NATIONAL MALARIA CONTROL PROGRAMME

1. ANTIMALARIA CONTROL
PROGRAMME
BY
P.NISHA
M.Sc Nursing II year

2. NATIONALANTI-MALARIA PROGRAMME
 NATIONAL ANTI-MALARIA PROGRAMME
(NMCP) was launched in india in April 1953.
 It was based on indoor residual spraying with DDT ( 1 g
per sq. metre of surface area ) twice a year in endemic
areas where spleen rates were over 10 percent.
 The NMCP was in operation for 5 years (1953-58).The
results of the programme were highly successful in that
of the incidence of malaria is has declined sharply from
75 million cases in 1953 to 2 million cases in 1958, an
estimated 80 per cent reduction of malaria problem .

3. CONTD….
 According to the international standards, the programme
was divided into
a. preparatory phase
b. consolidation phase
c. maintenance phase
 The annual incidence of malaria case in India escalated
from 50,000 in 1961 to a peak of 6.4 million cases in
1976.

4. MILESTONES OF MALARIA CONTROL
PROGRAMME
1953 National Malaria Control Programme(NMCP)
1958 National Malaria Eradication Programme (NMEP)
1977 Modified Plan of Operation (MPO)
1979 Multipurpose Worker Scheme (MPW Scheme)
1995 Implementation of Malaria Action Plan-1995 (MAP-95).
1997 Launching of World Bank Assisted Enhanced Malaria Control Project in
tribal districts of the State (EMCP)
2000 National Anti Malaria programme (NAMP)
2004 National Vector Borne Disease control programme (NVBDCP)

5. MODIFIDED PLAN FOR OPERATION
1. OBJECTIVES
 The modified plan of operation under the NMEP in to
force from 1st April 1977 with the following objectives.
 To prevent death due to malaria
 To reduce malaria morbidity
 To maintain agricultural and industrial production by
undertaking intensive antimalarial measures.
 To consolidate the gains so far achieved.

6. CONTD….
2. RECLASSIFICATION OF ENDEMIC AREAS
 The report of consultative committee indicated in order
to stabilize the malaria situation in the country ,areas
with annual parasite incidence 2 and above should taken
up for spray operation .
 This led to the abolition Of the earlier phasing of
antimalaria unit as attack, consolidation and maintenance
areas and reclassification of area according to annual
parasite incidence.

7. CONTD….
3. AREAS WITH API MORE THAN 2
a. spraying –
 All areas with API and above are brought under
regular insecticidal sprays with rounds of DDT
unless vector is refractory
 when vector is refractory to DDT,3 rounds of
malathion are recommended.
 Areas refractory both to DDT and Malathion are to be
treated with 2 rounds of synthetic pyrethroids sprays
at regular intervals of 6 weeks .
 DDT,malathion and pyrethroids appled are 1.0,2.0,
and o.25 g per square meter surface respectively.

8. CONTD..
b. Entomological assessment- This is done by
entomological teams.they carry out susceptibility tests
and suggest appropriate insecticide to be used in
particular areas.
c. surveillance – The collection and examination of blood
smears is a key element of the modified plan of
operation.
d. Treatment of cases- Great emphasis on radical
treatment.

9. CONTD..
4. AREAS WITH API LESS THAN 2
a. spraying- These area will not be under
regular insecticidal spraying. however ,focal
spraying is to be undertaken only around
p.falciparum cases detected during surveillance
.
b. surveillance – Active and passive
surveillance operations will have to be carried
out vigorously every fortnight.
c. Treatment – All detected cases should
receive radical treatment as prescribed.

10. CONTD.,.
d. Follow up.- blood smear should collected
from all positive cases on completion of the
radical treatment and monthly interval for
three months.
e. Epidemiological investigation - All
malariaey positive cases are to be
investigated. This may include mass survey.

11. CONTD…
5. DRUG DISTRIBUTION CENTRES AND FEVER
TREATMENT DEPOTS
 With the increasing number of malaria cases ,the
demand for antimalarial drugs has increased.
 This led to the establishment of wide network of
drug distribution centers and fever treatment
depots
 Fever treatment depots collect the blood slides
in addition to distribution of antimalarial drugs.
 About 3.57 lakhs of such centers are functioning
all over the country in rural areas.

12. CONTD…
6. URBAN MALARIA SCHEME
 This scheme was launched in 1971 to
reduce or interrupt the malaria transmission
in town and cities .
 The urban component of NMEP,covers 181
cities and towns, including New Delhi
,Mumbai, Kolkata, and Chennai.
 It is implemented in 131 countries.

