National Action Plan Book Final

National Action Plan
Prevention and Control of Dengue in Sri Lanka
2019 - 2023
National Action Plan on Prevention and Control of Dengue in Sri Lanka 2019 - 2023
National Dengue Control Unit

Ministry of Health, Nutrition & Indigenous Medicine
National Action Plan
Prevention and Control of Dengue in Sri Lanka
2019 - 2023

Ministry of Health, Nutrition & Indigenous Medicine
Suggested citation:
National Dengue Control Unit, Ministry of Health, Nutrition and

Indigenous Medicine, 2019. National Action Plan on Prevention
and Control of Dengue 2019 - 2023, Sri Lanka.
Published in April 2019
ISBN 978-955-3666-16-1

Ministry of Health, Nutrition and Indigenous Medicine
Public Health Complex
555/5, Elvitigala Mawatha, Narahenpita
Colombo 05
Sri Lanka
Tele : 011-2368416, 011-2368417

Fax : 011-2369893
E-mail : [email protected]
Web : www.dengue.health.gov.lk
Printed by : Nanila Publication (Pvt) Ltd.

No.227/30, Nirmana Mw,
Nawala Rd, Nugegoda.
Tel: 011 4809400
ii Page National Dengue Control Unit

NATIONAL ACTION PLAN AT A GLANCE
Country Sri Lanka

Title National Action Plan on Prevention and Control of Dengue
Organization Ministry of Health, Nutrition & Indigenous Medicine
Duration 2019 - 2023
Budget Rs:1,858,943,750.00
Implementing
National Dengue Control Unit of the Ministry of Health
Institute
Geographical
National & subnational
Target areas
Outcome Objectives:
To achieve case incidence below 100/100,000 population by
Project
the year 2023
Objectives
To reduce and maintain case fatality rate below 0.1 % by the
year 2023
Specific Objectives:
1. To intensify epidemiological surveillance to detect and

notify dengue cases real-time
2. To intensify entomological surveillance to forecast vector
density and to take appropriate control measures
3. To apply appropriate integrated vector management (IVM)
strategies to interrupt dengue transmission
4. To improve early diagnosis and case management
5. To detect epidemics early and to respond to potential
epidemics effectively
6. To strengthen monitoring and evaluation to ensure optimal
programme implementation, management and performance
7. To facilitate, link and conduct operational research in the
prevention and management of dengue infections
National Dengue Control Unit Page iii

FOREWORD
It gives me great pleasure to present the National Action Plan on Prevention and
Control of Dengue: 2019 – 2023 developed by the National Dengue Control Unit
with the support of the expert committee appointed by me. The Government of Sri
Lanka is conscious of the possible adverse consequences of Dengue on affected
communities. Therefore, all necessary measures have been taken to reduce the
health impact due to dengue to such an extent that it would no longer be a major
public health issue by 2023.
To achieve this goal, Sri Lanka must put forward an integrated and evidence
based action plan in order to implement an effective and sustainable preventive
programme. This national action plan prepared after several consultations presents
sustainable strategies and activities for prevention and control of this disease in
Sri Lanka. A series of multi-disciplinary, broad-based, multi-pronged strategies
are proposed, with long-term sustainability achieved through direct integration
with the national programme.
The National Dengue Control Unit under the direct guidance of the Ministry
of Health will be the primary implementer of this action plan with the support
of its partner organizations. The Ministry of Health solicits cooperation of all
stakeholders for the effective implementation of this plan. I am confident that
all stakeholders within the Government as well as the development partners will
provide their unconditional support towards this national endeavour.
Dr. Rajitha Senaratne

Minister of Health, Nutrition and Indigenous Medicine
Sri Lanka
National Dengue Control Unit Page v

