Under National Urban Health Mission scheme, one Urban Primary Health Centre shall be there for every 50,000 population. The Greater Chennai Corporation is already running 138 Urban Primary Health Centres and two are under construction.
| Water borne |
|---|
| a). Cholera b). ADD c). Typhoid fever d). Viral Hepatitis |
| Water Related |
| a). Leptospirosis |
| Air Borne: |
| a). Chicken pox b). Herpes Zoster c). Measles d). Mumps e). Tuberculosis f). Pneumonia / ARI |
| Vector borne Diseases |
| a). Malaria b). Dengue c). Chikungunya |
Patients are admitted round the clock and '0' delay principle is effectively followed to render immediate medical care to the patients who are even brought in a critical condition.
| Duration | 2 years |
|---|---|
| Qualification | Pass in Plus 2 with science group |
| Fees | Rs.300/- per month |
| Maximum No. of candidates | 30 |
| Duration | 1 years |
|---|---|
| Qualification | Pass in Xth Standard |
| Fees | 75/- per month |
| Maximum No. of candidates | 50 |
Starting of Health Inspector and ANM courses are under final stage of completion
In Greater Chennai Corporation 6 Diagnostic centres are being functioned in which the public are checked for various blood and urine investigations at free of cost.
| Zone | Name of Diagnostic Centre |
|---|---|
| 6 | Perambur Diagnostic Centre |
| 6 | Chellappa St Diagnostic Centre |
| 8 | EVR Periyar Salai Diagnostic Centre |
| 9 | Valluvar Kotttam Diagnostic Centre |
| 10 | Saidapet Diagnostic Centre |
| 11 | Thiruvanmiyur Diagnostic Centre |
The Non-Communicable diseases such as diabetes and hypertension are detected both by active and passive surveillance and those who require continues medical treatment are registered and treated in the nearby Urban Primary Health Centers as per the norms. Complicated cases are referred to tertiary level hospital.
Introduction :
The Vector Control Department of Greater Chennai Corporation comprises of three wings, mosquito viz., Menace Control. Vector - borne Diseases Control and Zoontic Diseases Control. The first wing monitors aquatic habitats which are the primary breeding sources of mosquitoes, especially Culex species. The next wing screens the public community for major mosquito-borne diseases like dengue, chikungunya, malaria, filariasis and Japanese Encephalitis. The last wing keeps the rodents under checks as they responsible for the outbreak of leptospirosis and scrub typhus.
Control of Mosquitoes and Mosquito-Borne Diseases :
Chennai city is encountering twin problem of mosquito menace and mosquito borne diseases like malaria, dengue and filariasis.
Between these two public health issues, the problem of mosquito menace is realized more by the people of Chennai than the diseases.
The chief sources for mosquito menace in Chennai are waterways and storm water drains. There is a total of 247.09kms length of major and minor waterways crisscrossly flowing within the city limits. In addition to this, there is a total of about 2062.94kms length network of storm water drains in the city. On account of certain inherent problem these sources have become highly mosquitogenic.Mosquito Menace :
Mosquitoes are distributed worldwide in tropical regions with hot and humid climate and they belong to the order Diptera, suborder Nematocera and Family Culicidae, arranged under three sub-families namely Anophelinae,Culicinae and Toxorhynchitinae.
The mosquito fauna in Chennai consists of three vectors, viz., Anopheles (Malaria), Aedes (Chikungunya, Dengue, and Zika) and Culex (Filariasis and Japanese Encephalitis), while the first two vectors breeds in clean water, the latter breeds in polluted water.
Water ways and canals actas a potential breeding sources for Culexquinquefasciatus which is also called the nuisance/menace mosquito.
Of the three major vectors, Aedes is responsible for the transmission of Dengue, Dengue Haemorrhagic Fever, Dengue Shock Syndrome, Zika Virus Fever and Yellow Fever, whereas Anopheles for Malaria. Culex species are involved in the transmission of Filariasis and Japanese Encephalitis.
It is vital to understand the distribution of vector-borne diseases, about transmission and their vectors in order to plan control and prioritise resources since disease endemicity are determined by factors, viz., pathogen, vector, human and environmental conditions.