13. CONTD…
7. P.FALCIPARUM CONTAINMENT
 p.falciparum containment programme was
introduced from October 1977.
 The specific purpose of this component to
prevent or control the spread of p.
falciparum malaria.

14. CONTD..
8. RESEARCH
 Six monitoring teams are now working in
different parts of country to identify the
p.falciparum sensitivity to cholroquine.
 Studies by the Indian council of medical
research have revealed.chloroquine
resistance foci in several states.

15. CONTD..
9. HEALTH EDUCATION
 Health education of the public to enlist their
cooperation in malaria control activities.
10. REORGANIZATION
 Laboratory services are decentralized to
minimize the time lag between collection of
blood smears and their examination.
 Epidemiological teams have been attached to
all the 72 zones in the country.

16. SURVEILLANCE
A) Active surveillance
1.This is carried out by the workers known as “Surveillance workers
“ who are n now replaced by the multipurpose workers
2.one surveillance workers for 8000 population and one surveillance
inspectors for 32,0000 population.
3. The surveillance workers will visit each house once a fortnight and
enquire
a. Whether fever cases in the houses including guest or
visitors in the house
b. fever cases in between the previous visit and present
visits.
4. The surveillance workers collects a blood film and administer a
single dose 600 mg of chloroquine drug according to NMEP
schedule .This is known as presumptive treatment.

17. CONTD…
B. Passive surveillance
 The search for the malaria cases by the health
agencies such as sub centres , primary health
centres, Hospitals ,dispenseries and local
medical practitioners is known as passive
surveillance.
 The passive agencies collect the blood smear
from all the fever cases and single dose of
treatment for malaria is administered.
.

18. CONTD…
Parameters of malaria surveillance
 Annual parasite incidence rate(API)
 Annual blood examination rate (ABER)
 Annual falciparum incidence(AFI)
 Slide positive rate (SPR)
 Slide falciparum rate (SFR)

19. MALARIA CONTROL THROUGH PRIMARY HEALTH
CENTRES
 A new approach to malaria control was
approved by WHO in 1978.implementation of
malaria context in primary health centers.
 This is because many of the malaria control
activities are carried it by peripheral centers
 The voluntary health workers in the local
community was selected for supplies of
drugs and to collect blood smear for fever
cases.

20. ENHANCED MALARIA CONTROL PROJECT.
 The anti- malaria activities have been intensified
with input of 100 cities. The total project cost is
about Rs 891 crores for 5 years.
The selection of PHC was based on following criteria
 The annual parasite incidence is more than 2 years
for past 3 years.
 The p. falciparum cases being more than 30
percent of malaria cases.
 20 per cent of population PHC is tribal people
 Reported death due to malaria from the PHC

21. COMPONENTS UNDER THE MALARIA PROJECT.
 Early detection of cases and treatment
 Selective vector control and personal protective
methods including insecticide and treated mosquito
nets.
 Epidemic planning and rapid response.
 Intersectoral coordination and strengthening
institution.
 Use of lavivorous fish.

22. NATIONAL ANTI MALARIA PROGRAMME
In 1999 Government of India decided to drop the national
malaria eradication programme and renamed as National
malaria eradication programme.
The present strategies for prevention and control of malaria
are .
 Early case detection and prompt treatment.
 Integrated vector management –residual spraying in
selected areas .the bed nets are provided for free of costs .
The priority benef.
 Use of lavivorous fish is being promoted in local water
bodies in selected urban and rural areas.
 Epidemic preparedness and epidemic control measures.
 ICE activities in creating awareness.

23. URBAN MALARIA SCHEME
 Control of urban malaria primarily implementation of civil by
laws to prevent mosquito breeding in the domestic and pre
domestic areas.. This scheme is presently protecting the
96.7 million from malaria and other mosquito borne disease
.

24. ANTI MALARIA MONTH CAMPAIGN
 Anti malaria month is observed in every year in the month if June
in every country prior to monsoon and transmission season .
 Enhancing the level of awareness and community participation
through mass media campaign interpersonal communication with
other department and voluntary agencies.

25. PRESUMPTIVE TREATMENT
Age group Chloroquine tablets
Below 1 year 75 mg (1/2 tablet)
1 to 4 years 150 mg (1 tablet)
5 to 8 years 300 mg (2 tablets)
9 to 14 years 450 mg (3 tablets)
Above 15 years 600 mg (4 tablets)