PREAMBLE 1
The National Action Plan on Prevention and Control of Dengue in Sri Lanka
2019 - 2023 has been developed by the National Dengue Control Unit in response
to the increasing endemicity level with intermittent outbreaks which warrants
re-organized and strengthened framework for prevention, control and clinical
management of Dengue through an integrated approach.
National Dengue Control Unit of the Ministry of Health was established in 2005
for coordinating dengue control and prevention following the major Dengue
outbreak in the year 2004. When dengue illness increasingly expanded in high
magnitude in 2011 it was upgraded to a directorate as the National Dengue
Control Unit with a dedicated annual budget allocation.
With coherent and coordinated efforts undertaken to reverse the alarming trends,
this National Action Plan on Dengue Prevention and Control, 2019–2023,
incorporates wider perspectives of Dengue control to support the restructuring of
the programme at national and subnational levels. It aims to move from a reactive
response to an emergency situation, to proactive risk assessment, early warning
systems, and preventive measures through advocacy, resource mobilization,
strategic partnerships, capacity-building, monitoring and evaluation.
The partnership and resources of members of the Presidential Task Force

for Dengue Prevention will be solicited under a single plan of action aligned
to the Ministry of Health. Close collaboration has been maintained with all
representatives at both national and sub-national levels.
The plan emphasizes coordinated actions among multisectoral partners for

preparedness and epidemic response ensuring sustainable and cost-effective
efforts that can build capacities and increase resilience to future outbreaks, in line
with global and regional strategic framework.
Through the effective implementation of its many components, this plan is

expected to reduce dengue morbidity, making Dengue transmission not a major
public health problem in Sri Lanka.
Mrs. Wasantha Perera

Secretary
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PREAMBLE 11
Dengue has become a major health issue in recent years in Sri Lanka, with high
morbidity, and considerable mortality.
The aim of this national action plan is to achieve case incidence below 100/100,000
population and to reduce and maintain case fatality rate below 0.1 % by the year
2023 by adhering to the comprehensive set of activities included under specific
objectives given in the document.
The overall purpose of this national action plan is to adopt an integrated approach
to minimize the impact of Dengue as a public health problem, with collaborative/
synergistic support and commitment from relevant stakeholders.
This publication will be a useful reference document for programme managers

in the NDCU/ provinces/ districts for planning and implementing the prevention
and control activities of Dengue nationally and sub-nationally.
I believe this document will serve as a reference for coordinated and integrated
actions with partners within the health sector and other stakeholders in
strengthening and streamlining Dengue preventive and control activities and
improving clinical management to reduce the impact of this vector-borne disease.
Further, the results framework included could be used to monitor and evaluate the
activities stated.
Dr. Anil Jasinghe

Director General of Health Services
National Dengue Control Unit Page vii

PREFACE
Since its establishment in 2005, the National Dengue Control Unit has done a
significant amount of work to plan and implement Dengue control and prevention
in Sri Lanka. However, over the past decade there were several major cyclical
epidemics together with the number of dengue cases reported growing annually at
an exponential rate. Therefore, a sustainable programme through a comprehensive
integrated approach aiming to reduce both morbidity and mortality to such an
extent that it will no longer be a major public health issue needed to be developed.
The intention of this National Action Plan on Prevention and Control of Dengue,
2019 – 2023 is to outline the road map in sustaining key interventions through
meticulous planning and a holistic approach in implementation.
Today, Sri Lanka has reached the lowest-ever case fatality rate of <0.2%
(51,659 cases with 58 deaths) in 2018 from a high 5% and 1% in 1996 and
2009 respectively, despite an increase in the proportion of more severe Dengue
Haemorrhagic Fever (DHF) to 10 - 15%. Lowering mortality from the current
case fatality rate and maintaining it is the country’s top priority. During the next
5 years further strengthening of healthcare and laboratory facilities for early
diagnosis through enhanced fever screening and emergency care at the level of
first contact is emphasized.
The country will pay more attention to reducing morbidity in the coming
years, which is an equally challenging task that requires adaptation of specific
collaborative actions. Multiple opportunities have opened up in terms of advocacy,
social mobilization and legislation, with the presidential task-force providing a
platform for both intra- and inter-sectoral collaboration. Together with the new
strategies of risk mapping, innovation and risk modification, more positive results
should be expected.
In order to achieve the sustainable implementation of strategies and activities

highlighted here, availability of adequate funds and resources together with
trained and skilled workforce is paramount. It is hoped that this action plan will
be a catalyst for Sri Lanka in order to move forward to achieve the ultimate aim
of diminishing impact of Dengue as a public health problem.
Dr. Hasitha A. Tissera

