= siae INDIAN INSTITUTE OF PUBLIC ADMINISTRATION REGIONAL BRANCH, ORISSA BHUBANESWAR ISSUES) OF HEALTH:CARE AND:POPULATLON VOLUME - Xill 2004-2005 SARAT CHANDRA MISRA JUGAL KISHORE MISRA Chief Editor EditorDISEASE PROFILE IN ORISSA “RAJAN R PATIL According to the constitution of the World Health Organization (WHO) ‘Health is a state of complete physical mental and social well- being and not merely the absence of disease or infirmity. By this definition, health can be seen as an important determinant of well being in the broadest sense of the term MALARIA Malaria is number one Public Health Problem of the State. About 25% of malaria cases and 34.6% of malaria deaths are from Orissa in the country observed in 2003. Earlier malaria deaths were about 45% of the country. Enhanced Malaria Control activities with World Bank support are going on, in 158 blocks of state. 82 blocks are selected to be included under Enhanced Malaria Control Project in 2004 ~ 05. However intensive IEC, training are going on in entire state including computerized MIS. Table-1. State Malaria Status (1997 - 2002 - 2003) Year Malaria | SPR PMH API |Deaths Cases 1997 421928 | 11.4 86.4 11.8 350 2002 468046 | 10.3 83.3 12.4 465 2003 421323 | 9.5 83.2 41.1 333 2003 November } 381851 | 9.61 82.63 | _ 283 2004 November | 372960 | 9.73 84.03 | _ 240 FILARIA Filariasis has been considered as a major public Health problem in Orissa State next to Malaria. National Filarial Control Programme was launched in the State during 1963. So far 15 Filaria Control Units, 15 Filaria Clinics and one Filaria Research Centre at Puri have been established in Urban local bodies, catering; a population of 33 lakhs.7 The Journal of Indian Institute of Public Administration (ORB) These organizations were established with the objective of check disease transmission and case detection through Night Blood Survey with treatment of micro-filaria carriers to eliminate disease preservers in the community . The Filaria control units undertake recurrent weekly antilarval operation applying larvicides like M.L. oil, Baytex & Abate etc. in the breeding sites following minor sanitary engineering method. The Filaria clinics attached to the control Units undertake case detection & treatment in the targeted population. Table-2 YEARWISE FILARIASIS ENDEMICITY RATES OF ORISSA STATE, FROM 2000 - 2004 SLNo, | N®0f Persons | Persons positive for_| Mf | Disease [Endemicity Examined Mt Disease | Rate | Rate | Rate 2000 25622 316 3323|—1.35|__—12.97 14,32] 2001 20517 369{2229[ 1.79] _ 10.97] 2002 32814 4ui[470i[ 1.25] 14.32, 2003 35919) 547|_4368[ 1.52] 12.16 13.68) 2004 up to October 35289 726] 2558] 2.05] __7.24 9.30] ‘VACCINE PREVENTABLE DISEASES Of the Six VPDs, the number of reported cases in Orissa came down between 1985 and 1993 in the cases of diphtheria, measles, and whooping cough. The number of reported cases has increases in the cases of tetanus and tuberculosis Table- 2A. Number of Reported Cases of Vaccine Preventable Diseases Vaccine Preventable} Disease Diphtheria Whooping Cough Measles Poliomyelitis Tetanus Tuberculosis - 266 - 981 376 _| 2378 2671 54710 . 10198VOL XIII-2005 TUBERCULOSIS e The National TB Control programme implemented since 1964. © Directly Observed Treatment - Short Course (DOTS) under Revised National TB Control Programme (RNTCP) with Danida assistance started since October 1997 e 30 districts are covered under RNTCP. Global Drug Facility is providing anti TB drugs (CAT-I; CAT-II and CAT-III) for all categories of patients along with Prolongation pouches and all other loose drug requirement is met from RNTCP (DANIDA support) budget Table-3. District wise case detection and outcome. Year - 2003. District Patients treated under DOTS Cured & Complete | Total treatment death CAT-1 CAT-IIL Cured | Complete! [Mayurbhany 212 Keonjhar 7066 | 178 [954 2198 | 618 ‘| 717 103 ‘Sundargarh 7636_| 381 [1158 | 3175 | 895 tie7__| 109 ‘Sambalpur 628 _| 135 | 566, 7329_|_286 57 ® Deogarh wa l75 229 [8 64 5 sharsuguda set | x6 [ats | 7ez_| 223 255 A Kore it e2_| 199 ‘| 209 7380_| 603 293 52 Ray ada 338 __[ 130 [315 1283 | 539 305 Gy mane 501 118 +1179 798 | 262 159) 43 fowarangpur 370 | 66 [231 ea7_|_ 353 214 @ [Kalahandi y3e2_| 255 [632 | 2279 | a9 ‘| 423 77 Nuapada 406 [159 [373 [938 | 129 ‘| 262 33 [Garapati s52_ | 17 [316 104s [262 ‘| 359 46 Prulbani 505 [| 99 [2ie | e20 | 309 ‘| 217 3 60 [07 388 | 61 Ey 10 89 144 500 16 7 1 144 159 502 58 118 14 e+ a7 244 | 63 23 2 49 [153 [403_| 0 0. 