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Community Participation In
            y        p
     Aedes Mosquito Control.

            DR.G.C.SAHU
         Regional Director [i/c]
           g               [ ]
            ROH&FW;GoI;
            ROH&FW;GoI;
             Ahmedabad.
1
Re-emergence of Vector Borne Diseases
      Uncontrolled Urbanization




                       The unrestrained
                    production and use of
                   non-
                   non-biodegradable food
                  and drink packaging, and
                    drums and other water
                  storage vessels that often
                   become larval habitats;




                          Non-
                          Non-existent,
                         inconsistent, or
                      fragmented national
                      f        t d ti     l
                        programmesā€¦in
                           urban areas




2   Sources: Gubler, 1998; PAHO, 1997.
                                              Dr.G.C.Sahu/ROH&FW/GoI/A'bad
Re-emergence of Vector Borne Diseases
Inadequate Environmental Management


    Insufficient waste                  Insufficient and
    collection and                      inadequate water
    management.                         distribution.
    Non-biodegradable
    N    bi d     d bl                  Increased number of
                                        I        d     b   f
    containers.                         water storage containers.
    Improper tyre disposal.             Inadequate septic
                                        system conditions.




           Increase in breeding sites for the vector
3                     Dr.G.C.Sahu/ROH&FW/GoI/A'bad
Re-emergence of Vector Borne Diseases
     Population Movements


                                   More than 750 million people annually
    Migration                      cross international borders.


                                   Increase in rural migration into
                                   urban areas.


                                   Ever increasing international travelers
                                   all across the globe.
    International
    tourism
                                   Continuous i
                                   C ti         increase in international
                                                           i i t    ti   l
                                   tourist arrivals in all the countries
                                   across the globe.

                                                                  Source: OMT data.
                       Traffic of microorganisms
4                       Dr.G.C.Sahu/ROH&FW/GoI/A'bad
Growth in global air traffic




5                       Dr.G.C.Sahu/ROH&FW/GoI/A'bad
INCREASE IN MARITIME PASSENGER AND CARGO TRAFFIC




6                 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
I
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7   Dr.G.C.Sahu/ROH&FW/GoI/A'bad
Re-
            Re-emergence of Vector Borne Diseases ā€“
                  Factors due to Climate Change


                            Climate change                  Changes in transmission


    Ideal conditions for
                                                              Ecological changes
           VBDs:                Alteration
Latitude:  350 north          of ecosystems
                              o ecosyste s
          350 south
Altitude:  2,200 m
                                                             Socio-
                                                             Socio-economic changes
Temperature: 15-40 Ā°C
             15-
Relative humidity:                Alteration of
            high-moderate
            high-            Geographical distribution
                                  of pathogens
                                   and vectors




                                 Increase in
                            vector-
                            vector-borne diseases

8                                                        Dr.G.C.sahu/ROH&FW/GoI/A'Bad
Effects of Climate change
          on A d Mosquito
             Aedes M        it


    Speed up viral incubation in mosquito
    Shorten mosquito breeding cycle
    Increase mosquito feeding frequency
    More efficient transmission of
    dengue/chikungunya
    dengue/chikungunya virus from
    mosquito to human.
                 human
9               Dr.G.C.Sahu/ROH&FW/GoI/A'bad
10   Dr.G.C.Sahu/ROH&FW/GoI/A'bad
THE EXTENT OF THE VBDs AND THE GLOBAL REACH OF AEDES MOSQUITO
                                                        Q




11                      Dr.G.C.Sahu/ROH&FW/GoI/A'bad
Global Endemicity of Chikungunyaā€¦ā€¦..




                                                  ā€¦..and Yellow fever
12                        Dr.G.C.Sahu/ROH&FW/GoI/A'bad
GLOBAL REACH OF EMERGING AND RE-EMERGING DISEASES
                                  RE-




13                     Dr.G.C.Sahu/ROH&FW/GoI/A'bad
THE VECTORā€¦ā€¦                                        ā€¢ Dengue ,Chikungunya and yellow fever
                                                    is transmitted by infected female Aedes
                                                    mosquito

                                                    ā€¢ Primarily a daytime feeder and mainly
                                                    bites in the morning or late in the
                                                    afternoon

                                                    ā€¢ Lives around human habitation

                                                    ā€¢ Lays eggs and produces larvae
                                                    preferentially in artificial containers




            Although it may feed at any time, the mosquito's
     periods of peak biting activity are few hours after dawn and
     in the late afternoon until a few hours after dark.
            The mosquito's preferred breeding areas are in areas of
     stagnant water, such as flower vases, uncovered barrels,
     buckets, and discarded tires, but the most dangerous areas
     are wet floors, underground tanks, cement tanks and also
     toilet bowls, as they allow the mosquito to breed right i the
       il b    l       h    ll    h        i     b   d i h in h
     residence.