Consultant Epidemiologist/ National Coordinator for Dengue
Acting Director, National Dengue Control Unit
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MEMBERS OF THE EXPERT COMMITTEE
Prof. Rajitha Wickramasinghe - Senior Professor of Public Health
Faculty of Medicine, University of Kelaniya
Prof. Kamini Mendis - Senior Consultant in Malaria and Tropical Medicine, WHO
Prof. Deepika Fernando - Professor of Parasitology
Faculty of Medicine,University of Colombo
Dr. Palitha Abeykoon - Consultant to WHO
Dr. Nihal Abeysundara - Consultant to WHO
Dr. Pushpa Herath - Senior Entomologist WHO
Dr. Sarath Amunugama - Former DDG PHS1, Ministry of Health
Dr. Jayantha Weeraman - Senior Consultant Paediatrician
Dr. Ananda Wijewickrama - Consultant Physician
National Institute of Infectious Diseases, Angoda
Dr. LakKumar Fernando - Consultant Paediatrician, Base Hospital, Gampaha
Dr. Geethani Galagoda - Consultant Virologist, Asiri Hospital
Dr. Hasitha Tissera - Consultant Epidemiologist/ Acting Director, NDCU
Dr. Nimalka Pannila Hetti - Consultant Community Physician, NDCU
Dr. Samitha Ginige - Consultant Epidemiologist, Epidemiology Unit
Dr. Preshila Samaraweera - Consultant Community Physician, NDCU
Dr. D.S Anoja F. Dheerasinghe - Consultant Community Physician, NDCU
Dr. Mizaya Cader - Consultant Community Physician, NDCU
Dr. Prasad Liyanage - Regional Epidemiologist, RDHS Office, Kalutara
Dr. Subashini Ariyaprema - Entomologist, RDHS Office, Colombo
Mrs. M.D. Sakunthala Janaki - Entomologist, NDCU
MEMBERS OF THE NATIONAL DENGUE CONTROL UNIT

Dr. O.B.W. Rajapakshe - Senior Registrar
Dr. K.A.S.D. Kumarapperuma - Medical Officer
Dr. Iroshini Abeysekera - Medical Officer
Dr. B.D.W. Jayamanne - Medical Officer
Dr. W.M.I.P. Weerasinghe - Medical Officer
Dr. R.M.T.D. Rathnayake - Medical Officer
Dr. K.A.L.C. Kodituwakku - Medical Officer
Dr. U.N. Premathilake - Medical Officer
Dr. T.G.A. Sanjeewani - Medical Officer
Dr. M.T.A. Rikarz - Medical Officer
Mrs. Dinusha Perera - Entomologist
EDITED AND COORDINATED BY

Dr. D.S. Anoja F. Dheerasinghe
Consultant Community Physician,
National Dengue Control Unit Page ix

ACKNOWLEDGEMENT
This National Action Plan on Prevention and Control of Dengue: 2019 – 2023
was developed by the National Dengue Control Unit of the Ministry of Health
through a series of consultative/stakeholder meetings and consolidating the
opinion of experts in relevant fields.
Independent experts facilitated by the World Health Organization (WHO) and

experts of the Ministry of Health provided necessary technical support for the
development of this action plan. Further, Ministry of Health provided the financial
support for printing of this document.
x Page National Dengue Control Unit

ABBREVIATIONS
BH Base Hospital MOOH Medical Officers Of Health

BI Breteau Index NDCP National Dengue Control
CBO Community Based Organization Programme
CCP Consultant Community Physician NDCU National Dengue Control Unit
CIDA Construction Industry NGO Non Governmental Organization

Development Authority NIE National Institute of Education
CSR Corporate Social Responsibility NO Nursing Officer
DENV Dengue Virus NS1 RDT Non Structural Protein 1 based
DF Dengue Fever Rapid Diagnostic Test
DHF Dengue Haemorrhagic Fever OPD Out Patient Department

