Level of monitoring	Person responsible for monitoring	Way of monitoring
Sub center	MPW (M&F)	No. of RDK used & balance No. of Positive case found No. of tablet used & No. of B. S. Collection
PHC	Health Supervisor	Do

Medical Check Gate

There is emergence of malaria in new areas due to migration of people from endemic to non- endemic areas and vise versa. Malaria check gates were established in Dhubri district of Assam bordering Garo hills of Meghalaya state during 2007 transmission. The following check gates are identified for the year 2008.

Sl No	District of Assam	State bordering Assam	No. of check gates
1	Dhubri	Meghalaya	5
2	Goalpara	Meghalaya	2
3	Lakhimpur	Arunachal	3

Malaria Technical Supervisor (MTS)

Under the new initiative in the GFATM fund by GOI, appointments of 32 numbers of MTS are in process and will be placed in the malaria high risk PHCs. The proposed sites of engagement of MTS in the districts are as follows

Sl No	District	HQ of MTS ( PHC )
1	Barpeta	Nagaon
2	Baska	Masalpur
3	Bongaigaon	Srijangram
4	Chirang	Ballamguri
5	Cachar	Lakhipur
6	Darrang	Jaljali
7	Dhemaji	Sisibargaon
8	Dhubri	South Salmara
9	Dibrugarh	Panitola
10	Goalpara	Mornoi , Lakhipur
11	Golaghat	Bokakhat, Sarupathar
12	Hailakandi	Katlichara
13	Jorhat	Baghchung
14	Kamrup(R)	Boko
15	Kamrup (M)	0
16	K- Anglong	Donkamokam, Bokajan
17	Karimganj	Patharkandi
18	Kokrajhar	Balajan
19	Lakhimpur	Dholpur, Boginadi
20	Morigaon	Jhargaon
21	Nagaon	Simanabasti, Lanka
22	Nalbari	Mukalmuah
23	N C Hills	Dayangmukh
24	Sibsagar	Galeki
25	Sonitpur	Dhekiajuli, Gohpur
26	Tinsukia	Nasadia
27	Udalguri	Udalguri
	Total	32

Proposal for engagement of MPW (M) vide GOI letter No. 6-30/07-08/ NVBDCP(P&C) Annual Action Plan - 2008 dated 24-01-2008

SL No	DISTRICT	MPW (M)	Distribution of MPW (M) in Malaria High Endemic PHCs.
1	BARPETA	6	Barpeta Road - 2, Bhabanipur - 2, Kalgachia - 1, Nagaon - 1
2	Baksa	18	Tamulpur - 4, Massalpur - 4, Golagaon - 4, Jalah - 3, Niz-Kaowrbaha - 3
3	BONGAIGAON	9	Bongaigaon - 3, Boitamari - 3, Manikpur - 3
4	CACHAR	12	Lakhipur - 3, Harinagar - 3, Bikrampur - 3, Barkhola - 3
5	Chirang	6	Ballamguri - 3, Sidli - 3
6	DARRANG	6	Patharighat - 3, Kharupetia - 3
7	DHEMAJI	16	Jonai - 4, Sisibargaon - 4, Gogamukh - 4, Dhemaji - 4
8	DHUBRI	18	Dharamsala - 3, Chapar - 3, Gazarikandi - 3, golokganj - 3, Raniganj - 3, South Salmara - 3
9	DIBRUGARH	6	Khowang - 3, Nahorani - 3
10	GOALPARA	15	Agia - 3, Rongjuli - 3, Matia - 3, Lakhipur - 3, Mornoi - 3
11	GOLAGHAT	18	K.B.Ali - 5, Bokakhat - 5, Sarupathar - 4, Charingia - 4,
12	HAILAKANDI	16	Hailakandi - 4, Algapur - 4, Lala - 4, Katlicherra - 4
13	JORHAT	15	Bagsung - 5, Titabar - 5, Nakachari -5
14	KAMRUP	20	Boko - 4, Chaygaon - 4, Azara - 4, Nagar bera - 4, Bihdia - 4
15	Kamrup(M)	6	Sonapur - 6,
16	K -ANGLONG	33	Chowkihola - 3, Bokajan - 3, Manja - 3, Dhansiri - 3, Howraghat - 3, Langhing - 3, Dengaon - 3, Donkamokam - 3, Boithalanso - 3, Umpani - 3, Zirikinding - 3
17	KARIMGANJ	9	R.K.Nagar - 3, Patharikandi - 3, Nilambari - 3
18	KOKRAJHAR	16	Gossaigaon - 4, Balajan - 4, Kachugaon - 4, Dotma - 4
19	LAKHIMPUR	20	Boginodi - 5, Nowboicha - 5, Bihpuria - 5, Dhalpur - 5
20	MORIGAON	6	Jhargaon - 3, Lahorighat - 3
21	NAGAON	28	Kathiatoli - 4, Barapujia - 4, buragohaithan - 4, Simanabosti - 4, Jakhalabandha - 4, Lanka - 4, Samuguri - 4
22	NALBARI	8	Mukalmua - 4, Kamarkuchi - 4
23	N.C. HILLS	15	Mahur - 3, Langting - 3, Dayangmukh - 3, Gunjung - 3, Harangajao - 3
24	SIBSAGAR	15	Geleki -5, Sapekhati - 5, Patsaku - 5
25	SONITPUR	24	Gahpur - 4, Bihali - 4, B. Chariali - 4, N. Jamuguri - 4, Dhekiajuli - 4, Balipar - 4
26	TINSUKIA	15	Kakopathar - 5, Ketetong - 5, Na-Sadia - 5
27	Udalguri	15	Orrang -5, Udalguri - 5, Khairabari -5
	Total	391