Control measures are aimed at both immature and adult stages of the mosquitoes. For immature control, effective anti-larval measures are adopted.
Elimination of breeding sources, environmental management, larvicide treatment are some of the ways used for immature control.
For control of adult mosquitoes, indoor residual spray and space spray are mainly followed. The breeding water sources are treated, covered up or drained as it is the most effective method.
Malaria :
Malaria in India is mainly caused by two major malaria parasites namely plasmodium vivax and plasmodium falciparum( though cases of malaria from plasmodium ovale and plasmodium malariae have also been reported from some parts of the country ) Plasmodium vivax ( Pv) and Plasmodium Falciparum (PF) are the most common species causing malaria in the country. While Plasmodium vivax ( Pv) is more prevalent in the plains, Plasmodium Falciparum (PF) predominates in forested and peripheral areas.
Malaria is transmitted by a female Anopheles mosquito bite which has been infected through a blood meal taken from an infected person. A single infected vector, during her lifetime, may infect several persons. Afterabout a week of taking infected blood meal mosquito is able to transmit malaria. This is known as vector transmission. The malaria parasite undergoes 2 cycles of development the human cycle (Asexual cycle ) and the mosquito cycle ( Sexual cycle). Human is the intermediate host and mosquito the definitive host.
Anopheles Stephensi is a major vector species for malaria in Chennai.
Dengue :Dengue is currently the most important arboviral disease with 2.5 billion people living in area of risk and tens millions cases occurring in each year, affecting more than 100 countries. It is one of the most rapidly emerging mosquitos borne disease in the world and W.H.O has identified dengue as a re-emerging disease in South East Asia.
Dengue virus was first isolated in India during 1945. There are three forms of disease. 1) Dengue fever (DF) 2 Dengue Hemorrhagic fever and 3) Dengue shock syndrome (DSS). Nearly 44% of DHF and DSS can be fatal/ there are four serotypes namely DENV-1, DENV-2, DENV-3 & DENV-4.
In 1995, DHF became a leading cause of hospitalization and death among children in many Asian countries. In India the first outbreak of DHF/DSS was documented in Delhi 1985. But prior to this endemic transmission of all for dengue serotypes has been reported.
Aedes aegypti / Aedes albopictus is the main vector mosquito responsible for transmission of dengue. This mosquito has characteristic white stripes on the back and legs. Hence, it is also called as Tiger mosquito. The mosquito breeds indoors in closets, fridges, aquatic, ornamental plants kept in water. The mosquito rests indoors in closets and other dark places. Outside they rest where it is cool and shady. The female mosquito lays eggs in clean water containers and around the houses. This mosquito is a domestic breeder and breeding can occur in any water catching or water storage container such as wells, overhead-tanks discarded items tyres, utensils and large containers used for rain water collection which are not emptied and cleaned periodically. Since, water is essential during the first 8 days in the life of the mosquito, emptying containers once a week will greatly reduce the risk of dengue fever. Aedes mosquito can fly upto a limited distance of 400 meters (usually not more than 100 meters) but can spread over vast distances mechanically in various types of vehicles used by man.Japanese Encephalitis :
Disease situation: Japanese encephalitis (JE) is a viral disease of major public health importance in India because of its epidemic potential, high case fatality rate and presence of life – long complications in survivors. It is a single – stranded RNA virus that belongs to the genus flavivirus. Disease in prevalent in most of south central, northern and northeast states of India, predominantly in rural areas, although some urban areas also report cases. JE is a paediatric problem affecting mainly 1- 15 years olds. However, in areas where JE has not been reported earlier, all age groups may be affected during an outbreak due to lack of immunity.
In areas at risk, Japanese encephalitis is primarily a disease of children, but it can occur in a person of any age. JE Virus is transmitted to humans through the bite of infected Culexvishnui group of mosquitoes, particularly Culextritaeniorhynchus. The main reservoirs of the JE virus are pigs and water birds, and in its natural cycle, virus is maintained in these animals. Man is an accidental host and does not play a role in JE transmission. After 9-12 days (extrinsic incubation period) mosquitoes transmit disease to other vertebrate hosts. Epidemics occur during monsoon and post monsoon period because the vector density is high. However, in endemic areas, sporadic cases may occur throughout the year.