14                   Dr.G.C.Sahu/ROH&FW/GoI/Ahmedabad
THE VECTORā€¦ā€¦
                                               ā€¦..THE VECTOR IS AN
                                                  THE
                                             AGGRESSIVE BITERā€¦AND
                                               MOSTLY BITES WITH A
                                            PAINFUL STING DURING DAY
                                                    TIMEā€¦ā€¦.




       ā€¦ā€¦..JUST WATCH THE
     FEROCITY OF THE STING !!!



15                   Dr.G.C.Sahu/ROH&FW/GoI/Ahmedabad
THE VECTORā€¦ā€¦ IN HER ETERNAL CYCLEā€¦




         ONE GENERATION
     IS BORN ROUGHLY EVERY
              WEEK
                                                        EVERY THING IN A
                                                          PLATTER !!!


16                   Dr.G.C.Sahu/ROH&FW/GoI/Ahmedabad
ā€¦ā€¦AND HER PARAPHRENALIA




                                            THE PLOT
                                                 IS
                                            HATCHED
                                             ā€¦.. !!!###
                                             ALMOST
                                              UNDER
                                            WATER !!!




17       Dr.G.C.Sahu/ROH&FW/GoI/Ahmedabad
Aedes aegypti breeding sitesā€¦ā€¦.. Mostly domestic and peri-domestic
                                                      peri-




18
                                       Dr.G.C.Sahu/ROH&FW/GoI/A'bad
ā€¦ā€¦.Aedes aegypti breeding sites Mostly domestic and peri-domestic
                                                     peri-




19                                 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
ā€¦ā€¦.Aedes aegypti breeding sites




                                           Urban:
                                            Both
                                            B th
                                            posh
                                             &
                                           Slums
                                           Areas.




20          Dr.G.C.Sahu/ROH&FW/GoI/A'bad
Typical water containers in urban/rural set up that can be potential
                   breeding place for Aedes mosquitoes.




21                          Dr.G.C.Sahu/ROH&FW/GoI/A'bad
Typical water containers in rural/urban set up that can be potential
                   breeding place for Aedes mosquitoes.




22                            Dr.G.C.Sahu/ROH&FW/GoI/A'bad
The obstacles for Aedes
        Mosquito control.
              i         l



23         Dr.G.C.Sahu/ROH&FW/GoI/A'bad
ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control.




       Present-
       Present-day Aedes Mosquito control
      programs are not progressing because:
         Community participation in dengue
     prevention and control is limited to official
       demands and never attains community
                    ownership;

24                 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control.




     Local health services, now politically and
       administratively responsible for the
        d i i t ti l           ibl f th
     prevention and control programmes are
           not sufficiently established;


25                 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control.




          Individual and community
      behavioral change strategies are
      b h i    l h       t t i
     weak and are not incorporated into
                 the programs;


26               Dr.G.C.Sahu/ROH&FW/GoI/A'bad
ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control.




          Water
          W t supply and solid waste
                      l   d lid        t
     management are limited in high-risk areas;
                               high-




27                Dr.G.C.Sahu/ROH&FW/GoI/A'bad
ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control.




      Sustainability and continuity of control
     actions are constantly compromised by
     other health demands and policies that
               compete with them;


28                   Dr.G.C.Sahu/ROH&FW/GoI/A'bad
ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control.




     Little capacity for intersectoral
              coordinationā€¦

       Aedes Mosquito problem is
                  not the
                       h
         sole responsibility of the
            Ministry of Health.
                        Health
29                   Dr.G.C.Sahu/ROH&FW/GoI/A'bad
ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control.




     Operational research on individual or
      community-based strategies have
      community-y             g
             not been sufficient;




30             Dr.G.C.Sahu/ROH&FW/GoI/A'bad
The Global Strategy for Mosquito/ VBD control




                Surveillance for planning
                      ll     f    l
                      and response




      Reduction of                              Behavioral
     disease burden
     di      b d                                 change
                                                  h
31               Dr.G.C.Sahu/ROH&FW/GoI/A'bad
This is what you
     can do to helpā€¦
         d t h l


32       Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.



