Action Plan and Measures taken to eliminate diseases

Ministry of Health and Family Welfare
Ministry of Health and Family Welfare

Minister of State (Health and Family Welfare), Shri Ashwini Kumar Choubey has informed that The target year set by the Government to eliminate following diseases

Kala-azar- Kala-azar is targeted for elimination by 2017 i.e. 1 case per 10,000 population at block level.  As of 2016, 85% of the endemic blocks have achieved elimination target.

Leprosy:- Elimination of Leprosy i.e., 1 case/ 10000 population at national level was already achieved in the year 2005.  The short term target is reduction of Grade II disability cases to less than one million population, as per WHO document on Global Leprosy Strategy, 2016 – 2020.

Measles:- Ministry of Health and Family Welfare has accepted the recommendation of Mission Steering Group for wide age group measles and rubella (MR) campaign covering children in the age group of 9 months to less than 15 years followed by introduction of measles rubella vaccine in routine immunization to further reduce morbidity and mortality due to measles and rubella.

As on 18th December 2017, more than 6.5 crore children have been vaccinated with MR vaccine in 13 States/UTs, namely, Andhra Pradesh, Chandigarh, Dadra & Nagar Haveli, Daman & Diu, Goa, Himachal Pradesh, Karnataka, Kerala, Lakshadweep, Puducherry, Tamil Nadu, Telangana and  Uttarakhand.

The target year set by the Government to eliminate following diseases are as under:-

    Diseases                                 Target Year of Elimination

  1. Kala-azar:                           2017
  2. Leprosy:                             2018
  3. Measles:                             2020
  4. Tuberculosis:                      2025

Tuberculosis As per the Global TB Report 2017, the incidence of TB has reduced from 217 per lakh per year in 2015 to 211 per lakh per year in 2016 and mortality has reduced from 36 per lakh per year in 2015 to 32 per lakh per year in 2016.

 Number of cases reported State/UT wise during the last three years in respect of Kala Azar, Leprosy, Measles and Tuberculosis are given below:

 

State/UT-wise Kala-Azar cases during the last three years

Sl.No. State 2014 2015 2016
1. Bihar 7615 6517 4773
2. Jharkhand 937 1262 1185
3. West Bengal 668 576 179
4. Uttar Pradesh 11 131 107
Total * 9241 8500 6249

* 10, 14, and 5 sporadic cases have been reported from other states during 2014, 2015 and 2016 respectively

 

State/UT-wise new Leprosy cases detected during the last three years

S. No. State/ UT No. of new cases detected
2014-15 2015-16 2016-17
1 Andhra Pradesh 4687 4355 4228
2 Arunachal Pradesh 32 33 28
3 Assam 856 781 1019
4 Bihar 16848 16185 21818
5 Chhattisgarh 8847 10440 12609
6 Goa 55 136 130
7 Gujarat 9024 10138 7266
8 Haryana 635 672 491
9 Himachal Pradesh 176 162 146
10 Jharkhand 4873 4432 6253
11 Jammu & Kashmir 159 189 143
12 Karnataka 3314 3065 2897
13 Kerala 663 574 496
14 Madhya Pradesh 6921 6597 7152
15 Maharashtra 16415 15695 15012
16 Manipur 17 19 20
17 Meghalaya 25 33 33
18 Mizoram 11 9 6
19 Nagaland 42 67 34
20 Odisha 8004 10174 10045
21 Punjab 620 651 626
22 Rajasthan 1060 1106 1042
23 Sikkim 13 21 23
24 Tamil Nadu 3604 4925 4937
25 Telangana 2905 2800 2658
26 Tripura 47 42 34
27 Uttar Pradesh 22223 22777 22301
28 Uttarakhand 532 382 375
29 West Bengal 10315 8170 11236
30 A & N Islands 25 29 18
31 Chandigarh 173 136 128
32 D & N Haveli 318 425 384
33 Daman & Diu 21 4 7
34 Delhi 2280 2068 1812
35 Lakshadweep 4 0 45
36 Puducherry 41 42 33
Total 125785 127334 135485

 

State/UT-wise Measles cases during the last three years

S.No States/UTs 2014 2015 2016
1 Andaman & Nicobar Islands 37 31 25
2 Andhra Pradesh 281 44 115
3 Arunachal Pradesh 35 17 365
4 Assam 507 1225 1382
5 Bihar 141 339 370
6 Chandigarh 4 105 78
7 Chhattisgarh 7 32 62
8 Dadra & Nagar Haveli 78 142 51
9 Daman & Diu 14 0 0
10 Delhi 1875 1083 1460
11 Goa 72 28 14
12 Gujarat 823 790 940
13 Haryana 155 262 348
14 Himachal Pradesh 267 928 461
15 Jammu & Kashmir 2840 2148 2071
16 Jharkhand 1019 1299 432
17 Karnataka 1116 1182 524
18 Kerala 1257 1782 1425
19 Lakshadweep 0 0 0
20 Madhya Pradesh 352 809 500
21 Maharashtra 2030 1888 1988
22 Manipur 232 419 314
23 Meghalaya 228 266 1010
24 Mizoram 123 759 654
25 Nagaland 319 98 95
26 Odisha 583 808 581
27 Puducherry 27 13 6
28 Punjab 1 32 16
29 Rajasthan 294 1407 592
30 Sikkim 102 802 278
31 Tamil Nadu 499 405 251
32 Telangana* 83 91
33 Tripura 452 702 174
34 Uttar Pradesh 298 1801 1525
35 Uttarakhand 382 311 272
36 West Bengal 3777 3521 3227
Total 20227 25561 21697