DS District Secretariat PCU Primary Care Unit
DSS Dengue Shock Syndrome PHI Public Health Inspector
e-IMMR Electronic Indoor Morbidity and PHM Public Health Midwife
Mortality Record PI Premises Index
FBC Full Blood Count PTF Presidential Task Force
GH General Hospital RDHS Regional Director of Health
GIS Geographic Information Systems Services
GN Grama Niladhari RE Regional Epidemiologist
GP General Practitioner SHEO Supervising Health Entomological

Officer
HDU High Dependency Unit
SHO Senior House Officer
HEB Health Educational Bureau
SKS Saukya Karya Sahayaka
HEO Health Entomological Officer
SOP Standard Operational Procedure
HO House Officer
SPHI Supervising Public Health
ICNO Infection Control Nursing Officer
Inspector
IMMR Indoor Morbidity and Mortality
SPHID Supervising Public Health
Record
Inspector District
IVM Integrated Vector Management
TH Teaching Hospital
LG Local Government
TOT Training of Trainers
M&E Monitoring and Evaluation
UDA Urban Development Authority
MO Medical Officer
WHO World Health Organization
MOH Medical Officer of Health
National Dengue Control Unit Page xi

xii Page National Dengue Control Unit
CONTENTS
Foreword v
Preamble I vi
Preamble II vii
Preface viii
Members of the Expert Committee ix
Acknowledgement x
Abbreviations xi
Executive Summary 1
Introduction
Purpose 5
Context 7
Global Situation 7
Sri Lankan Situation 8
National Dengue Control Unit 14
Rationale 16
National Action Plan on Prevention and Control of Dengue 18
2019 - 2023
Objectives 21
Monitoring and Evaluation Framework 59
Time Frame (Gantt Chart) 62
Budget Summary 77
References 79
Annexures
I. Presidential Task Force on Dengue Prevention & 81
Control and Inter-sectoral Coordination
II. Development of the Capacity of Field Workforce to 84
Augment Elimination of Mosquito Breeding Places
III. Organizational Structure of the National Dengue 86
Control Unit & Proposed Organizational Structure at
Provincial/ Regional Level
IV. Current and Proposed Cadre Positions at National & 87
Sub-national Level
National Dengue Control Unit Page xiii

Executive Summary
EXECUTIVE SUMMARY
Dengue has become a major public health issue in recent years, with high
morbidity, and considerable mortality.
The National Dengue Control Unit (NDCU) of the Ministry of Health is the focal
point for coordinating dengue prevention and control activities with stakeholders
mandated by the Presidential Task Force on Dengue Prevention and Control. This
unit was established in the year 2005 through a policy decision that was taken by
the Ministry of Health following the major Dengue outbreak in the year 2004.
NDCU is responsible for coordinating entomological surveillance, integrated
vector management, inter-sectoral collaboration, social mobilization and capacity
building in clinical management along with regular monitoring and evaluation of
both national and sub-national activities for prevention and control of Dengue.
A comprehensive strategic plan for prevention and control of Dengue in Sri
Lanka was developed for 2011 – 2015. The National Action Plan on Prevention
and Control of Dengue in Sri Lanka 2019 - 2023 has been developed by the
National Dengue Control Unit in response to the increasing endemicity level with
intermittent outbreaks which warrant re-organized and strengthened framework
for prevention, control and clinical management of Dengue through an integrated
approach.
The National Action Plan for 2019 - 2023 incorporates wider perspectives of
Dengue control to support the restructuring of the programme at national and
subnational levels.
Based on the vast experience gained from the 2017 major outbreak and changing
serotypes of virus sociocultural changes and urbanization etc., the following
outcome objectives are laid down to reduce morbidity and mortality due to
Dengue:
● To achieve case incidence below 100/100,000 population by the year

