- Through Drug Distribution Centers (DDCs)
About 66000 Drug Distribution Centers are established in Grampanchayats, Aanganwadi and Primary Schools at village level Chloroquine 150 mg. tablets are being distributed to fever cases coming to them without obtaining Blood Smears through these Depot holders.
- Through Fever Treatment Depots (FTDs)
1500 Fever treatment Depots are established only in tribal districts of the State. Chloroquine 150 mg. tablets are being distributed to fever cases coming to them with obtaining Blood Smears through these Depot holders.
- Through Malaria Clinics
Malaria Clinics are established in the State in hospitals & Primary Health Centers where Laboratory Technicians are posted. At present, 1028 Malaria Clinics are functioning in the State at various level.
At these clinics, blood smears are collected from fever cases coming for treatment. Presumptive treatment is administered after collection of Blood smears. These Blood Smears are examined immediately on priority.
Vector Control measures
Indoor Residual Spraying Since 1999, State has stopped the use of DDT due to development of resistance in vector species. Synthetic Pyrethroid has been introduced for IRS since 1995–96 in Maharashtra State.
Indoor Residual Spraying (IRS) is being carried out in identified High Risk villages i.e. in Rural area.
Two regular rounds of IRS are being carried out every year during transmission season.
Focal spraying is also being carried out in outbreak areas.
Anti Larval spraying: Weekly spraying of larvicides (Temephos, Fenthion, MLO, BTI etc.) on mosquito breeding places is being carried out in urban areas.
Mosquito Control – Source Reduction
Source reduction involves preventing development of mosquito larvae. The female anopheles mosquito lays eggs in collections of clean water. Each female anopheles mosquito lays millions of eggs in its lifetime of 4–8 weeks. The eggs hatch into larvae which then develop into pupae and adults in a span of 7–10 days. The best method of mosquito control is preventing the development of the eggs into adult mosquitoes. These anti larval measures are not only simple and cost effective, but also environment friendly.
Urban malaria scheme (UMS)
Is being implemented in selected 15 towns of the State. viz. Mumbai, Nasik, Manmad, Dhule, Jalgaon,Bhusawal, Ahmednagar, Pune, Pandharpur, Solapur, Aurangabad, Parbhani, Beed, Nanded, Akola.
Anti larval measures are the mainstay in malaria control and include the following
a. Preventing egg laying: The easiest, cheapest and most environment–friendly meathod to control malaria is by preventing the mosquito from laying eggs. This is done by avoiding or eliminating the clean water collections. Most such collections are artificial, temporary and man made.
It is common habit to throw the unutilized utensils, buckets, bottles, tyres, tender coconut shells etc. into the open. During the rains, water gets collected in these containers and provides ample breeding locations for the female anopheles mosquito.
|Tender Coconut shells
In the cities, the other sites for mosquito breeding are the water tanks. Shortage of water supply in large cities makes it necessary to have these tanks in virtually every building. Overhead tanks, sump tanks, storage tanks, ornamental tanks etc. are often left uncovered and this provides scope for mosquito breeding.
There is abundant scope for water collection in and around the construction sites: water stored in tanks; the layer of water on the surface of the cement concrete (used for ‘Curing’ the concrete and left as such for 3 weeks); puddles of water in and around the place of construction – all these provide scope for mosquito breeding. To add to the problem, construction workers tend to harbour the malarial parasite, due to frequent infections owing to their poor standards of living. Thus, construction sites not only provide for mosquito breeding but also supply the parasites. This is the reason why malaria tends to be more common in cities where construction activities are in full swing.
The older houses have tiled roofs that are sloping. This helps easy drainage of water during rains, thus minimising water logging. In the recent years, most new constructions have concrete roofs and terraces that tend to be flat and non–sloping. These roofs/terraces may not have proper drains for water–flow. As a result, water tends to collect on these rooftops during the rains and this provides ample scope for mosquito breeding.
In addition, there are the natural collections of water like the wells, lakes, ponds, paddy fields, marshlands etc. where mosquito breeding occurs in abundance.
Therefore, unless these breeding sites (most of which are man–made and temporary) are taken care of, it is impossible to control mosquito breeding and hence malaria. And it is impossible to achieve this without the participation of the general public. Education of the people is thus very important for any meaningful action. The following measures are called for to minimize mosquito breeding and these measures require only a trifle of human efforts:
Do not throw utensils, vessels, buckets, tyres, bottles, tender coconut shells etc. in the open. They should be either destroyed or buried or at least kept inverted so that water cannot collect in them. All such things should be cleared during the rainy season.
All tanks should be kept tightly closed. A black plastic sheet can be used for the purpose. Also, all tanks should be emptied, cleaned and allowed to dry for at least half an hour, once every week.
Terraces and roofs should ideally have a slope, particularly in places where monsoon tends to be heavy. All such roofs/terraces should have adequate drainage for water. Any collection of water on these surfaces should be cleared at least once a week.
At construction sites, all the care should be taken to avoid collection of water at one place for more than a week. The layer of water on the surface of the concrete, used for concrete curing, should be cleared at least once a week and allowed to dry for half an hour. All other puddles should be cleared regularly. Collections of water in the toilets and closets under construction should also be cleared. All tanks should be kept snugly closed. All labourers should be frequently checked for parasitemia and adequately treated. They should also be provided with mosquito nets.
All unused wells and tanks should be closed or destroyed. Engine oil or kerosene has been used as a larvicidal on these collections. Another method to prevent egg laying on unused wells is by adding EPS polyesterene beads onto the surface of water. These beads are non–toxic, cheap and long lasting. They coat the water surface and prevent the mosquito from laying eggs.
Wells that are being used and ornamental tanks can be treated with biological larvicides that do not harm the quality of drinking water. Also, these wells should be covered with either mosquito–proof nets or with plastic sheets.