Source: Central Bureau of Health Intelligence, National Health Profile reports

Statewise Case Notification of TB for India

S No State/UTs 2014 2015 2016
1 Andaman & Nicobar 756 584 509
2 Andhra Pradesh 88638 61758 64420
3 Arunachal Pradesh 2691 2748 2758
4 Assam 38317 38014 36724
5 Bihar 67991 64928 59020
6 Chandigarh 2869 3143 2980
7 Chhattisgarh 28864 29950 30821
8 Dadar& Nagar Haveli 450 487 510
9 Daman & Diu 279 284 368
10 Delhi 54037 55260 55657
11 Goa 1660 1599 1576
12 Gujarat 77395 82585 89293
13 Haryana 39498 40913 41389
14 Himachal Pradesh 14441 14333 14070
15 Jammu & Kashmir 10243 9873 9244
16 Jharkhand 35907 34792 35130
17 Karnataka 61328 59932 59732
18 Kerala 23439 22785 20969
19 Lakshadweep 27 40 23
20 Madhya Pradesh 100034 103108 113172
21 Maharashtra 135465 130874 122172
22 Manipur 2198 1881 1768
23 Meghalaya 4944 4674 3934
24 Mizoram 1993 2088 2162
25 Nagaland 3298 3316 2274
26 Orissa 45777 45814 41807
27 Pondicherry 1409 1288 1415
28 Punjab 38152 38625 37093
29 Rajasthan 94908 90296 90032
30 Sikkim 1630 1400 1463
31 Tamil Nadu 84570 80543 82107
32 Telangana 18655 39498 38829
33 Tripura 2507 7394 2344
34 Uttar Pradesh 255364 246589 260572
35 Uttarakhand 14429 14317 13255
36 West Bengal 89819 87468 85179
TOTAL 1443942 1423181 1424771

Kala-azar:-

  • Intensification of surveillance activities for early identification of cases & prompt treatment.
  • Active case searches in all endemic villages.
  • Intensified IEC/BCC activities
  • IRS spray with  Synthetic Pyrethroid  on regular basis and focal spray as per guideline.
  • Hand Compression Pumps for quality spray introduced in 2015 in Kala-azar districts of endemic States.
  • Treatment with single day single dose Ambisome Injection to Kala-azar patient.
  • Incentive to patients for loss of wages.
  • Incentive to ASHAs.
  • The States fill up the vacant positions.

Leprosy:-

(i)                 implementation of routine activities and all innovations introduced during 2016-17 viz. three pronged strategy for early case detection i.e., i) Leprosy Case Detection Campaign (LCDC) (specific for high endemic districts), ii) Focussed Leprosy Campaign (for hot spots i.e., rural and urban areas where Grade II disability is detected), iii) Special plan for hard to reach areas.

(ii)               Sparsh Leprosy Awareness Campaign for awareness, Grade II disability case investigation,

(iii)             Post Exposure chemoprophylaxis administration to the contacts of cases detected in LCDC districts etc.

(iv)             ASHA based Surveillance for Leprosy Suspects (ABSULS) has been introduced during 2017-18 to enhance early case reporting.

 Measels:-

The following measures have been taken  to achieve the target of measles elimination by 2020:

  • Government of India introduced measles vaccine across the country in 1985 under the Universal Immunization Programme (UIP). To further reduce the measles burden, a second dose of measles vaccine was introduced in the country in the year 2010.
  • With an aim to increase the full immunization coverage to 90% by December 2018 including improving measles vaccine coverage particularly in pockets with low immunization coverage, the Ministry of Health and Family Welfare has launched Intensified Mission Indradhanush on 8th October 2017. The Intensified Mission Indradhanush is being carried out in 173 districts and 17 urban areas across 24 states of the country and three rounds (Oct, Nov and Dec) have been completed since the launch.
  • An India Expert Advisory Group on Measles & Rubella (IEAG-MR) has been established, comprising national and international experts, to provide technical guidance on the disease elimination efforts from time to time. The group has met twice since its formulation.

Tuberculosis:

The National Strategic Plan (NSP) for elimination of Tuberculosis (2017-25) has been formulated by the Ministry of Health and Family Welfare.

In addition to the existing strategies under Revised National Tuberculosis Control Programme (RNTCP), the NSP focusses on:

  • early diagnosis of all the TB patients, prompt treatment with quality assured drugs and treatment regimens
  • suitable patient support systems to promote adherence.
  • engaging with the patients seeking care in the private sector.
  • prevention strategies including active case finding and
  • contact tracing in high risk / vulnerable population
  • airborne infection control.

 

Under the National Health Mission (NHM), financial and technical support is provided to the States/UTs to strengthen their health-care system based on the requirements posed by the States/UTs in their Program Implementation Plans. Vacancies in the State are filled by respective State/District Health Societies under NHM. Regular follow up is done with the States to ensure that the vacant positions are filled up.

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