Leptospirosis :
Leptospirosis is a zoonotic disease of world – wide distribution. The spectrum its clinical presentation and the tedious laboratory procedure required for its confirmatory diagnosis has made its recognition difficult in most of the instances and consequently it is grossly under-reported. Though it is considered as an occupational hazard in many countries, the environment and life style of people of the developing countries put the whole population of such countries at risk of acquiring leptospiral infection. The bacteria-Leptospira was identified in 1915 and its association between Weil’s disease and many other clinical syndromes like Seven Day Fever, Canicola Fever etc. Has been known for the past many decades. Though the disease has a worldwide distribution, surveillance against it is restricted to a few countries.
During the first few decades of this century, the disease had been reported from many parts of the country based purely on clinical suspicion. Bacteriological confirmation of the presence of human leptospiral infection in the country was first reported from Andaman Islands in 1929. Later, it was reported from other places like Bombay, Calcutta and Assam. All these were isolated reports from localised areas.
Since leptospirosis presents in a wide variety of clinical forms, identification of suspects on clinical grounds is not possible in many instances. The association between Weil’s disease and leptospirosis is so strong in the minds of etiology is never suspected. This leads to a significant proportion of the cases going unnoticed. Hence the necessity to formulate a broad-based clinical definition was felt by delegates and the following case definition was agreed upon.Scrub typhus :
Scrub typhus, first described in Japan in 1899, caused by Orientiatsutsugamushi (formerly Rickettsia), is an acute infectious disease of variable severity that is transmitted to humans by an arthropod vector of the Trombiculidae family. It affects people of all ages including children. Humans are accidental hosts in this zoonotic disease. While scrub typhus is confined geographically to the Asia Pacific region, a billion people are at risk and nearly a million cases are reported every year.
The infection is transmitted to human and rodents by some species of infective trombiculid mites (“Chiggers,” L. deliense, and others), feeds on lymph and tissue fluid rather than blood. Once they are infected in nature by feeding on the body fluid of small mammals, including the rodents, they maintain the infection throughout their life stages and as adults, pass the infection on to their eggs in a process called transovarial transmission.
To break the mite life cycle, the home and the pets should be treated as well as the outside surroundings of the house. Control of mites outdoors requires more than one application of insecticides and the pets require several treatment.
The Greater Chennai Corporation has opened 3 AYUSH clinics (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) in Zone 4, 10 and 13 (location of clinic) to provide five alternative Indian system of medicines. These clinics are manned by 5 doctors each from Indian alternative system of medicines. Since March 2016, every day 200 out patients are being benefited in these clinics.
The Greater Chennai Corporation has established 37 shelters for urban homeless and 10 special shelters (Hospitals) for inpatient attendants, since June 2013 which are run by Non Governmental Organizations
The RNTCP is run by the Chennai Corporation since 1999. Presently 36 TB Units and 70 Designated Microscopic Centre (DMC) functioning in the RNTCP. The number of patients registered for treatment has increased from 7000 to 8000 per year. All TB patients are registered and given free DOTS treatment for 6-8 months in all the UPHCs of Chennai Corporation. During the year 2016, the number of individuals tested for TB was 74,782, out of which 7990 patients were diagnosed with TB and treatment given. The treatment success rate is 80%.
Presently sputum AFB is done in all 138 UPHCs. DOTS treatment and MDR treatment is available in all centres. Patients are given proper counseling by Health Visitor (HV), Senior TB Treatment Supervisor (STS) and adherence monitored. Whenever patient does not come for taking treatment, the staff go to their residence and counsel him/her on the need for regular treatment and retrieve them. Sputum microscopy being the backbone of the Programme, the Lab Technicians are well trained by the Programme. The STLS do the rechecking of the slides regularly thus maintaining the effectiveness of the programme. For the People Living with HIV(PLHIV) Fixed Drug Combination(FDC) has been implemented in all five ART centres, the adherence of the patient is being monitored through 99DOTS software. Isoniazid Prophylaxis Therapy (IPT) will be started for the PLHIV not having TB. Chennai is one of the few sites for implementing the new drug Tab.Bedaquiline for MDR patients.
