Fortnight Campaign for prevention of Malaria,

Dengue & Diarrhoea (MDD), 2013

August, 1st – 15th 2013

HEALTH & FAMILY WELFARE DEPARTMENT,GOVERNMENT OF ODISHA

Malaria & dengue are vector borne

diseases and diarrhoea is a water borne

disease.

- Both vector and water borne diseases are

monsoon related outbreak prone diseases.

–Cause immense public health problem in our

state

–Both morbidity and mortality increase during

monsoon and post monsoon months

These diseases are preventable

Malaria • Malaria is transmitted by female Anopheline

mosquitoes – biting time is night

• Man develops malaria 8 to 14 days of the

bite of infective mosquito.

• Out of 5 types of malaria parasites ,P.vivax &

P. falciparum pose major problem in our state

– Falciparum causes dangerous variety of

malaria which may lead to complication

and death

• Two mosquitoes are primary vectors:

– A. Culicifacies & A. Fluviatilis transmitting

malaria in Odisha.

Malaria

• Symptoms of uncomplicated

Malaria) :

- Rigor, fever, headache, vomiting

and other flu-like symptoms.

• Symptoms of complicated

Malaria:

– High fever, convulsions, Renal

failure, Hypoglycaemia, alter-

sensorium, jaundice unable to

sit & move.

Malaria:

Breeding sites of Anopheles mosquitoes

• Breeds in rainwater pools

and puddles, borrow

pits, river bed pools,

irrigation channels,

seepages, rice fields,

wells, pond margins,

sluggish streams with

sandy margins.

(preferably clean water)

• Extensive breeding is

generally encountered

following the monsoon

rains

How to control and prevent malaria?

1. Early case Detection and Complete

Treatment (EDCT) : diagnosis through

RDT and Microscopy test of all

suspected cases within 24 hours

2. Positive cases must be treated with full

course of medicine

2. Vector Control:

Breeding source reduction, Release of

larvivorous fish in breeding sites

Indoor Residual Spray,

Sleeping under bed nets/LLIN,

3. Community awareness and Inter-sectoral

coordination & Monitoring and Supervision

Do’s

Don’ts

Dengue • Dengue is a viral disease

transmitted by infected Aedes

Mosquito (Tiger mosquito)

• Aedes mosquito is a day biter

• There is no specific medicine or

vaccine for dengue

• Aedes mosquito breeds in clean

stagnant water over hard surface

like artificial storage containers,

unused tyres, coolers, discarded

containers in and around the

domestic surroundings

Life Cycle of Aedes Mosquito

Stagnant water

2-3 days 4-5days

Eggs Larvae Pupae

1-2 days

2-3

days

Dengue fever symptoms & signs

• Sudden onset of high

fever

• Severe frontal headache

• Pain behind the eyes,

worsening eye

movement

• Muscle and joint pains

• Loss of appetite

• Nausea and vomiting

Measles-like

rash

Wide spread rash – consult for

medical attention

Dengue Complication symptoms & signs

- Dengue Hemorrhagic fever

Similar to dengue fever with

• Severe continuous stomach pains

• Bleeding from nose, mouth & gums and skin

rashes

• Frequent vomiting with or without blood

• Thirsty and dry mouth

- Dengue Shock Syndrome

• All above with

• Rapid weak pulse

• Pale, cold or clammy skin

• Sleepiness and restlessness

• Low Blood pressure for age

• & Difficulty in breathing

Remember • In case of simple dengue fever:

– For remission of fever, cold sponging and

paracetamol tablet helps

– For pain relief don’t use any other pain killers – Patient should be advised to take lot of fluid and

take adequate rest

• In case of signs and symptoms of

complication doctor should be consulted -

patient may need hospitalization for medical

observation and management

Aedes breeding sites

Aedes breeding sites

Aedes breeding sites

Aedes breeding sites

Dengue prevention – Vector control measure

Source Reduction:

• Detection & elimination of mosquito breeding sources,

Management of roof tops, porticos and sunshades, Proper

covering of stored water, Reliable water supply

• Observation of weekly clean and dry day

• Personal protection measures: Use of mosquito repellent

creams, liquids, coils, mats etc, Wearing of full sleeve shirts and

full pants with socks

• Use of bednets for infants, young children, pregnant women

and old peoples when they sleep in day time to prevent

mosquito bite

Anti Larval Measures: Application of larvicides like temephos

Anti Adult Measures: Application of Space Spray, Fogging etc.