     Maintenance of water supply systems




                  Leakage in water supply pipe line
         While augmenting water supply scheme in urban areas, sewage system
         with sewage treatment should also be installed simultaneously in these
         towns for proper collection, treatment and waste water
         generated.
         generated.


33                              Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.
      Establishing proper drainage system




               Open sluice-valve chambers with leakage.
                    sluice-                    leakage
      Municipal Corporations shall formulate an integrated approach/ programme for water
      supply, sewerage, drainage and solid waste management so as to keep the environment
      free from the risks of vector breeding / growth.
                                           g g
      Storm water drains should invariably be covered and maintain them properly by
       way of regular cleaning, de-silting etc. to prevent stagnation of water.
                                de-        etc.                          water.
      Larger storm water drains may be suitably channeled to facilitate adequate velocity for
      flow of waste water.
                    water.


34                    Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.
     Implementation of bye laws at construction sites can take care of
       p                y
     mosquito breeding.




          Construction sites                       Open overhead tanks
            Water stagnation in constructional areas should be prevented.
            Overflow of water from the water tanks (individual and
            community) shall be controlled through proper floating valves.
            Proper drainage system should be provided around all Public
            Stand Posts to facilitate smooth drain of used water.
35                         Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

                                    Model Civic Byelaws:
                                 Standard design for the lids of
     Bad Design                  Overhead Tanks and Cisterns




         X                                                          Check nut




                                                               Over flow
                                                             Pipe protected
                                                            with perforation
                                                            Not exceed 45nm
                                                                       45nm
                                        MS Plate 50 mmx
                         Hinge               5mm

36                           Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.
     Elimination of intra domestic breeding sources very essential
     Leaking water tanks, sprinkler systems, coolers etc that cause water
     stagnation, should be repaired and reinstalled.




37                         Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.


     Elimination of intra domestic breeding sources very essential

           The vent pipe of septic tanks shall be covered with
                    pp        p
           mosquito nets so that the mosquito grown, if any, in the
           septic tanks may not be find way to come out.




38                             Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

     Prevent Aedes mosquito from
              Breeding!

           Remove ALL sources of
           R                   f
              stagnant water.
                 g

      Deny the mosquitoes of any chance to
                    breed.


39                     Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

                     Easy Steps
                          Steps..


                                       ā€¢Change water in vases/
                                        bowls
                                        b l every other d .
                                                    th day
                                                         day.




                                           ā€¢Add sand granular
                                          insecticide to water.


40                      Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

                    Easy Steps
                         Stepsā€¦



                                         ā€¢Remove water from
                                       flower pot plates every
                                             other d .
                                              th dayday.




41                     Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

                   Easy Steps
                        Stepsā€¦.



                                         ā€¢Turn over all storage
                                               containers




42                       Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.


                   Easy Stepsā€¦..
                   E    St


                                         ā€¢clear blockages and put
                                           Bti insecticide in roof
                                          gutters at least once a
                                                   month




43                           Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.
 If citizens going on a holiday or keep their houses closed for a long timeā€¦..




         ā€¢Seal off all floor and            ā€¢Cover all toilet bowls
               gully traps Leave your contact number
                             with your neighbor so that the
                             corporation authorities can
                             contact you should there be a
                             need to inspect your premises
44                           urgently.
                               Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.



     Adult vector control in urban areas.




       Chemical fogging shall be periodically carried out in the urban areas where
       there is a potential risk for the transmission of the diseases..
       Proper sanitation including community toilets and drainage facilities
       should be provided in the slum areas.
       Bio-
       Bio-environment control shall be carried out in urban areas to control
       mosquito menace.
45                             Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.


     Promoting the use of larvae eating fishes
     for control of mosquito breeding.




          Introducing larvae eating f
                    g             g fishes                         Larvae eating fish


         Gambusia fish, which eats larva of the mosquito, shall be grown
              in all water bodies/ lakes/ ponds / over head tanks.


46                                  Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

        Creating awareness among
        school and college going students.