2023
● To reduce and maintain case fatality rate below 0.1 % by the year 2023
The following comprehensive set of specific objectives are laid down to achieve
the above outcome objectives;
1. To intensify epidemiological surveillance to detect and notify dengue cases

real-time
2. To intensify entomological surveillance to forecast vector density and to take

appropriate control measures
2 Page National Dengue Control Unit
3. To apply appropriate integrated vector management (IVM) strategies to
interrupt dengue transmission
5. To detect epidemics early and to respond to potential epidemics effectively
6. To strengthen monitoring and evaluation to ensure optimal programme

implementation, management and performance
7. To facilitate, link and conduct operational research in the prevention and

management of dengue infections
In order to track the progress of implementation and evaluate programme

achievements and sustain the activities, a “Performance Framework” is
incorporated for the current action plan with easily quantifiable and verifiable
process, output, outcome and impact indicators.
In the next five years, the planned activities will be implemented in a phased
manner with an estimated budget ranging from Rs. 350-400 million as a collective
effort to reduce the health and socioeconomic impact due to dengue in the country.
National Dengue Control Unit Page 3

Introduction
PURPOSE
Dengue has become a major public health issue worldwide in the current century,
with high morbidity and mortality. Aedes aegypti and Aedes albopictus are the
vectors responsible for the transmission of dengue viruses (DENV). The four
DENV serotypes (1, 2, 3, and 4) have been co-circulating in Sri Lanka for more
than 30 years. Despite the presence of Dengue since the early 1960s, over the past
two decades, there has been a dramatic increase in the transmission of Dengue
Fever (DF), Dengue Haemorragic Fever (DHF) and Dengue Shock Syndrome
(DSS) tending to occur in outbreaks in Sri Lanka. The frequency and magnitude
of dengue epidemics have increased over the recent decades which have become
a major health challenge to the country calling for comprehensive efforts to
combat the disease.
As the central level organization responsible for coordination of control and

preventive activities related to dengue, the National Dengue Control Unit has
compiled the “National Action Plan on Prevention and Control of Dengue in
Sri Lanka 2019 – 2023”. This includes more comprehensive efforts entailed
in the “Strategic plan for prevention and control of Dengue Fever/Dengue
Heamorrhagic Fever in Sri Lanka 2011 – 2015”. The updated action plan for
2019 - 2023 is developed aiming to restructure the current health response to
the disease situation, optimally utilizing the innovative techniques to improve
effectiveness and efficiency while invigorating multi-sectoral collaboration for
cohesive action.
This action plan has been developed under the following major strategies;
● Monitoring Disease Surveillance
● Vector Surveillance and Integrated Vector Management (IVM)
● Providing Facilities for Evidence-based Clinical Care
● Inter-sectoral Coordination and Social Mobilization
● Risk Communication and Outbreak Preparedness and Response
● Innovative Research
Aforementioned strategies are elaborated in this action plan developed by national

level experts and partners. In the implementation of this action plan, it would be

necessary to harness the technical and logistical expertise available at the national
and regional levels through various collaborations and networking. In order to
track the progress of implementation and evaluate programme achievements and
sustain the activities, a “Performance Framework” is incorporated for the current
action plan with easily quantifiable and verifiable process, output, outcome and
impact indicators.
In the next five years, the planned activities will be implemented in a phased
manner in an effort to reduce the health and socioeconomic impact due to dengue
within the country.
This document is recommended as a guide for the health sector as well as other
relevant partners and stakeholders in developing their operational plans at
national and regional settings to harmonize and intensify dengue prevention and
control activities.

CONTEXT
Dengue viruses (DENV) are mosquito-borne flaviviruses that have plagued humans for centuries.
Unplanned urbanization and rapid human population growth in tropical and subtropical regions of
the world have produced favourable conditions for DENV transmission. Moreover, changes due to
urbanization and human population growth have led to the current global dengue pandemic, characterized
by emergence of new serotypes of DENV and an expanding geographic distribution of both DENV and
the mosquito vectors, Aedes aegypti and Aedes albopictus, which transmit DENV among humans. The
extent of dengue transmission and therefore the risk of outbreaks are determined by a combination
of various modifiable and non-modifiable factors; distribution and virulence of the virus, population
density, movement of humans, level of herd immunity in the porpulation, vector competence of Aedes
mosquitoes, and weather and climate variables are amongst other environmental factors accentuated by
human behaviour.
GLOBAL SITUATION
The more severe form of the illness [also known as Dengue Haemorrhagic Fever (DHF)] was first
recognized in the 1950s during dengue epidemics in the Philippines and Thailand. Before 1970, only
9 countries had experienced severe dengue epidemics. The disease is now endemic in more than 100
countries mainly in the regions of the South-East Asia, the Western Pacific, the Americas and the Eastern
Mediterranean. There are 4 billion people at risk and 390 million dengue infections occurring each year
which includes nearly 5 million Dengue Heamorrhagic Fever cases and 22,000 deaths. The America,
South-East Asia and Western Pacific regions are the most seriously affected, exceeding 1.2 million cases
in 2008 and over 3.2 million in 2015.
In the South East Asian region, Dengue Fever/Dengue Haemorrhagic Fever is endemic in 10 countries
and detection of all four serotypes has now rendered these countries hyperendemic. Sri Lanka is
grouped under the hyperendemic category by the World Health Organization, together with Bangladesh,
India, Indonesia, Maldives, Myanmar, Thailand and Timor – Leste (other categories being ‘endemicity
uncertain’ and ‘non-endemic’).