DIARRHOEA

Diarrhoea

Definition : Diarrhoea is defined as the passage

of three or more loose or liquid stools per day

that leads to dehydration.

-Frequent passing of formed stools is not

diarrhoea, nor is the passing of loose, "pasty"

stools by breastfed babies.

- However passage of a single bout of large

watery stool may also lead to dehydration in

children.

DEFINITION

• Watery Diarrhea: 3 or more liquid or watery

stools in 24 h

• Dysentery: Presence of blood and/or mucus in

stools

• Persistent Diarrhea: Diarrhea lasting for 14

days or more

TYPES OF DIARRHEA

Rota virus diarrhea

E. coli diarrhea

Cholera

Watery diarrhea

Shigellosis

Amebiasis

Dysentery

Causes are mostly unknown

Persistent diarrhea

Diarrhea

Diarrhoea is caused by Bacteria, Parasites, Virus &

other agents. Of all Causes , 5-10% of cases are only

due to Cholera.

Seasonality

Disease Common Season

Cholera Pre Monsoon &

Monsoon

Rota Virus diarrhoea Winter

Shigellosis Dry Summer

TRANSMISSION

• Most of the diarrheal agents are transmitted

by the faeco-oral route

• Some viruses (such as rotavirus) can be

transmitted through air

• Nosocomical transmission is possible

• Shigella (the bacteria causing dysentery) is

mainly transmitted person-to-person

Sick People defecate in

or near a water source

Animals defecate in

or near a water

source

Caregivers

contaminating their

hands after care of

baby Lack of Personnel

hygiene; people,

contaminating surfaces

they touch

Preparation of food with

unwashed hands,

contaminating the food

Families eat and drink

contaminated food and

water

unwashed Vegetables

contaminated with

water

Farmer use

contaminated water to

irrigate their crops

People use contaminated

water for drinking and food

preparation

PERSON-AT-RISK

• Cholera: 2 years and above, uncommon in very young infants

• Shigellosis: more common in young children aged below 5 years

• Rotavirus diarrhea: more common in young infants and children aged 1-2 years

• E. coli diarrhea: can occur at any age

• Amoebiasis: more common among adults

COMPLICATIONS:

WATERY DIARRHEA

• Dehydration

• Electrolyte imbalances

• Muscular cramps

• Convulsions

• Hypoglycemia

• Renal failure

Possible risk factor of diarrhoeal diseases during an Outbreak of Diarrhoea

Contaminated

pond

Contaminated well

Leakage of pipe water

Contaminated

Chua water collection at leaking PWS

TREATMENT

• Rehydration– replace the loss of fluid and

electrolytes ( ORS, Home available fluid-

Hospitalisation, IV fluids)

- Proper and timely replacement of fluid loss –

adequate hydration, life is saved)

• Antibiotics– according to the type of

pathogens ( On advise of Mos)

• Start food as soon as possible

What should we do

and where to seek

care when diarrhoea

occurs ?

Home available

fluid

How to prevent Diarrhoea

• Safe drinking water

• Good Personal Hygiene – Hand washing

• Environmental sanitation –

- Sanitary disposal of excreta

- Use of Sanitary latrines

• Early case management by ORS

SAFE DRINKING WATER

ORS CURES DIARRHOEA ; HOW TO PREPARE IT ?