            Importance of vector control and vector control measure
            shall be inducted in the course curriculum of primary and
                secondary level of education for dissemination of
            knowledge on vector control among student community (
                           schools as well as colleges)
                             h l         ll      ll   )

47                        Dr.G.C.Sahu/ROH&FW/GoI/A'bad
ELIMINATION OF AEDES
                AEGYPTI
            BREEDING SITES---
                      SITES---
             THE INITIATIVE
           MOSTLY LIES WITH
        INDIVIDUALS/COMMUNITY




48   Dr.G.C.Sahu/ROH&FW/GoI/Ahmedabad
What we should be doingā€¦ā€¦.

                     Main Types of Adaptive Strategies


     ā€¢    Public education and awareness
     ā€¢    Early-
          Early-alert systems: impending weather extremes, heatwaves; infectious
              y        y         p     g                 , heatwaves;
          disease outbreaks
     ā€¢    Community-
          Community-based neighbour-support/care schemes
                          neighbour-
     ā€¢    Mosquito-
          Mosquito-proofed housing design ā€¦ and ā€˜coolerā€™ urban layout
     ā€¢    Disaster preparedness, incl. health-system ā€˜surgeā€™ capacity
                                       health-
     ā€¢    Enhanced infectious disease control programs
           ā€¢   vaccines, vector control, case detection and treatment
     ā€¢    Improved surveillance:
           ā€¢   Risk indicators (e.g. mosquito numbers, aeroallergen concentration)
           ā€¢   Health outcomes (e.g. inf dis outbreaks, rural suicide rates, seasonal asthma peaks)
     ā€¢    Rural health services, counselling and community strengthening
                               ,           g             y      g      g
     ā€¢    Appropriate (esp. health) workforce training, mid-career development
                                                        mid-

49                                        Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.



       Strengthening the implementation of the
             g      g       p
       social-
       social-communication component in the
       state/national program.

       Promote the behavioral change focus
       so that it will be more than just
       dissemination of information.


50                 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

     Solid Waste Management.
                 Management.

       All the municipal waste should be collected from dust
       bins etc., and transported to the composting/land fill sites
             etc.           p                 p     g
       for treatment and disposal in order to avoid breeding of
       flies, mosquito etc.
                       etc.
       The solid waste should be transported in covered
       vehicles so as to prevent littering of the waste on streets,
       roads etc.
              etc.
       Likewise, hospital
       Lik i h i l waste and bi -medical waste should b
                                    d bio
                                      bio- di l          h ld be
       separately collected, treated and disposed in order to
       prevent breeding of mosquitoes, flies etc.
       p                g       q       ,      etc.

51                       Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

     Dead animals, carcasses should be removed
     immediately and buried under land fill sites
     and properly covered with soil to prevent
     breeding of mosquitoes and flies.
                                flies.
     Public
     P bli awareness on environmental cleanliness
                             i         t l l li
     may be created through IEC and mass media.
                                            media.
     Under JNNURM there is provision to
     formulate schemes, drainage and solid waste
     management simultaneously and incorporate
           g                    y            p
     the same in the City development Plan (CDP)
                                             (CDP)
     to make the environment free from vector
     menace.
     menace.
52                  Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.
                           g
        Social-
        Social-Communication Component


        Dissemination of the
        behavioral change strategy.
                           strategy.

        Social d
        S i l advocacy i fin favor of
                                    f
        intra-
        intra- and intersectoral actions to
        minimize environmental health problems
        (water and solid waste management).


53                Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.
        Social-
        Social-Communication Component


         It is not a ā€œmagic bulletā€ that can
                        g
         stop Aedes mosquito breeding.

         A person achieves behavioral
         changes in steps. There is a need
                    steps.
         to go from one phase to another
         sequentially.
         sequentially.

54               Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doing
                       doingā€¦ā€¦.




55             Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doing
                         doingā€¦ā€¦.
     Road and Buildings Department

             Proper
                p
        maintenance of
        public buildings
         and roads f
           d     d for
         prevention of
           mosquito
           breeding.


56                 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

     Industrial Sector

     Sensitizing the industrial
         work force and to
          open centers for
       distribution of drugs/
                       f    g
         collection of blood
        smears and also to
           initiate source
       reduction activities i
         d ti        ti iti in
       each of the industrial
                 unit.


57                    Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

     Education Department

         Propagating
            p g     g
        messages for
          community
      awareness through
      school children on
      vector mosquitoes
      and d
        d diseases they
                     h
           spread.

58               Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

     Indian Medical Association

      Sensitizing the private
          practioners on
        preventive aspects
        vector mosquitoes,
                mosquitoes,
         control aspect of
            VBDs,case
           management,
           management
      treatment, drug policy
                etc.

59                  Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

     Water supply Department


      Maintenance of
      M i t          f
       water supply
       schemes and
         h         d
       prevention of
         mosquito
               i
         breeding.
60                Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

                 Integrated Strategy.