SRI LANKAN SITUATION
General Profile
Sri Lanka is an island in the Indian Ocean with 65,610 km² in extent. According to the population and
housing census conducted in 2012, the total population is 20,359,439. The most urbanized Western
Province has a population of 5,851,130 which is 28.7% of the total. The least populated area is the
Northern Province (1,061,315; 5.4%). The country reports a population density of 325/km2 with the
highest of 3,438/Km2 in the Colombo district followed by 1719/km2 in the Gampaha district in Western
Province. Sri Lanka represents an ethnic mix with a majority of 74.9% Sinhalese followed by Sri Lankan
Tamils, Moors and other ethnic minorities. The working adult population (15 – 60 years) contributed
62.4% of the total population in the country.
Being a tropical country lying between Latitude 6° 55' 37.4844" N and Longitude 79° 51' 40.4784" E,
it has year-round warm weather, moderated by ocean winds and considerable moisture. The average
temperature ranges from 16 °C (60.8 °F) to 32 °C (89.6 °F). The rainfall pattern is influenced mainly by
two monsoon periods; Southwest monsoon from May to September, Northeast monsoon from December
to February. Humidity is typically higher and remains above 70% throughout the year.
In Sri Lanka, 48 Aedes species belonging to 11 subgenera have been reported to date. The established
Dengue vectors Aedes aegypti and Aedes albopictus belong to the subgenus Stegomyia while knowledge
on the role of the remaining 46 Aedes species in DENV carriage and transmission, remains yet to be
discovered. Sri Lanka has been affected by Dengue Fever (DF)/Dengue Hemorrhagic Fever (DHF)
epidemics for over two decades. DENV infections have been endemic in Sri Lanka since the mid 1960s.
DF was serologically confirmed for the first time in the island in 1962. The presence of DF in all of the
major towns situated below 1200 m elevation was confirmed in 1966 and in 1976–1978.

Source: Epidemiology Unit, Ministry of Health
Figure 1: The trend of notified DF/DHF patients and Case fatality rate: 1989 - 2018
Since 2000, dengue is increasingly posing a significant socio-economic and public health burden to
the country (Figure 1). The geographic spread, incidence and severity of disease is of major concern
ever since the first dengue hemorrhagic fever epidemic occurred in 1989. Periodic epidemics have
become progressively larger during 2009-2014 with 28,000 to more than 40,000 cases reported each
year (47,258 cases in 2014). In 2017, a total of 186,101 Dengue cases were reported, which corresponds
to an incidence rate of 865.9 per 100,000 population (in - 2016: 271.9 per 100,000) and 440 deaths
(Case Fatality Rate: 0.24) (Figure 2).
As a result of intersectoral activities coordinated by the Ministry of Health and the stakeholders of
Presidential Task Force on Dengue prevention and control (Annexure I), there were only 51,659
suspected Dengue patients (at an incidence rate of 245.6 per 100,000 population) and 58 fatalities (Case
Fatality Rate: 0.11%) in 2018 (Figure 2).