From the year 2013 onwards, free breakfast from Amma Unavagam was issued for TB patients for one year. The facilities for detecting MDR TB patients were improved. Presently the time taken for detection is only 2 hours by CBNAAT (GeneXpert) machine as against 2 months by solid culture. Such MDR TB patients are given a cash incentive of Rs.1000/- per month to support their financial needs.
To improve the notification from Private Sector, New Coordinator posts was created in the year 2016. To reduce the Pre-Treatment Lost to follow ups CUG numbers were given to all RNTCP staff to reduce the gap in communicating the referral status and initiating the treatment of the patient. As a part of intensified control activities a active case finding camp was conducted for six days in Tsunami quarters, Ernavoor and five patients were identified and they are under treatment. It is further planned to conduct weekly camp on all Saturdays in all slums covering all 15 zones.
Further, Greater Chennai Corporation has entered into a MOU with USAID and STOP TB partnership to intensify the TB control activities in the city. These international agencies will be supplying 10 GeneXpert machines to improve the case detection. Moreover, the Greater Chennai Corporation is planning to procure 7 Mobile Medical Units to do active case finding in vulnerable population. All these activities will help in achieving the goal of a “TB Free Chennai”.
Chennai District Blindness Control Society with the collaboration of Government, Private hospitals and NGO’s are performing free Cataract surgeries. In addition to this, diagnosis and treatment for Cataract, Glaucoma, Diabetic retinopathy, Squint and childhood eye diseases are given to the public residing in the vicinity of Greater Chennai Corporation.
Chennai District Blindness Control Society has conducted 4,734 Eye camps in the year 2011 to 2017 in which 3,75,228 persons were operated for cataract, and the remaining were treated for various eye defects.
In the year 2011 to 2017 Chennai District Blindness Control Society has received 14,271 numbers of cornea through eye bank of Regional Institute of Ophthalmology and Government Ophthalmic Hospital, Chennai and through NGO’s and they were used in cornea transplantation, totally 6,767 persons were benefited through this programme.
Palli Sirar Kannoli Kappom Thittam implemented in all Chennai schools, including Government schools and Government Aided schools to identify the students having any eye defects by screening programme through out the year with the collaboration of the Government and Ngo’s private eye hospitals.
In the year 2011 to 2017, 6,91,432 students were screened and 39,991 students had been identified with refractive error and they were given spectacles at free of cost under this scheme.
Chennai MACS was started on 31st August 1998 for HIV/AIDS prevention in Chennai city funded directly by NACO. The Components of IEC, NGO, ICTC, Blood safety, STD were functioning in Chennai MACS. Now we have only Institutional strengthening , IEC and ICTC with Chennai MACS other components are merged with TANSACS (NGO 2009, STD 2011, Blood safety 2014). From FY 2014-2015, funds are routed through TANSACS as per policy decision taken by NACO. During the year 2016-2017, 2,43,665 General clients were tested and 955 clients were deducted as HIV positive in the 42 ICTC Centers. And 46,924 ANC mothers were tested and 9 ANC mothers were deducted as HIV positive.
All school children are examined once in a year by a team of UPHC medical officers of Greater Chennai Corporation and treated for minor ailments and chronic diseases which are identified and students are reffered to the concerned specialties for further treatment.
Children are checked and treated for:
The Health Department is conducting a slum health programme regularly once in a week to cover each slum. A health team headed by a Medical Officer and para Medical staff visit the slums dwellers for treating minor ailments.IEC activities are also undertaken to create awareness among the slum dwellers about prevention of communicable disease and improvement of environmental sanitation.
Under National Urban Health Mission scheme, one Urban Primary Health Centre shall be there for every 50,000 population. The Greater Chennai Corporation is already running 138 Urban Primary Health Centers and two are under construction. So far, the patients with communicable and non- communicable diseases were only treated in UPHCs. Now, the other medical services like ante-natal and post-natal, child health care and basic diagnostic investigation are being given under one roof. Steps have been initiated to establish 15 Urban Community Health Centers for every 2.5 lakh population, minimum of one center per zone with 100 beds and upgraded diagnostic facilities etc., out of which 9 are running successfully, at present. The remaining 6 UCHCs are under different stages of construction.
a. This scheme is being administered by Chennai City Urban Health Mission and a sum of Rs.181.62 crore have been allotted from National Urban Health Mission to Greater Chennai Corporation till 31.03.2017 for carrying out the said activities.
a. This scheme is being administered by Chennai City Urban Health Mission and a sum of Rs.181.62 crore have been allotted from National Urban Health Mission to Greater Chennai Corporation till 31.03.2017 for carrying out the said activities.