Vector Control

DDT 50% is recommended in the state for indoor spraying at malaria prone areas. The Annual Parasite Incidence (API) is the criteria for selection of malaria prone areas for spraying operation. Accordingly details operational plan is furnished below considering API above 3 as per GIS data of the district.

DDT Spray for 2008

District	:	27
PHC	:	128/156
Sub-center	:	1868/ 5109
Village	:	13758/ 29000
Projected Population	:	10251991

Supervision & Monitoring Plan of DDT Spray Operation

1. Consecutive supervision by MPW (M)
2. Concurrent supervision by Medical Officers/District Malaria Officers/ Joint DHS (district)/ Officers from State Head Quarter.
3. Wages of spray workers will be release after getting completion certificate from PRI.

Personal Protection

The uses of mosquito net by the people are also an important strategy for prevention of malaria. The mosquito nets are to be impregnated with a insecticide (Deltamethrine). Because the malaria mosquito bite the people at night. The community of the state preferred the uses of mosquito net. The GOI supplied 1032500 bed net to the state in the year 2006-07 & 08. Details programme of bed nets impregnation are furnish below.

Impregnation of Bednets

Year	Supplied	Community	Total
2006	200000	569000	769000
2007	200000	815565	1015565
2008	632500	4367500 (projected)	5000000 (projected)

Larvivorous Fish

Introduction of Larvivorous fish in the state as a vector control measure will be initiated from 2008. The considering the hilly terrain and landscape of the state 4 districts are identified in the first step for culture distribution & monitoring of Larvivorous fish.

The identified districts are Kamrup, Lakhimpur, Hailakandi & Karbi-Anglong.

Fogging

Out door space spray with Malathion Technique is one of the strategies for control malaria specially when there is high incidence of fever cases in urban and semi-urban areas.