* Incidence – Number of dengue patients per 100,000 population
Figure 2: Dengue incidence in Sri Lanka in 2017 and 2018
Dengue Epidemic in 2017
Since January 2017, an unusual increase in reported cases of dengue throughout the country was
observed, a trend which steadily continued till the end of the year. However, the massive outbreak was
curtailed successfully with more intensive integrated actions. Furthermore, the preceding lower case
fatality rate below 0.2% was maintained around 0.24% during the outbreak, despite the increase in the
proportion of the more severe Dengue Haemorrhagic Fever (DHF) to 10-15%.
Possible reasons for the epidemic were;
- change of the causative virus type from type I to type II,
- shift of breeding places from households to other common premises (schools, construction sites etc),
- migration of susceptible population from low endemic areas to high endemic areas

Seasonality
2014 2015 2016 2017 2018
12000
10000
8000
No. of Dengue patients
6000
4000
2000
0
1 2 3 4 5 6 7 8 9 10111213141516171819202122232425262728293031323334353637383940414243444546474849505152
Weeks
Source: Epidemiology Unit, Ministry of Health
Figure 3: Distribution of suspected DF/DHF in Sri Lanka by week, 2013 – 2018
Dengue fever exhibits a seasonal pattern in many parts of the island. Rainy season is a major determinant
of Dengue driven by a combination of climatic or environmental factors for transmission in both urban
and rural areas (Figure 3).

4A
4B
* Breteau Index (BI) = Number of positive containers for Ae.aegypti/Ae.albopictus larvae and/or pupae per 100 houses inspected
Figure 4: Mean combined Breteau Index* and Summary of Aedes aegypti breeding places
in 2017 & 2018
BI of districts Puttalam, Mannar, Kurunegala, Monaragala, Kandy, Kalmunai, Kegalle, Rathnapura,
Hambantota, Kilinochchi, Mullativ and Ampara in 2018 were higher than that in 2017 (Figure 4A).
When compared to breeding container summary of Aedes aegypti in year 2017, in year 2018 Western,
Uva, North Central and Central Provinces have shown an increased percentage in discarded containers.
North Central, Northern and North Western Provinces have been observed as having an increased
percentage in water storage containers. However, Uva province has shown a drastic reduction in the
precentage of positive water storage containers in year 2018 when compared to year 2017 (Figure 4B).
Implementation of Dengue related control activities in Sri Lanka
Dengue prevention and control activities are carried out to the grass root level through responsible
central and provincial bodies. At the central level, the National Dengue Control Unit, provides technical
guidance including policy development, planning, capacity building, resource allocation and monitoring
and evaluation. At the provincial level, execution of field level dengue prevention and control activities
are carried out through a network of district and divisional (Medical Officer of Health Unit) preventive
health services (Annexure II). At the central level, integrated disease surveillance is carried out by the
Epidemiology Unit. Provision of patient care services are rendered by both central and provincial health
care institutions based on National Guidelines on Clinical Management of DF/DHF.

NATIONAL DENGUE CONTROL UNIT
National Dengue Control Unit is the focal point for Dengue control programme in the Ministry of
Health in Sri Lanka. It was established in the year 2005 on a decision taken by the Ministry of Health
following a major DF/DHF outbreak in 2004. Although it functioned initially as a coordinatiion unit,
with annually increasing case load, and high socio-economic and public health burden, it was upgraded
to a directorate as National Dengue Control Unit (NDCU) with annual budget allocation.
NDCU is responsible for the following major strategies which are jointly carried out with the provincial
level curative and preventive health facilities.
i. Monitoring Disease Surveillance
ii. Vector Surveillance & Integrated Vector Management (IVM)
iii. Providing Facilities for Evidence-based Clinical Care
iv. Inter-sectoral Coordination and Social Mobilization
v. Risk Communication and Outbreak Preparedness and Response
vi. Innovative Research
NDCU is closely collaborating with the Epidemiology Unit and analyses disease surveillance data to
identify clustering of patients for timely action and to mitigate outbreaks. The disease surveillance
system combines both passive paper-based system and real-time online sentinel site system. Both these
systems work parallel with weekly reporting and online updates.
National Dengue Control Unit is mandated for Dengue vector surveillance and vector control island-
wide. NDCU is responsible for collection and interpreting data that is gathered by district teams. Data
on vector densities (immature stages - larval, pupae and adult vector) overtime enables predicting early
outbreaks/epidemics. The NDCU organizes and facilitates environmental management through premise
inspection and source reduction campaigns as a mainstay of IVM (Figure 5). Further, capacity building
for public health staff in relation to dengue control along with regular monitoring and evaluation of
provincial, district and MOH level activities are carried out. A significant proportion of district-level
Dengue prevention activities are funded and guided by NDCU.
National Dengue Control Unit is also responsible for procurement of necessary insecticides (adulticides,
larvicides), equipment for vector control and entomological activities, and capacity building/ training
for the field work force.