0 6 ‘(7 7 [0 0 0 7% [40 7% [0 0 0 148 34 4 ma [76 (165 —~*| 405_~| 74 7 7 310 | 2811 [e265 | 24186] 6959 | 6605 944 - 267 -The Journal of Indian Institute of Public Administration (ORB) GASTROENTERITIS Although the case fatality ration has been declining over last two decades, the prevalence rate has steadily increasing. In 2002, there were 156872 cases of severe diarrhoea resulting in 453 deaths, and in 2003 there were 144672 gastroenteritis resulting in 513 deaths. LEPROSY The state’s prevalence rate of leprosy rate was 121.4 10000 populations in the year 1982-83 and at the national level it was 55 per 10000 population. Due to successful implementation of the programme in the sate the prevalence rate of leprosy at the state level has come down to 1.91 per10000 populations an at the national level it has come down to 1.34/10000 population. The integration of leprosy elimination services with general health care system. ICDS & the panchayati raj system will further be strengthened during 2005-2006. YAWS Anti YAWS scheme started functioning in Orissa under Tribal & Rural Welfare Dept. since 1956 with 2 YAWS team. During 1978 the scheme was transferred to Health & FW Dept. 4 YAWS teams started functioning under the scheme during the year 1987 at Keonjhar, Phulbani, Dhenkanal & Koraput. Govt.-of India initiated the programme as central sector health programme during 1996. NICD is the nodal agency for the programme. NICD placed funds for training, IEC, Search operation. 1* Phase : 1996 - 97 YEP was implemented at Koraput, Malkanagir, Rayagada, Nawarangapur. 2 Phase : 2000 - 2001 Mayurbhanj, Balasore, Kandhamal, Kalahandi, Keonjhar, Dhenkanal districts were included. Table-4. No of cases confirmed Year-wise YEAR 98-99 | 99-00 | 00-01 | 0 02-03 | 03-04 [rotac(vearyara [in [ee [ne | 154 | 145 [46 o INFANT MORTALITY Infant Mortality rate of Orissa was highest ie 97/1000 live births and was showing no significant reduction since 1997. For this govt. of Orissa launched Infant mortality Reduction Mission on 15 august 2001 with a goal to reduce it to 60/1000 live births by 2001. Tod 1035 - 268 -VOL XII-2005, Present I.M.R (2002) of our state is 87/1000 live births. Though there is a system of collection and compilation of district-wise I.M.R by CNAA system, the report so far received and compiled is not presentable probably duel to severe under reporting and wrong reporting Table-5. Contribution (percent) Infant Deaths by Major Causes , Rural Orissa. 1998-2000 Specific Causes Per Cent of Total Deaths Prematurely 38.5 Pneumonia 15.4 Respiratory Infection of newbon| 8.7 Anaemia 8.1 Bronchitis and Asthma Tetanus Diarrhoea of Newborn Others 19.3 ORISSA MULTI DISEASE SURVEILLANCE SYSTEM (OMDSS) The Orissa Multi Disease Surveillance System was set up in the aftermath of the cyclone in 1999, with technical assistance of MSF and financial assistance from WHO and OHSDP. Subsequently, it was expanded with financial and technical inputs from WHO-UNDP Orissa unit, and OHSDP. The quantitative parameters for reporting completeness and timeliness have been at about 90% levels at state and district levels for the last two years, however, a lot of emphasis needs to be given to ensuring the quality of data, analysis of data at all levels, and definitely at sector, block and district levels. The second edition of the OMDSS Operations Manual is an exhaustive reference material for disease surveillance in the Orissa context, and contains all the formats required for repyrting as annexure. These annexure can be photocopied and disbursed from district level to the various reporting units as and when required. The Manual also contains monitoring tools and evaluation checklists that need to be used by the personnel responsible for implementing the system. Analysis of data at the sector level and block level is the responsibility of the medical officer - in -charge, and the ADMO-PH is responsible for convening the weekly meeting and analyzing data at district level. A brief report highlighting the action points and the intervention taken/ planned after analysis of OMDSS data also needs to be sent along with the weekly report > 269 -