakan “3M”, has three components: (i) Health education using mass media, women’s groups and schoolchildren; (ii) Door-to-door visits by PKK volunteers for implementing the “3M” programme, i.e. (a) Covering water containers (Menutup); (b) Cleaning water containers (Menguras), and (c) Burying discarded containers (Mengubur); and (iii) Source reduction using community participation and Intersectoral coordination. The capacity-building strategy includes : The capacity-building strategy includes Provision of training at all levels through regular training courses, workshops and seminars. Training in clinical diagnosis has been provided to many doctors and nurses from health facilities such as hospitals and health centres. Sentinel DF/DHF laboratories have been developed for surveillance of the disease. In 1992, the Ministry of Health issued a law, No. 581, concerning the National DF/DHF ROLE OF COMMUNITY HEALTH NURSE. : ROLE OF COMMUNITY HEALTH NURSE. Surveillance. Epiodemiological surveillance. Fever surveillance Case finding Collection of blood samples Reporting of DF/DHF to the authorities. CONTD……… : CONTD……… Vector surveillance Larval surveillance during the pre-monsoon and post monsoon Stratification of the areas Adult surveillance CONTD…… : CONTD…… Prevention and control Environmental sanitation Aerosol and liquid spray applying Promoting use of mosquito coils, electric mosquito mats Promoting the use of mosquito nets. Slide 30: Treatment Promote bed rest Administer antipyretics/ sponging to reduce the body temperature Pain reduction measures including mild analgesics Provide ORS. Slide 31: Health education To prevent mosquito bites advice the people to: Use mosquito nets or repellent during night Cover whole body To prevent mosquito breeding, advice the people to:- Clean and remove breeding places Periodical cleaning and drying of manmade water tanks, water containers. CONCLUSION : CONCLUSION Today, dengue prevention and control requires long term activities. Many of the affected countries are the poorest. The India Government has taken measures for the control of the Dengue fever and Dengue haemorrhagic fever. But this is dependent on the National Anti-Malarial Programme. As the disease is endemic in many states, it may require more intensified activities. REFERENCES : REFERENCES BT Basavanthappa. Community Health Nursing. 2nd edition. Bengaluru (India): Jaypee publications; 2008 K. Park. Preventive and Social Medicine. 18th edition. Jabalpur (India): M/s Banarsidas Bhanot;2005 Arogya.com. dengue fever control programme. Retrieved June 28, 2010 from http://www.aarogya.com/index.php?option=com_content&view=article&id=2615:national-dengue-control-programme&catid=140:health-programs&Itemid=3381 EHP. Best practices for dengue control. Retrieved June 28, 2010 from http://www.ehproject.org/PDF/Strategic_papers/SR7-BestPractice.pdf You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.