Integrated Diseases Surveillance Programme was initiated in Greater Chennai Corporation in November 2009. The key objective of the programme is to strengthen/maintain decentralized laboratory base IT enable disease surveillance system for epidemic prone diseases to monitor disease trend and to detect and respond to outbreaks in early rising phase through trained Rapid Response Team (RRTS).
Disease surveillance is recognized as an important tool for early detection of diseaseoutbreaks for institution effective control measures in timely manner.
Chennai has a total population of 70 Lakhs approximately with a 10 Lakh migrant and floating population. There are 22 Government Hospitals, one Apex Lab -King Institute and around 560 Private Hospitals/Nursing Homes and around ten thousand private Medical Practitioners Practicing medicine across Chennai city.
The District Surveillance Unit receives line list of patients suffering from infectious diseases from 32 major private hospitals spread across Chennai city and also from 9 government hospitals of Chennai and the same is disseminated to the respective Zones of Chennai and ensure that an early comprehensive preventive and control measures are taken in the zones so that outbreaks are prevented.
Dissemination of data is also sent across districts and states through the State Surveillance Unit.
This Surveillance system is a very sensitive and effective programme enabling at most Public Health Care the people of Chennai
For the convenience of Public, birth and death certificates can be downloaded at free of cost from www.chennaicorporation.gov.in webpage. since 07.09.2008. Certificates can be downloaded at any internet centre or at home at anytime from any part of the world. approximately 1,24,52,136 crores of birth certificates and 31,23,948 lakhs of death certificates have been downloaded by the public till date 24.05.2017.
Birth certificates are issued within 24 hours after delivery occurred in the Major Govt Hospitals. All the hospitals in Corporation of Chennai has been given individual user name and password for registering the details of births, still births and deaths through online.
All the birth and Death records have been computerized from the year 1930 in Corporation of Chennai. The process of uploading the birth and death events from the records which are not computerized in the extended areas is going on at Zonal level.
For inclusion of Child name in the birth certificate, photocopies for the proof date of birth, individual name and parent name with self declaration has to be produced for the issuance of fresh birth certificate with child name.
Corrections like spelling mistakes in parent name, addition / deletion of surname / family name is done based on the valid supportive documents subjected to the birth and death registration act 1969.
Spelling corrections in the deceased name is done on the documentary evidence produced by the legal heirs of the deceased and on the personal satisfaction of the Registrar based on the facts of the case as per the B&D Act 1969.
There are totally 88 burial grounds maintained by Greater Chennai Corporation. There are total 23 Gasifiers, 7 Electrical and 2 LPG Gasifiers. Cremation and Burial are done free of cost.
The Greater Chennai Corporation is running 3 Animal Birth Control (ABC) centers to control stray dogs birth such as.
The stray dogs are being caught based on regular inspection and specific complaints from the public, sterilized and immunized against rabies. These dogs are then released in the same area where they are caught as per ABC Rules.
During 2016-17 to till March 2017 through these ABC centers 21,622 stray dogs have been sterilized. A total of 16 dogs catching vehicles are deployed for dog catching operations. Private dog catchers are also engaged for catching and relocating.
The Greater Chennai Corporation is running 3 Animal Birth Control (ABC) centers to control stray dogs birth such as.After receiving the complaints about stray dogs through toll free no. 1913 complaints are forwarded online to the respective Zonal Veterinary Assistant Surgeons. 42 dog catchers and twelve dog catching vehicles are pressed into service daily to the various Zones thereby catching the stray dogs and being handed over to the Animal Birth Control centers run by the Corporation of Chennai
Following centers are being conducted by the Corporation of Chennai, Public Health Department giving treatment and vaccination for the pets.
License system is being carried by Corporation of Chennai, Public Health Department for pet dogs. By this Rs.50/- has to be paid for an yearly licence by which aluminium dog licence disc is being issued by this department.
