Malaria, Vector-Borne and Communicable Disease Control
The highest-yield technical domain: malaria first, then dengue, chikungunya, Japanese encephalitis, kala-azar and filariasis. India runs these under the National Vector Borne Disease Control Programme, now the National Centre for Vector Borne Diseases Control, which observes June as Anti-Malaria Month.
Vectors and control
- Malaria: female Anopheles. An. culicifacies in rural plains, An. stephensi in urban settings and wells, An. fluviatilis in foothills, An. sundaicus in brackish coastal water.
- Dengue, chikungunya, Zika: Aedes aegypti, a day-biter breeding in clean stored water and containers.
- Japanese encephalitis: Culex; filariasis: Culex quinquefasciatus; kala-azar: sandfly Phlebotomus argentipes.
- Control: source reduction, anti-larval measures, indoor residual spray, long-lasting insecticidal nets, larvivorous fish such as Gambusia, and epidemic preparedness.
Worked example
A slide-confirmed P. falciparum case with no danger signs is reported from a village. Reasoning: falciparum is treated with artemisinin-based combination therapy - artesunate plus sulfadoxine-pyrimethamine - for three days, with a single primaquine dose as gametocytocide (avoided in pregnancy and infancy). Vivax gets chloroquine for three days plus primaquine for 14 days. Any danger sign, severe anaemia or pregnancy changes the pathway to referral and parenteral therapy. Simultaneously, the locality gets active case detection and anti-larval work.
Traps that cost marks
- Giving 14-day primaquine for falciparum - that is the vivax regimen.
- Naming Aedes as the malaria vector.
- Forgetting that Aedes bites by day, so night nets give little protection against dengue.
- Mixing up the kala-azar vector with a mosquito.