     IV.
     IV    Environmental management and addressing
           basic services such as water supply,
           disposal of used water, solid waste management and
           disposal of used tires.
           di      l f    d ti

     V.    Patient care within and outside of the health system.

     VI.   Case reporting (clinical cases, confirmed cases, DHF
           and deaths due to DHF, circulating serotypes).



61                            Dr.G.C.Sahu/ROH&FW/GoI/A'bad
What we should be doingā€¦ā€¦.

               Integrated Strategy

     I.    Integrated epidemiological and entomological
           surveillance.
           surveillance.

     II.   Advocacy and implementation of intersectoral
           actions between health, environment and
           education as well as other sectors such as
           industry and commerce for new materials
                                             materials,
           tourism, legislation and judiciary.

     III. Effective
     III Eff ti community participation.
                      it participation.
                             ti i ti
62                       Dr.G.C.Sahu/ROH&FW/GoI/A'bad
Integrated Strategy

                                      Components




63     Dr.G.C.Sahu/ROH&FW/GoI/A'Bad
Knowing is not enough; we must apply.
      Willing is not enough; we must do.
                   (G th )
                   (Goethe)
64            Dr.G.C.Sahu/ROH&FW/GoI/Ahmedabad
GOVT
         EFFORTS
      COUPLED WITH
       THE PUBLIC
     PARTICIPATIONā€¦.
     PARTICIPATIONā€¦.
        IS THE KEY.




           Acknowledgements:
           Acknowledgements:
           ā€¢NVBDCP: India
           ā€¢ NVBDCP: Gujarat
           ā€¢ NCDC: India
           ā€¢ WHO: Geneva
           ā€¢ CDC: Atlanta
           ā€¢ NEA : Singapore

                                                     ā€¦ā€¦.. THANKS
          e-mail :gcsahu61@gmail.com
65                        Dr.G.C.Sahu/ROH&FW/GoI/A'bad

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Aedes mosquito control dr.sahu