 

Situation Analysis of JE in Assam

Year	Case	Death	CFR
1996	64	29	43.31
1997	88	26	29.54
1998	26	06	23.07
1999	11	02	18.18
2000	135	73	54.07
2001	343	160	46.64
2002	472	150	31.17
2003	109	49	44.95
2004	235	64	27.23
2005	145	52	35.85
2006	392	119	30.00
2007	424	133	31.36

District wise JE Case & Death

Sl No	District	2002		2003		2004		2005		2006		2007
		C	D	C	D	C	D	C	D	C	D	C	D
1	Dhemaji	3	1	4	1	28	3	4	2	24	5	49	9
2	Lakhimpur	12	4	0	0	19	4	8	3	93	31	69	15
3	Tinsukia	29	13	3	1	16	3	12	2	30	12	57	16
4	Dibrugarh	142	40	51	21	60	12	46	13	70	24	116	50
5	Sivsagar	146	52	44	23	69	26	43	21	41	21	42	27
6	Jorhat	88	20	6	2	33	12	5	3	32	10	5	2
7	Golaghat	41	13	1	1	9	4	15	3	97	14	63	4
8	Morigaon	1	1	0	0	0	0	1	0	0	0	0	0
9	Sonitpur	8	4	0	0	0	0	11	5	0	0	8	2
10	Darrang	1	1	0	0	0	0	0	0	0	0	1	1
11	K- Anglong	0	0	0	0	1	0	0	0	2	1
12	Bongaigaon	0	0	0	0	0	0	0	0	0	0	6	0
13	Hailakandi	0	0	0	0	0	0	0	0	0	0	1	1
14	Kamrup	0	0	0	0	0	0	0	0	2	1	7	5
	Total	471	149	109	49	235	64	145	52	391	119	424	133

I. Early case detection and management

The following Sentinel Sites are identified in the state for AES surveillance

Sl. No.	District	Sentinel Surveillance Site with Lab	Sentinel Surveillance Site without Lab (
1	Dibrugarh	1.Assam Medical College Hospital 2. Sivsagar civil Hospital	1 .Naharani CHC 2.Tengakhat PHC/ CHC 3.Khoang PHC
2	Tinsukia		4.Tinsukia CH 5.NasadiaCHC
3	Sivsagar		7.Sivsagar C H 8.Sapekhati CHC
4	Jorhat	3 Jorhat Civil Hospital	9.Titabar FRU 10.Kamalabari CHC
5	Golaghat		11.Sarupather CHC 12.Bokakhat PHC / CHC
6	Dhemaji	4.Lakhimpur C.H	13 Dhemaji C H &.Jonai CHC
7	Lakhimpur		14.Baginadi 15 Naobaisa
8	Sonitpur	5.Gauhati Medical College Hospital	16 Biswanth Char Ali CH 17 Tezpur CH
9	Darrang		18 Manaldoi CH 19 Udalguri CHC / PHC 20 Orang CHC /PHC
10	Nagaon		21 Jakhalabandha CHC /PHC 22 Nagaon CH 23 Hojai CH
11	Marigaon		24 Marigaon CH
12	Kamrup		25 MMC hospital 26 Rangia CH
13	Nalbari		27 Nalbari C H 28 Tamulpur CHC
14	Barpeta		29 Barpeta CH
15	Bongaigaon		30 Bonaigaon CHC
16	Kokrajhar		31 Kokrajhar CH
17	Dhubri		32 Dhubri CH 33 Hatsingimari CH
18	Goalpara		34 Goalpara CH
19	K- Anglong		35 Diphu CH 36. Hamren CH
20	NC Hills		37. Haflong CH
21	Cachar		38. Silchar Medical College
22	Hailakand		39 Hailakandi CH
23	Karimganj		40. Karimganj CH

II. Rapid Response Team (RRT)

Each endemic district will form a RRT for all vector borne diseases comprising the followings.

1.	MO.	SDM& HO (epidemic duty) / HQ
2.	Lab. Tech	two numbers
3.	Spray workers	five numbers
4.	Field workers	two numbers
5.	Driver / Hired vehicle
6.	DMO	entomological study / vector control

III, Integrated Vector Control

A) Out door space spray (with Malathion Technique) FOGGING will be carried out during outbreak situation

