Role of Long Lasting Insecticide

Treated Nets usage and Indoor

Residual Spray coverage in higher
malaria burden in the tribal villages
of Dhalai District, Tripura India 2016
Dr Sanjoy Biswas
MPH Scholar,8th cohort
Roll No 030802
ICMR-SPH,NIE ,Chennai,India

Background on the problem

Globally 214 million people suffer from malaria with 4,38,
000 deaths per year (2015)*
India contributes to 61 per cent of malaria cases and 41
per cent of malaria deaths in SEAR countries**
About 0.9% of the total population suffer from malaria
annually in the state of Tripura resulting economic loss to
the nation (2015)***
Annually 3.3 % of the population in tribal villages in Dhalai
District ,Tripura suffer form malaria(2015)#
From 20th Nov 2015 to Feb 2016 administrative coverage
LLIN is 100% (13990 Nos LLINs)$
DDT spray coverage in Dhalai District is 80% in 2015@
*WHO fact sheet, World malaria report 2015, ** Indian J Med Res 141, May 2015, pp 537545,*** NVBDCP Tripura 2015, #,$,@ NVBDCP report of Dhalai District 2015

Spelling out the local

public health problem
Annual Parasite Incidence of Malaria is
much higher(32.7) amongst the
inhabitants of tribal villages of Dhalai
of Tripura, India in 2015

Estimating the public health importance

Burden estimates
63149 suspected malaria cases with 9431 confirmed
malaria cases in tribal villages (VC) during 2015
13 deaths due to malaria during 2015
Out of 8 Blocks Chawmanu, Ganganagar, Manu,
Damburnagar, and Ambassa, Blocks shows high API.
About 3000 cases are the adult folk suffer from
malaria resulting INR 3.5 million direct wages loss of
the community with many fold invisible economic loss
of the community and country as well
Point to the effective interventions that may be done:
Early detection and complete treatment, vector control,
specific protection and supervision and monitoring

4. Analyze the problem

Indirect

Health
problem

Direct
Determinants contributing contributing
- factors
factors
level I
Density
source

Vector

:Consequence
Morbidity
Mortality
Economic loss

Malaria
in
tribal
villages

Possible intervention 1
-EDCT
-Source reduction
-Ensuring compliance
-Proper supervision
-IEC/BBC

EDCT

Climatic diversity
Typical Geography

<livelihood>
Service Utilization
inaccessibility

LLIN coverage &

Availability
Stock
Utilization
Coverage
IRS coverage
Awareness
Possible intervention 2
-Quality IRS
Possible intervention 3
-Providers motivation
-Alternative livelihood
-Early Detection ,complete -Inventory control
treatment
-Better communication
-LLINSupply and utilization -awareness programme

Mapping out completed, ongoing,

planned and possible interventions

Describing interventions
Completed:
Training of the MO, ANM/ MPWs/ ASHA (2015)
LLIN distribution, impregnation(2015)
DDT Spray(2015)
Ongoing:
Early Detection & Complete Treatment
LLIN Fortnight Campaign
Special health camp
Surveillance
IEC- BCC activities
Planned: Training, IEC- BCC activities, Surveillance, impregnation, border areas
programme, convergence

Describing the status of these interventions

Input- Resource including HR, process- Training/surveillance, output- cases
detected for malaria and complete treatment, Regrouping of tribal population
with improved communication & quality IRS outcome- morbidity and mortality
reduced

Identifying the information that is

missing to prevent more effectively
Summarizing what is already established

Peak incidence of malaria in June July every year consistent with Anopheles minimus and
An. dirus*
A combination of the monthly maximum temperature in the range 14 to 29C and relative
humidity in the range 55% to 80% provides suitable conditions for malaria transmission **
Deforestation influences increased malaria incidence***
Early Detection & Complete Treatment important strategy of NVBDCP

Summarizing the unknown

Information about complete treatment
Socio-economic up-gradation of the tribal community
Behavioural practices of the tribal community

*Malaria transmission in Tripura: disease distribution & determinants, Indian J Med Res . 2015 Dec; 142(Suppl 1): S12
S22,**Meteorological variables and malaria cases based on 12 years data analysis in Dehradun (Uttarakhand) India ,***A
longitudinal study of malaria associated with deforestation in Sonitpur district of Assam, India, Geocarto International
27(1):79-88February 2012

7. Spell out the research question

How much is the contribution of the usage of long Lasting
Insecticide Treated Nets and DDT spray coverage in
occurrence of malaria among the population of tribal
villages of two blocks under Dhalai district of Tripura, India
in 2015?

8. Write the objectives of the study

Primary objective:
To determine the coverage & utilization of Long Lasting Insecticide Treated
Nets in Chowmanu and Ganganagar Block under Dhalai District of Tripura
State India in 2016

Secondary Objective:
1) To determine the factors associated with usage of the Long Lasting Mosquito
Nets in Chowmanu & Ganganagar Block under Dhalai District of Tripura,India
in 2015
2) To estimate the coverage of DDT spray in Chowmanu & Ganganagar Block
under Dhalai District of Tripura ,India in 2015

9. Anticipate future benefit

The study will specifically light the
community based effective measures /
interventions to be taken to reduce the
burden of malaria tribal community thus
reduction in the burden of malaria