ONE PKT. OF ORS TO BE MIXED IN ONE LITER OF

WATER, TO BE USED WITHIN 24 HRS OF

PREPARATION

Step -1

Step -5 Step -4

Step -2 Step -3

Step -6

DO’S & DON’TS

Malaria, Dengue and Diarrhoea

BCC Fortnight Campaign

1st to 15th Aug’13

Centre of Excellence

State Institute of Health and Family Welfare, Odisha

District level Activities • District level Planning Meeting (led by CDMO

involving all wing officers, DPMU, DPHCO to convene)

• District level Sensitisation cum Orientation meeting

(all line depts., municipality, culture, PRI bodies)

• Printing of communication materials and distribution

to blocks

– Poster, Leaflet, FAQ booklet (technical

specification for printing communicated to

DPHCO/ADPHCO)

– Flex print for Hoarding (2 at DHQ and 1 per

block)

• Launching Ceremony (1st of August)

• Nidhi Rath- One van for each block and one van for

District Headquarter (follow guideline with

specification, DPHCO/DPHCO to develop and execute

HQ plan)

• Monitoring & Supervision- formation of Monitoring

team & (format already provided)

• Documentation of every activity (format given

separately)

• ADPHCO/DPHCO will act as nodal Officer for this

campaign at district level

* Follow guideline for details of activity and budget

Mass Cleanliness Drive on

13th & 14th August 2013

Block level Activities

• Block level Planning Meeting-Development of Micro

plan (led by MO I/C involving all wing officers, BPMU,

PHEO to convene)

• Block level Orientation meeting (all line depts.,

municipality, culture, PRI bodies)

• Nidhi Rath- development of a Micro plan along with

route chart for Rath Movement by PHEO and submit a

copy to district (follow guideline with specification to

design)

• Folk Show per GKS – develop a Micro plan(Date wise

and village wise) for folk show at village level by PHEO

and submit copy to district

• Distribution & display of IEC materials to sub

centre/village

– Poster for every swasthya kantha,health and other

institutions

– Leaflet, FAQ (with Nidhi Rath and to every GKS)

– Display of hoarding at Block HQ

* Follow guideline for details of activity and budget

Block level Activities .. contd • Launching Ceremony (1st of August)

• Sensitization of school children and

teacher through School Health

programme. Reading materials like FAQ

booklet on Dengue, Leaflet on Diarrhoea

and a Comic booklet on malaria(Masanka

Bhaga dauda) to be utilized for this

programme (budget integrated under

school health programme)

• Monitoring & Supervision- formation of

Monitoring team (format attached in

guideline)

• Documentation (format given separately)

• PHEO will act as nodal Officer for this

campaign at block level

* Follow guideline for

details of activity and

budget

Mass Cleanliness

Drive on 13th & 14th

August 2013

GP/Village level Activities • GP level Orientation meeting under the chairmanship of

Sarpanch - Facilitated by Health Worker(M/F) under the

guidance of PHEO/MTS as per micro plan

• Nidhi Rath-facilitation of Nidhi Rath Movement by Health

Worker(M/F) and ASHA as per the micro plan

• Display/ distribution of IEC materials at appropriate

locations

– Poster for Swasthya Kantha

– Leaflet distribution during Nidhi Rath and folk show

• Sensitization of GKS members on MDD campaign and folk

show and cleanliness plan finalisation

• Folk show at Village- Health worker(M/F) and ASHA will give

advance intimation to the house hold along with

counselling on the campaign and regarding the date &

venue of folk show through door to door visit and date and

venue to be written in Swasthya Kantha

• ANM ,ASHA and AWW to conduct group counselling on key

messages

• ASHA /AWW will update the Swasthya Kantha with key

messages on Malaria, Dengue and Diarrheoa (list of

messages provided in guideline)

Mass Cleanliness Drive

on 13th & 14th August

2013

Cleanliness Drive by GKS

• Every village will develop a micro plan for the cleanliness drive under the chairmanship of President of GKS and FLWs.

• Mass Cleanliness drive at all places on 13th & 14th August 2013.

• Mobilise the community for the cleanliness drive Ex: elimination of Mosquito breeding sites, bush cutting, cleanliness of office campus etc.

INTER DEPARTMENTAL

CONVERGENCE

Panchayati Raj Department

1. Decision making and review meetings at all the level of 3

tier Panchayati Raj System to undertake measures on

prevention of water loggings, waste management,

environmental sanitation, community level cleanliness

drives.

2. Review by Sub-collectors at Sub-Divisional level. BDOs

should be nodal officer at Block level for Inter-sectoral

coordination at Block level

3. Organizing sensitization of all Panchayat Samiti members

for focused action to be undertaken for prevention of Vector

Borne and Water borne diseases – invite Health Dept,

personnel to sensitize.