Sl. No.	District	Predicted areas	Month & periodicity
1	Dibrugarh	Dib town, 5 BPHC areas	June, July, Aug7 days interval
2	Sibsagar	Sibsagar town, Sonari town, Moran town & 7B PHC areas	June, July, Aug7 days interval
3	Tinsukia	Tinsukia town, Magherita town , 4 BPHC areas	June, July, Aug7 days interval
4	Jorhat	Jorhat town, Titabar town, Kamalabari & 5 BPHCs	June, July, Aug7 days interval
5	Golaghat	Golaghat town, Sarupather town, Bokakhat town & BPHC areas	June, July, Aug7 days interval
6	Dhemaji	Dhemaji town, Jonai town, Silapather & 4 BPHC areas	June, July, Aug7 days interval
7	Lakhimpur	Lakhimpur, Bihpuria, Dhakuakhana towns & 5 BPHC areas	June, July, Aug7 days interval

B) Promotion of ITBN

Most of the families of the JE endemic districts are using bed nets. Community owned bed nets of the JE endemic districts are

Sl. No.	District	Total net
1	Dibrugarh	608190
2	Sibsagar	443333
3	Tinsukia	502624

IV . Behaviour Change Communication (BCC)

BCC is a continuous process and will be carried out throughout the year. More stress will be given during transmission season and during immunization campaign.

1. Advocacy workshop / sect oral meeting will be organized in
State : 1
Districts : 7
Block PHC : 38
Sub- center : 1214

2. Inter personal communication through ASHA / AWW / ANM
Focal Group Discussions in endemic villages.

3. Mass Communication program through

Radio jingles - AIR Guwahati, AIR Dibrugarh -weekly in June , July August

Television - DDK Guwahati and Dibrugarh. Cable TV in 11 towns

News paper insertion - Weekly in June, July August

Hording & wall painting - In Health institution and Public places

Rally - During immunization camp

Miking - During immunization campaign and during out-break situation

V. INERSECTORAL COLLABORATION & SOCIAL MOBILIZATION

The Tea Estates and PSU like Coal India , ONGC , OIL are involved in vector control measures, such as in fogging operation . PRI, NGO SHG are also involved in ITBN programmes.
Some private hospitals are sending reports to the state on JE.
IMA holds workshop on JE case management in Collaboration with State VBDCP, Assam.

VI. J.E IMMUNIZATION

Immunizations against JE started in the state from 2006 as a campaign program and the districts are as follows.

Year	District	% of coverage
2006	Dibrugarh	90
	Sibsagar	74
2007	Jorhat	94.54
	Golaghat	92.2

According to endemicity the following districts are identified for immunization campaign against JE during. 2008- 09 period.

Sl. No.	District	Total population	Children 1- 15 yrs of age
1	Tinsukia	1277125	421451
2	Dhemaji	640977	211522

VII. CAPACITY BUILDING

Sl. No.	Purpose of training	Category of trainee	Venue/ Trainer
1	Implementation of AES Surveillance system	Joint directors , CM&HO (CD), DMO of districts	Guwahati/ SPO
2		MO. PHC, CHC FRU CH, Private practitioner	District/ District trainer
3	Clinical- JE case management	Clinician, pediatricians , medical officers ( govt./ private/ PSU )	AMC, DibrugarhGMC, GauhatiSMC, Silchar
4	Laboratory diagnosis( reorientation)	Microbiologist, Pathologist, Lab Tech	RMRC, Dibrugarh
5	Entomology	State entomologist, Asst. entomologist, DMO of endemic districts	RMRC Dibrugarh
6	Early reporting of AES	SMI,MI, SI, LHV, SW, ANM, AWW, ASHA FTD	PHC/ MO PHC

VIII. MONITORING & EVALUATION PLAN

Field visits

Sl. No.	Category of officer / Staff	Frequency of visit
1	State Program Officer	Quarterly -monthly but weekly in transmission season.
2	District officers	Monthly / weekly
3	M O PHCs	Weekly/ daily ( during outbreaks)
4	SMI/ MI /SI	Daily

Review Meetings:-

Sl. No.	Reviewer/ Place of review	Frequency of review
1	State Program Officer/ State	Quarterly ( weekly/ daily in transmission season)
2	District officers	Monthly / weekly /daily
3	M O PHC	Weekly / daily

IX LOGISTIC MANAGEMENT.

