The state has per capita one of the highest concentrations of health manpower among the North-Eastern states. The state has two medical colleges RIMS & JNIMS and their attached hospitals plus 7 districts hospitals. Further there are 26 private hospitals and nursing homes registered under Manipur Nursing Home & Clinic registration Act 1992. Medical facilities in the state were mainly provided by the state government. It is the basic social input for healthy and efficient human resources.

The incidence of vector borne diseases viz. Malaria, Filaria, Kala-azar, Acute Encephalitis Syndrome (AES) including Japanese Encephalitis (JE), Dengue and Chikungunya are linked with economic and social development of the community. There are various factors which govern the transmission of these diseases. The spread of many of these diseases may likely be the impacts of climate change.

Based on the relative humidity and temperature, the transmission windows (TWs) of Malaria may remain open for at least 7-9 months in a year at most parts of the state. Tamenglong, Churachandpur and Imphal East districts account for 70% of the total Malaria cases in the state. Health maybe directly or indirectly linked to the climate change in many ways like propagation of the vector and water borne diseases and its related outbreaks, deterioration in nutritional health due to loss of food security and reducing cereal yields etc. Moreover, with projected increase in surface temperature, increased in frequency and intensity of extreme events such as increased in night temperature, increased in number of warm days, extreme heat and heavy precipitation etc. the conditions in health sector is likely to deteriorate. Climate change can further impact the population which has a lower capacity to combat the impacts and their access to medical facilities. In the future, due to anthropogenic causes, the impacts on human health are likely to escalate with respect to their virulence and spread to hitherto disease-free areas.

 


 

 

VECTOR BORNE DISEASES AND CASES IN MANIPUR

 

1.    Malaria

 

Malaria is an acute parasitic illness mainly caused by Plasmodium Vivax and Plasmodium falciparum in India.

 

 

Table 1.    Malaria incidence                                                   

Annual Parasite Incidence (API)

Total

2009

>10

5 to 10

2 to 5

1 to 2

<= 1

 

 

0

0

1

1

10

12

2010

>10

5 to 10

2 to 5

1 to 2

<= 1

 

 

0

0

2

0

10

12

2011

>10

5 to 10

2 to 5

1 to 2

<= 1

 

 

12

0

0

1

11

12

2012

 

 

 

 

 

255

2013

 

 

 

 

 

120

2014

 

 

 

 

 

118

             Source: NVBDCP Annual Report 2012 to 2014

Table: 2. District wise percentage contribution of Malaria cases

Sl. no

Districts

2006

2007

2008

2009

2010

2011

1

Tamenglong

42

26

18

24

35

52

2

Churachandpur

11

8

16

19

23

24

3

Imphal East

7

17

28

14

17

5

4

Ukhrul

14

10

8

9

3

6

5

Chandel

10

13

12

9

4

6

6

Other districts (Bishnupur, Thoubal, Imphal West & Senapati

7

23

16

23

18

7

              Source: Directorate of Environment Government of Manipur 2013

Intensified Malaria Control Project II (IMCP II) under GFATM R9 In the month of January 2015 under the IMCP, 77 fever cases were tested with RDT which is used for early parasitological diagnosis. The highest number of cases records from Imphal East with 51 cases folllowed by Tamenglong district 25 cases and 1 case from Chandel district.

 

 

National Rural Health Mission (NRHM)

The malaria related expected outcome of the NRHM is reduction of malaria mortality by 50% by 2010 and an additional 10% by 2012. The NRHM has already had tangible results. The number of government hospitals had increased from 4,751 in 2000 to 7,663 in 2006. There has been a scale up of ASHAs in malaria endemic and tribal areas and a total of 481,308 ASHAs have been selected.

Table 3.  Status of ASHAs in Manipur

Number of ASHAs In-Position

Number of ASHA Trained in Malaria

3878

3120

                             Source: www.wbhealth.gov.in

 


 

2.    Dengue

Dengue is an outbreak prone seasonal viral disease caused by any one of four strains of Dengue virus (DEN-1, DEN-2, DEN-3, or DEN-4). The virus is transmitted to humans by the bite of an infected Aedes mosquito. It is the fastest growing arbo-virus infection with a rapidly evolving epidemiology. Dengue is an ecological disease and the transmission is related to rainfall and temperature. Every year during the period of July-Nov there is an upsurge in the cases of Dengue.

Table 4. Dengue outbreaks

2010

2011

2012

2013

2014

2015

 

Case- death

    7   -   0

Case- death

220  -  0

Case- death

  6     -  0

Case- death

   9    -   0

Case- death

   0    -   0

Case- death

  32   -   0

 

Source: Annual report NVBDCP 2014-15. The Sangai Express. Dated Oct 29.2015


 

3.    Japanese Encephalitis

Japanese Encephalitis (JE) is the leading cause of viral encephalitis. It mainly attacks children younger than 15 years of age. Approximately 20-25% of those infected usually die and among the survivors, about 30% develop disabilities - mental, physical or both.

Table 5. Cases of Japanese Encephalitis

2010

2011

2012

2013

2014

Case-death

118   -  15

Case- death

   11 -  0

Case- death

   2   -  0

Case- death

   1  -   0

Case- death

   1  -   0

Source: Annual report NVBDCP 2014-15

Table 6. Climate Change on Sensitive Disease in Manipur

Year

Malaria

Dengue

Japanese Encephalitis

Cases

Death

Cases

Death

Cases

Death

2001

943                  5

Nil                   Nil

Nil                  Nil

2002

1268                9

Nil                   Nil

Nil                  Nil

2003

2589                17

Nil                   Nil

2                     1

2004

2736                 8

Nil                   Nil

1                     Nil

2005

2071                Nil

Nil                   Nil

Nil                   Nil

2006

2709                 8

Nil                   Nil

Nil                   Nil

2007

1194                 4

5                      1

65                   Nil

2008

708                   2

Nil                  Nil

4                      Nil

2009

1069                 1

Nil                  Nil

64                   Nil

2010

947                   4

7                     Nil

118                 15

2011

714                   1

220                Nil

11                    Nil

2012

255                   Nil

6                    Nil

2                      Nil

2013

120                   Nil

9                    Nil

 1                     Nil

2014

118                   Nil

Nil                 Nil

  1                    Nil

             

           Source:  Directorate of National Vector Borne Disease Control Programme

As per the report of Health Dept. incidence of the cases of Japanese Encephalitis & Dengue are on the rise in the state. Disease and epidemiological points towards the relationship between the occurrence of Dengue and Japanese Encephalitis to subtle change in climatic conditions that favour the breeding and proliferation of their vectors.


 

Table 7. Data on Varying of Weather causes common diseases in Manipur

 

 

Therefore, health sector should be giver more importance in regards to the changing climatic condition and more improvement in the infrastructure and services should be initiated.