Sandfly survey in Nainital and Almora districts of Uttaranchal with particular reference to Phlebotomus argentipes, vector of kala-azar.

Kala-azar continues to pose a major public health problem in Bihar, West Bengal and parts of eastern Uttar Pradesh in India causing great deal of morbidity and mortality. During 1998, several kala-azar cases from Sub-Himalayan region were treated in Delhi hospitals. And a suspected focus of kala-azar was subsequently reported from this area. Therefore a preliminary sandfly survey was carried out during October, 1999 in 18 randomly selected villages at different altitudes in Nainital & Almora districts of Kumaon region Uttaranchal. The surveys revealed relative preponderance of vector sandfly Ph. argentipes as 77%; mainly confined to cattlesheds and mixed dwellings in the villages at an altitude ranging from 350-960 metres main sea level. The other sandfly species encountered were: Ph. papatasi 6.9%, Ph. major 2.9% and 13.2% Sergentomyia spp. 17.4% Ph. argentipes reacted positive with human antisera and 82.6% with bovine but none reacted with goat, pig dog and bird antisera indicating that Ph. argentipes in the area is mainly zoophilic. Ph. argentipes was found to be highly susceptible to DDT; mortality ranging from 98-100%.

Impact assessment of IEC campaign during anti-malaria month, June 1998 through KABP study.

To assess the IEC Campaign during anti malaria month (June, 98), a base line KABP study through pre-assessment and post-assessment was conducted in the State of Gujarat (four districts namely Ahmedabad, Dang, Panchmahal and Baroda). The study was carried out based on questionnaire (open and closed) developed by NAMP in the randomly selected population. A rapid assessment of the current level of KABP among a sample of population before and after the observance of anti-malaria month. The results of the KABP study revealed that there is definite impact (between 2.18 to 30%) and change in the KABP of the local people, where intensive and continuous I.E.C. activities are being undertaken. In order to achieve the desired change in knowledge, attitude, behaviour and practice of the respondents, it requires continuous I.E.C. campaign throughout the year. The attitude, behaviour and practice in the hard core areas need special efforts, where maximum efforts are required to bring a change in. It should be taken more intensively in the problematic and hardcore areas on priority basis.

Cost of mass annual single dose diethylcarbamazine distribution for the large scale control of lymphatic filariasis.

Economic analysis of the revised strategy to control lymphatic filariasis with mass annual single dose diethylcarbamazine (DEC) at 6 mg/kg body weight launched in one of the districts of Tamil Nadu in 1996 was carried out. This exploratory study, proposed for five years in 13 districts under 7 states on a pilot scale through the Department of Public Health is an additional input of the existing National Filaria Control Programme in India. A retrospective costing exercise was undertaken systematically from the provider's perspective following the completion of the first round of drug distribution. The major activities and cost components were identified and itemized cost menu was prepared to estimate the direct (financial) and indirect (opportunity) cost related to the implementation of the Programme. The total financial cost of this Programme to cover 22.7 lakh population in the district was Rs. 22.05 lakhs. The opportunity cost of labour and capital investment was calculated to be Rs. 7.98 lakhs. The total per capita cost was Rs. 1.32, with Rs. 0.97 and Rs. 0.35 as financial and opportunity cost respectively. Based on these estimates, the implementation cost of the Programme at Primary Health Centre (PHC) level was calculated and projected for five years. The additional financial cost for the existing health care system is estimated to be Rs. 27,800 per PHC every year. DEC tablets (50 mg) was the major cost component and sensitivity analysis showed that the cost of the Programme could be minimized by 20 per cent by switching over to 100 mg tablets. The analysis indicates that this Programme is a low-cost option and the results are discussed in view of its operational feasibility and epidemiological impact.

'Anti-malaria month'--a step forward in multisectoral collaboration and community involvement in malaria control.

For a long time malaria control in India has largely been a government responsibility with little involvement of the community at large, and other sectors of the economy in the control efforts. There is now increasing realisation that involvement of the community and a multi-sectoral approach should be essential components of the malaria control strategy. The National Malaria Eradication Programme is accordingly laying greater emphasis on coordination with other sectors of the economy, and changing community perceptions and health-related behaviour. A massive programme of community mobilisation with this objective in view has been taken up since 1997. A major component of this community mobilisation programme is the observance of an 'Anti-Malaria Month', during which, country wide awareness campaigns are undertaken at all levels of implementation, to promote inter-sectoral collaboration and community action for malaria control. The present paper summarises the rationale and messages of the 'Anti-Malaria month'.

Effect of DDT on Phlebotomus sandflies in Kala-Azar endemic foci in West Bengal.

Phlebotomous argentipes, the vector of Kala-azar was found susceptible to DDT and found to reappear in the nine months after one time DDT spray at the rate of lg/m2 in three endemic foci of districts North and South 24-Parganas of West Bengal. Ph. papatasi, the other predominant species found resistant to DDT appeared within one month of DDT spray.

Visceral leishmaniasis control in India through primary health care system--a successful experiment of district level planning.

A model district action plan for control of Visceral Leishmaniasis a serious public health problem in north-east Bihar was developed in late 1989 and implemented in 1992 in district Vaishali. A two years implementation resulted in decline in cases and deaths due to Visceral Leishmaniasis to the extent of 65.32% and 46.51% respectively in 1993 as compared to 1992 and 41.13% and 44.93% respectively in 1994 as compared to 1993 with an overall decrease of 79.58% in case and 70.54% in deaths in 1994 as compared to 1992. The implementation of action plan not only established declining trends in morbidity and mortality due to Visceral Leishmaniasis in the district but also successfully contained the cases unresponsive to first line treatment with Sodium Stibogluconate by reducing the prevalence of such cases from 12.42% in 1992 to 8.59% in 1994. Various components of the action plan, implementation strategy and consequent impact on disease situation are presented in this paper.

Susceptibility status of Phlebotomus argentipes to DDT in some kala-azar endemic areas of Bihar (India).

Susceptibility status of wild Ph. argentipes of Patna, Bhojpur and Samastipur districts (Bihar) were tested against 4 per cent DDT, following the standard WHO technique with WHO test kits. Ph. argentipes from Samastipur district had become tolerance to DDT, LT50 being 1.28 h. Ph. argentipes from Patna and Bhojpur districts were however found susceptible to DDT.