Sl. No.	Particulars	Opening balance	Technical requirement	Net requirement
Laboratory
1	ELISA reader (for new districts Jorhat, Sibsagar & North Lakimpur)	2 (AMCH/GMCH)	5	5
2	Mac Elisa Kit ( JE )	Nil	5	5
Vector control
3	Pyrithrum Extract 2%(Ltrs)	Nil	500	500
4	Malathion Tech. ( Kg)	26	1000	1000
5	Bed- nets( included in malaria )
6	Syn. Pyrithroid flow ( Ltrs )	Nil	40,000	40,000
7	Adult susceptibility test kit	Nil	3	3
8	Larval susceptibility test kit	Nil	3	3
9	Fogging machine( endemic PHC)		49	49

Filaria

Situation analysis of the diseases:

Table: 1.1 Micro filaria Survey Reports (2007) of Assam.
Mf survey of the following 7 number MDA districts were carried out from 20th September, 2007 to 25th October, 2007

Sl. No	Name of District	Survey Sites	BSC/BSE	No. of mf +ve	Mf %
1	Dhubri	Sentinel	2043	2	0.10
		Random	2162	Nil	Nil
		Total	4205	02	0.04
2	Kamrup	Sentinel	2066	03	0.60
		Random	1991	Nil	Nil
		Total	4057	03	0.07
3	Nalbari	Sentinel	2233	Nil	Nil
		Random	2113	Nil	Nil
		Total	4346	Nil	Nil
4	Darrang	Sentinel	2021	32	1.58
		Random	2100	14	0.66
		Total	4121	46	1.11
5	Sibsagar	Sentinel	2108	115	5.45
		Random	1952	89	4.55
		Total	4060	204	5.02
6	Dibrugarh	Sentinel	1990	101	5.07
		Random	2094	55	2.62
		Total	4084	156	3.81
7	Dhemaji	Sentinel	2103	1	0.04
		Random	1510	3	0.19
		Total	3613	4	0.11

Table: up dated Line listing of Lymph edema and Hydrocele Cases of MDA Districts of Assam.

Sl. No.	District	No.of Lymph edema Cases	No. of Hydrocele Cases
1	Kamrup	86	99
2	Nalbari	55	34
3	Dhemaji	18	Nil
4	Darrang	99	94
5	Sibsagar	185	Nil
6	Dhubri	69	11
7	Dibrugarh	270	Nil
	Total	782	238

Work Plan
Table; MDA District Profile

SL No	District	Population As per 2007	Eligible Population	No.of Block PHC	No. of MPHC, SD,SHC	No. of SC	No. of Villages	No.of NFCP Unit
1	Dibrugarh	13,50,822	12,15,740	6	21	230	1116	Nil
2	Dhemaji	6,40,977	5,76,880	5	14	97	1323	Nil
3	Sibsagar	11,11,404	10,00,264	8	25	224	1024	Nil
4	Darrang	17,04,089	15,33,680	7	37	305	1314	Nil
5	Kamrup	27,84,834	25,06,350	15	70	355	1938	1(one)
6	Nalbari	12,99,868	11,69,881	7	55	216	837	Nil
7	Dhubri	17,25,283	15,52,755	7	30	277	1530	Nil
		1,06,17,277	95, 55,550	55	252	1704	9082	1

Table: Requirement of Man Power.

SL No	District	Population As per 2007	Eligible Population	DEC (100mg) require-ment	No. of Super-visors required	No. of Drug Adminis-trator required
1	Dibrugarh	13,50,822	12,15,740	33,77,055	540	5403
2	Dhemaji	6,40,977	5,76,880	16,02,442	256	2563
3	Sibsagar	11,11,404	10,00,264	27,78,510	444	4445
4	Darrang	17,04,089	15,33,680	42,60,222	681	6816
5	Kamrup	27,84,834	25,06,350	69,62,085	1113	11139
6	Nalbari	12,99,868	11,69,881	32,49,670	519	5199
7	Dhubri	17,25,283	15,52,755	43,13,207	690	6901
		1,06,17,277	95, 55,550	2,65,43,191	4243	42,466