4. Ward members to take active role for proper utilization of

GKS fund.

* Follow guideline for details of activity and budget

Housing & Urban Development Dept. (NAC/Municipality Corporation)

1. Decision making review meeting at all level for

environmental management , prevention of water

logging, drain management , regular surveillance of

mosquito density, safe and regular water supply

2. All related staff need to be oriented and assigned for

their responsibility.

3. Urban NGOs can be involved for sensitization of

community at slum areas

* Follow guideline for details of activity and budget

1. Putting hoardings, banners, posters in public places

during the transmission season. (prototypes are

available with DPHCO/ADPHCO of Health Dept.)

2. Utilise Auto & city buses, Cinema halls, local TV

channels for display of messages during the

transmission season.

3. Sensitization of Garage owners / shop keepers/ tea

shops/ restaurants/ hotels/ schools / nursing homes/

hospitals and all other institutions for not creating

breeding sources.

- they should be held responsible for creating mosquitogenic conditions in their surroundings

Housing & Urban Development Dept. (NAC/Municipality corporation)

* Follow guideline for details of activity and budget

1. In permanent water bodies from where water can not be drained out - larvivorous fish should be released

2. Regular application of larvicides/ MLO needs full supervision 3. Setting up mechanisms for: - Awareness on changing water from Coolers/water tanks/ pots/

other possible breeding sources on weekly basis - Weekly lifting of garbage and flattening of tyres to prevent rain

water collection - Utilising existing health facilities & manpower, early reporting of

fever cases & diarrhoeal cases 4. Training of all base level workers on VBD & water borne disease

prevention to understand their role 5. Proper selection and deployment of Health Volunteers for dengue

prevention in transmission season

Housing & Urban Development Dept. (NAC/Municipality corporation)

* Follow guideline for details of activity and budget

School and Mass Education Department

1. Orientation of teachers for community awareness on

prevention of vector and water borne diseases.

2. Strengthening School Health progamme and a special

classes on hygiene and sanitation, Sleeping under

mosquito Net, identifying and eliminating possible

mosquito breeding sites in school campuses and own

houses.

3. Some Good communicator (teacher) around 2000 can be

developed as master trainers - The Comic book on

Malaria can be used

4. Symposiums/Seminars/ Debates/Quizzes and addressing

this causes in Morning assembly

* Follow guideline for details of activity and budget

Women and Child Development Department

1. In the routine monthly review meetings at District, Block

& Sector level, prevention /control of Malaria, Dengue &

Diarrhea must be discussed and action point be planned

– with technical support by Health Deptt.

2. As a part of GKS, AWWs are to take active role in

cleaning and sanitation drive, preventive disinfection of

drinking water supply, key informant of fever and diarrhea

cases to ASHA and local health functionary.

3. Monitor the use of LLIN provided to pregnant women in

High burden malaria districts.

4. AWWs may be involved in MDA for Elimination of

Lymphatic Filariasis (A National Prog.)- at least in Urban

areas.

* Follow guideline for details of activity and budget

SC & ST Development Department

1. Special skill based training of 2 teachers from each Tribal

Residential school on prevention of VBDs and Water

borne diseases.

2. Ensuring use of Mosquito nets, Hand washing and

personal hygiene, cleanliness of residential school

campus, weekly elimination of any water logging.

3. The students of tribal residential schools can be mobilized

to create awareness in their own community

4. Dept. can utilize their own resources for yearly

replenishment of LLIN to Tribal residential schools.

Health Dept. has already provided nets since last 2 years

under Mo- mashari scheme.

* Follow guideline for details of activity and budget

Rural Development Department

In the routine monthly review meetings, blocks should be

responsible for the following aspects and remedial

measures be taken during the campaign.

1. Reliable water supply

2. Preventive maintenance, repair of tube wells and

existing pipe water supply

3. Prevention of water logging around tube wells

4. Timely preventive disinfection

5. Destruction of all water logging sites after construction

work is over

6. All weather road

* Follow guideline for details of activity and budget

Glimpses of MDD Campaign-2012

Continued……….

If we understand and practice

the preventive measures,

we can be free from

Malaria, Dengue

and Diarrhoea.

THANKS