  • 1. Community Participation In y p Aedes Mosquito Control. DR.G.C.SAHU Regional Director [i/c] g [ ] ROH&FW;GoI; ROH&FW;GoI; Ahmedabad. 1
  • 2. Re-emergence of Vector Borne Diseases Uncontrolled Urbanization The unrestrained production and use of non- non-biodegradable food and drink packaging, and drums and other water storage vessels that often become larval habitats; Non- Non-existent, inconsistent, or fragmented national f t d ti l programmesā€¦in urban areas 2 Sources: Gubler, 1998; PAHO, 1997. Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 3. Re-emergence of Vector Borne Diseases Inadequate Environmental Management Insufficient waste Insufficient and collection and inadequate water management. distribution. Non-biodegradable N bi d d bl Increased number of I d b f containers. water storage containers. Improper tyre disposal. Inadequate septic system conditions. Increase in breeding sites for the vector 3 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 4. Re-emergence of Vector Borne Diseases Population Movements More than 750 million people annually Migration cross international borders. Increase in rural migration into urban areas. Ever increasing international travelers all across the globe. International tourism Continuous i C ti increase in international i i t ti l tourist arrivals in all the countries across the globe. Source: OMT data. Traffic of microorganisms 4 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 5. Growth in global air traffic 5 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 6. INCREASE IN MARITIME PASSENGER AND CARGO TRAFFIC 6 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 8. Re- Re-emergence of Vector Borne Diseases ā€“ Factors due to Climate Change Climate change Changes in transmission Ideal conditions for Ecological changes VBDs: Alteration Latitude: 350 north of ecosystems o ecosyste s 350 south Altitude: 2,200 m Socio- Socio-economic changes Temperature: 15-40 Ā°C 15- Relative humidity: Alteration of high-moderate high- Geographical distribution of pathogens and vectors Increase in vector- vector-borne diseases 8 Dr.G.C.sahu/ROH&FW/GoI/A'Bad
  • 9. Effects of Climate change on A d Mosquito Aedes M it Speed up viral incubation in mosquito Shorten mosquito breeding cycle Increase mosquito feeding frequency More efficient transmission of dengue/chikungunya dengue/chikungunya virus from mosquito to human. human 9 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 10. 10 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 11. THE EXTENT OF THE VBDs AND THE GLOBAL REACH OF AEDES MOSQUITO Q 11 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 12. Global Endemicity of Chikungunyaā€¦ā€¦.. ā€¦..and Yellow fever 12 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 13. GLOBAL REACH OF EMERGING AND RE-EMERGING DISEASES RE- 13 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 14. THE VECTORā€¦ā€¦ ā€¢ Dengue ,Chikungunya and yellow fever is transmitted by infected female Aedes mosquito ā€¢ Primarily a daytime feeder and mainly bites in the morning or late in the afternoon ā€¢ Lives around human habitation ā€¢ Lays eggs and produces larvae preferentially in artificial containers Although it may feed at any time, the mosquito's periods of peak biting activity are few hours after dawn and in the late afternoon until a few hours after dark. The mosquito's preferred breeding areas are in areas of stagnant water, such as flower vases, uncovered barrels, buckets, and discarded tires, but the most dangerous areas are wet floors, underground tanks, cement tanks and also toilet bowls, as they allow the mosquito to breed right i the il b l h ll h i b d i h in h residence. 14 Dr.G.C.Sahu/ROH&FW/GoI/Ahmedabad
  • 15. THE VECTORā€¦ā€¦ ā€¦..THE VECTOR IS AN THE AGGRESSIVE BITERā€¦AND MOSTLY BITES WITH A PAINFUL STING DURING DAY TIMEā€¦ā€¦. ā€¦ā€¦..JUST WATCH THE FEROCITY OF THE STING !!! 15 Dr.G.C.Sahu/ROH&FW/GoI/Ahmedabad
  • 16. THE VECTORā€¦ā€¦ IN HER ETERNAL CYCLEā€¦ ONE GENERATION IS BORN ROUGHLY EVERY WEEK EVERY THING IN A PLATTER !!! 16 Dr.G.C.Sahu/ROH&FW/GoI/Ahmedabad
  • 17. ā€¦ā€¦AND HER PARAPHRENALIA THE PLOT IS HATCHED ā€¦.. !!!### ALMOST UNDER WATER !!! 17 Dr.G.C.Sahu/ROH&FW/GoI/Ahmedabad
  • 18. Aedes aegypti breeding sitesā€¦ā€¦.. Mostly domestic and peri-domestic peri- 18 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 19. ā€¦ā€¦.Aedes aegypti breeding sites Mostly domestic and peri-domestic peri- 19 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 20. ā€¦ā€¦.Aedes aegypti breeding sites Urban: Both B th posh & Slums Areas. 20 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 21. Typical water containers in urban/rural set up that can be potential breeding place for Aedes mosquitoes. 21 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 22. Typical water containers in rural/urban set up that can be potential breeding place for Aedes mosquitoes. 22 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 23. The obstacles for Aedes Mosquito control. i l 23 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 24. ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control. Present- Present-day Aedes Mosquito control programs are not progressing because: Community participation in dengue prevention and control is limited to official demands and never attains community ownership; 24 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 25. ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control. Local health services, now politically and administratively responsible for the d i i t ti l ibl f th prevention and control programmes are not sufficiently established; 25 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 26. ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control. Individual and community behavioral change strategies are b h i l h t t i weak and are not incorporated into the programs; 26 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 27. ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control. Water W t supply and solid waste l d lid t management are limited in high-risk areas; high- 27 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 28. ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control. Sustainability and continuity of control actions are constantly compromised by other health demands and policies that compete with them; 28 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 29. ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control. Little capacity for intersectoral coordinationā€¦ Aedes Mosquito problem is not the h sole responsibility of the Ministry of Health. Health 29 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 30. ā€¦ā€¦ā€¦.obstacles for Aedes Mosquito control. Operational research on individual or community-based strategies have community-y g not been sufficient; 30 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 31. The Global Strategy for Mosquito/ VBD control Surveillance for planning ll f l and response Reduction of Behavioral disease burden di b d change h 31 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 32. This is what you can do to helpā€¦ d t h l 32 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 33. What we should be doingā€¦ā€¦. Maintenance of water supply systems Leakage in water supply pipe line While augmenting water supply scheme in urban areas, sewage system with sewage treatment should also be installed simultaneously in these towns for proper collection, treatment and waste water generated. generated. 33 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 34. What we should be doingā€¦ā€¦. Establishing proper drainage system Open sluice-valve chambers with leakage. sluice- leakage Municipal Corporations shall formulate an integrated approach/ programme for water supply, sewerage, drainage and solid waste management so as to keep the environment free from the risks of vector breeding / growth. g g Storm water drains should invariably be covered and maintain them properly by way of regular cleaning, de-silting etc. to prevent stagnation of water. de- etc. water. Larger storm water drains may be suitably channeled to facilitate adequate velocity for flow of waste water. water. 34 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 35. What we should be doingā€¦ā€¦. Implementation of bye laws at construction sites can take care of p y mosquito breeding. Construction sites Open overhead tanks Water stagnation in constructional areas should be prevented. Overflow of water from the water tanks (individual and community) shall be controlled through proper floating valves. Proper drainage system should be provided around all Public Stand Posts to facilitate smooth drain of used water. 35 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 36. What we should be doingā€¦ā€¦. Model Civic Byelaws: Standard design for the lids of Bad Design Overhead Tanks and Cisterns X Check nut Over flow Pipe protected with perforation Not exceed 45nm 45nm MS Plate 50 mmx Hinge 5mm 36 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 37. What we should be doingā€¦ā€¦. Elimination of intra domestic breeding sources very essential Leaking water tanks, sprinkler systems, coolers etc that cause water stagnation, should be repaired and reinstalled. 37 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 38. What we should be doingā€¦ā€¦. Elimination of intra domestic breeding sources very essential The vent pipe of septic tanks shall be covered with pp p mosquito nets so that the mosquito grown, if any, in the septic tanks may not be find way to come out. 38 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 39. What we should be doingā€¦ā€¦. Prevent Aedes mosquito from Breeding! Remove ALL sources of R f stagnant water. g Deny the mosquitoes of any chance to breed. 39 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 40. What we should be doingā€¦ā€¦. Easy Steps Steps.. ā€¢Change water in vases/ bowls b l every other d . th day day. ā€¢Add sand granular insecticide to water. 40 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 41. What we should be doingā€¦ā€¦. Easy Steps Stepsā€¦ ā€¢Remove water from flower pot plates every other d . th dayday. 41 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 42. What we should be doingā€¦ā€¦. Easy Steps Stepsā€¦. ā€¢Turn over all storage containers 42 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 43. What we should be doingā€¦ā€¦. Easy Stepsā€¦.. E St ā€¢clear blockages and put Bti insecticide in roof gutters at least once a month 43 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 44. What we should be doingā€¦ā€¦. If citizens going on a holiday or keep their houses closed for a long timeā€¦.. ā€¢Seal off all floor and ā€¢Cover all toilet bowls gully traps Leave your contact number with your neighbor so that the corporation authorities can contact you should there be a need to inspect your premises 44 urgently. Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 45. What we should be doingā€¦ā€¦. Adult vector control in urban areas. Chemical fogging shall be periodically carried out in the urban areas where there is a potential risk for the transmission of the diseases.. Proper sanitation including community toilets and drainage facilities should be provided in the slum areas. Bio- Bio-environment control shall be carried out in urban areas to control mosquito menace. 45 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 46. What we should be doingā€¦ā€¦. Promoting the use of larvae eating fishes for control of mosquito breeding. Introducing larvae eating f g g fishes Larvae eating fish Gambusia fish, which eats larva of the mosquito, shall be grown in all water bodies/ lakes/ ponds / over head tanks. 46 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 47. What we should be doingā€¦ā€¦. Creating awareness among school and college going students. Importance of vector control and vector control measure shall be inducted in the course curriculum of primary and secondary level of education for dissemination of knowledge on vector control among student community ( schools as well as colleges) h l ll ll ) 47 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 48. ELIMINATION OF AEDES AEGYPTI BREEDING SITES--- SITES--- THE INITIATIVE MOSTLY LIES WITH INDIVIDUALS/COMMUNITY 48 Dr.G.C.Sahu/ROH&FW/GoI/Ahmedabad