For the first time in India dead pet animals are being cremated free of cost in the following centers of Corporation of Chennai.
In order to control the traffic menace caused by the free movement of the cattle through the street of Chennai, Corporation of Chennai, Public Health Department, the stray cattle are being caught through its eleven cattle catching vehicles and impounded in the ‘D’ and ‘G’ cattle pounds. After imposing fine and maintenance charges of cattle are being collected impounded cattle are being handed over to the cattle owner.
As a special onetime programme, immunization against rabies for 60,826 stray dogs has been successfully completed during ¬August 2016.
For the purpose of providing a clean and hygienic meat to the people of Chennai three Slaughter houses are functioning at present under the direct supervision of (Greater Chennai Corporation) for providing clean and wholesome meat to the Public. The Veterinary Assistant Surgeons conduct Ante-Mortem and Post - Mortem inspection of animals meant for meat purpose. Animals slaughtered in other places are considered illegal. In addition a new slaughter house has been opened at Kallikuppam in Zone 7. Effluent Treatment Plants have been installed in these slaughter houses as per the guidelines of the Tamil Nadu Pollution Control Board.
Meat raid is regularly conducted in the Zone-I to XV with a team comprising of Sanitary Inspectors, Sanitary Officer, Veterinary Assistant Surgeons and Zonal Health Officer. Apart from regular raid, surprise raid are conducted based on specific complaints/secret information received from public and reports of daily News papers.
The unwholesome Meat seized is destroyed with proper sanitary measures and deeply buried in the dumping yards of the Greater Chennai Corporation. The offenders are given strict warning to stick on to the frame of rules or follow the cancellation of licensee to the shops.
As per the G.O.M.S No.122,R.D & L.A, Dated: 23.01.1980, strict enforcement of no slaughter and sale of meat, beef, pork, chicken stall shops is observed on the followings three days which is ensured through the inspection by a team of Health Official and Veterinarians.
To tackle cattle menace, cattle raid is regularly conducted in the Zones on receipt of specific complaints by the public and reports through Daily Newspapers. There are 11 cattle vehicles for catching cattle. The team comprising of Sanitary Inspectors, Veterinary Assistant Surgeons and cattle catchers with available cattle catching vehicle stray cattle are seized and sent to the cattle depots situated at Perambur and Pudupettai, maintained by Veterinary Assistant Surgeons of Greater Chennai Corporation. The cattle owners of the stray cattle are imposed with nominal spot fine and maintenance charges are collected before releasing the cattle to them with a with a written affidavit stating that “not to let out their animals in future”.
Enforcement under various sections of TNPH Act and CCMC Act are strictly implemented against the offenders causing Public Health nuisance.
The public health department co-ordinates in regulating proper disposal of solid waste, OAD, Toilet Constructions and other activities concerned with the environmental sanitation of the city.
Raids such as unwholesome water, banned tobacco products food and meat are conducted in the interest of public health.
A Separate IEC cell exists at the Head Quarters. Several IEC programmes have been conducted in the educational institutions, slums, public places, companies, General public etc., with the audio visual aids to prevent and control of communicable and non-communicable diseases. In addition, environmental sanitation programme like clean Chennai, etc., are also carriedout by the IEC cell.
Antenatal care, Identification of high risk antenatal and early referral, HIV testing for all antenatal mother and their spouse, Postnatal follow up, Provision of Temporary and Permanent Family Welfare methods.
In UPHCs & UCHCs Antenatal care, Intranatal care, Postnatal care are given to the mothers. Ultrasound for Pregnant women, Disposable Delivery Kit for safe Delivery, Nutritious diet for Delivered and Sterilized mothers, postnatal follow up are done. Annually around 12,000 Delivers and 9000 Family Welfare operations (Permanent Sterilization procedures) are being done. In our Secondary care Greater Chennai Hospitals, and Greater Chennai Maternity Hospitals health education and creation of awareness among the mothers regarding Nutrition, Personal Hygiene, Environmental sanitation, Family Welfare Procedures (Permanent & Temporary methods), importance of Immunization, Growth monitoring especially among Under five children.
New born Stabilisation Unit where all new borns are resusicated, stabilised and referred if necessary