  • 49. What we should be doingā€¦ā€¦. Main Types of Adaptive Strategies ā€¢ Public education and awareness ā€¢ Early- Early-alert systems: impending weather extremes, heatwaves; infectious y y p g , heatwaves; disease outbreaks ā€¢ Community- Community-based neighbour-support/care schemes neighbour- ā€¢ Mosquito- Mosquito-proofed housing design ā€¦ and ā€˜coolerā€™ urban layout ā€¢ Disaster preparedness, incl. health-system ā€˜surgeā€™ capacity health- ā€¢ Enhanced infectious disease control programs ā€¢ vaccines, vector control, case detection and treatment ā€¢ Improved surveillance: ā€¢ Risk indicators (e.g. mosquito numbers, aeroallergen concentration) ā€¢ Health outcomes (e.g. inf dis outbreaks, rural suicide rates, seasonal asthma peaks) ā€¢ Rural health services, counselling and community strengthening , g y g g ā€¢ Appropriate (esp. health) workforce training, mid-career development mid- 49 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 50. What we should be doingā€¦ā€¦. Strengthening the implementation of the g g p social- social-communication component in the state/national program. Promote the behavioral change focus so that it will be more than just dissemination of information. 50 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 51. What we should be doingā€¦ā€¦. Solid Waste Management. Management. All the municipal waste should be collected from dust bins etc., and transported to the composting/land fill sites etc. p p g for treatment and disposal in order to avoid breeding of flies, mosquito etc. etc. The solid waste should be transported in covered vehicles so as to prevent littering of the waste on streets, roads etc. etc. Likewise, hospital Lik i h i l waste and bi -medical waste should b d bio bio- di l h ld be separately collected, treated and disposed in order to prevent breeding of mosquitoes, flies etc. p g q , etc. 51 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 52. What we should be doingā€¦ā€¦. Dead animals, carcasses should be removed immediately and buried under land fill sites and properly covered with soil to prevent breeding of mosquitoes and flies. flies. Public P bli awareness on environmental cleanliness i t l l li may be created through IEC and mass media. media. Under JNNURM there is provision to formulate schemes, drainage and solid waste management simultaneously and incorporate g y p the same in the City development Plan (CDP) (CDP) to make the environment free from vector menace. menace. 52 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 53. What we should be doingā€¦ā€¦. g Social- Social-Communication Component Dissemination of the behavioral change strategy. strategy. Social d S i l advocacy i fin favor of f intra- intra- and intersectoral actions to minimize environmental health problems (water and solid waste management). 53 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 54. What we should be doingā€¦ā€¦. Social- Social-Communication Component It is not a ā€œmagic bulletā€ that can g stop Aedes mosquito breeding. A person achieves behavioral changes in steps. There is a need steps. to go from one phase to another sequentially. sequentially. 54 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 55. What we should be doing doingā€¦ā€¦. 55 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 56. What we should be doing doingā€¦ā€¦. Road and Buildings Department Proper p maintenance of public buildings and roads f d d for prevention of mosquito breeding. 56 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 57. What we should be doingā€¦ā€¦. Industrial Sector Sensitizing the industrial work force and to open centers for distribution of drugs/ f g collection of blood smears and also to initiate source reduction activities i d ti ti iti in each of the industrial unit. 57 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 58. What we should be doingā€¦ā€¦. Education Department Propagating p g g messages for community awareness through school children on vector mosquitoes and d d diseases they h spread. 58 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 59. What we should be doingā€¦ā€¦. Indian Medical Association Sensitizing the private practioners on preventive aspects vector mosquitoes, mosquitoes, control aspect of VBDs,case management, management treatment, drug policy etc. 59 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 60. What we should be doingā€¦ā€¦. Water supply Department Maintenance of M i t f water supply schemes and h d prevention of mosquito i breeding. 60 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 61. What we should be doingā€¦ā€¦. Integrated Strategy. IV. IV Environmental management and addressing basic services such as water supply, disposal of used water, solid waste management and disposal of used tires. di l f d ti V. Patient care within and outside of the health system. VI. Case reporting (clinical cases, confirmed cases, DHF and deaths due to DHF, circulating serotypes). 61 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 62. What we should be doingā€¦ā€¦. Integrated Strategy I. Integrated epidemiological and entomological surveillance. surveillance. II. Advocacy and implementation of intersectoral actions between health, environment and education as well as other sectors such as industry and commerce for new materials materials, tourism, legislation and judiciary. III. Effective III Eff ti community participation. it participation. ti i ti 62 Dr.G.C.Sahu/ROH&FW/GoI/A'bad
  • 63. Integrated Strategy Components 63 Dr.G.C.Sahu/ROH&FW/GoI/A'Bad
  • 64. Knowing is not enough; we must apply. Willing is not enough; we must do. (G th ) (Goethe) 64 Dr.G.C.Sahu/ROH&FW/GoI/Ahmedabad
  • 65. GOVT EFFORTS COUPLED WITH THE PUBLIC PARTICIPATIONā€¦. PARTICIPATIONā€¦. IS THE KEY. Acknowledgements: Acknowledgements: ā€¢NVBDCP: India ā€¢ NVBDCP: Gujarat ā€¢ NCDC: India ā€¢ WHO: Geneva ā€¢ CDC: Atlanta ā€¢ NEA : Singapore ā€¦ā€¦.. THANKS e-mail :gcsahu61@gmail.com 65 Dr.G.C.Sahu/ROH&FW/GoI/A'bad