IVM methods for Control of
Dengue Vectors
Biological & Inter-Sectoral

Environment Law
Chemical Methods Bio- chemical Collaboration,
Management Methods Enforcement
Methods Health Education
Environment Modification Source

Adulticiding Larviciding
Environmental Manipulation Reduction
Personal Protection - reduce man vector
contact Larvivorous Fish
e.g.
Thermal
Temephos
Fogging
1% SG Bacillus thuringiensis israelensis (Bti)
Ultra low
Temephos Insect Growth Regulators (IGR)
volume
50%EC (e.g. Pyriproxyfen, S-Methoprene,
spraying
Novaluron)
Figure 5: IVM Methods for Control of Dengue Vectors in Sri Lanka
Capacity development through establishment of high dependency unit (HDU) of primary, secondary
and tertiary care hospitals in relation to clinical management of Dengue is coordinated by the National
Dengue Control Unit. Further, training of clinicians to improve capacity is jointly coordinated by the
Epidemiology Unit and NDCU.
For bringing together multi-disciplinary partnership to raise public awareness and behavioural change,
the Presidential Task Force (PTF) on Dengue Control and Prevention was established in 2010 by liaising
closely with relevant ministries and stakeholders. Main stakeholders involved in PTF are ministries of
Provincial Councils and Local Government, Home Affairs, Education, Environment, Law and Order,
Defence, Hosing & Construction and Media. This multi-disciplinary partnership created at national
level flows through Provincial, district, divisional and community levels (Annexure I).
Risk communication, outbreak preparedness and response, and social mobilization are other strategies
mandated by NDCU. Identifying disease clusters with potential outbreaks are communicated with
Medical Officer of Health Units based on real-time epidemiological and entomological surveillance
data. Source reduction campaigns are organized with the support of armed forces and Police together
with field level health staff. Such programmes are monitored and evaluated by the NDCU.
Advocacy and effective communication targeting behaviour change and community empowerment for
a sustainable preventive action are one of the main functions of NDCU.
Further, capacity building of all levels of public health staff in relation to Dengue control along with
regular monitoring and evaluation of provincial, district and MOH level activities are carried out at
national level. NDCU is involved in operational research with both international and local collaborators
on innovative Dengue prevention activities. One of the novel research projects is Wolbachia initiative
which transmits Wolbachia bacteria into wild mosquito populations to reduce the ability of these
mosquitoes to transmit disease.

RATIONALE
Increasing endemicity level for Dengue Fever and Dengue Haemorrhagic Fever (DF/DHF) with
intermittent outbreaks in Sri Lanka has created a challenging situation which needs re-organised and
strengthened framework for prevention, control and clinical management of Dengue.
The demand for central level leadership and technical contribution to the district and divisional level
in relation to Dengue control is growing rapidly. Further, a strong link between the central organization
and peripheral institutions for technical inputs, service provision, monitoring and evaluation has been
identified as a priority. Since, there are success stories for prevention and control of communicable
diseases with vertical disease control programmes in Sri Lanka (e.g. Malaria, Filariasis and Leprosy
programmes), the scope of the present capacity of NDCU has been revisited by an expert panel and
a more comprehensive vertical programme has been suggested at national and sub-national levels.
Hence, the physical and functional structure of the National Dengue Control Unit as a coordinating
body needs to be restructured as a more responsible central organization while developing the capacity
of subnational structure in a similar manner (Annexure III & IV).
Due to rapid urbanization and climate change, with limited adherence to conditions and requirments
building construction, in and out-migration of people, challenges in solid waste management and other
sanitary measures and the presence of wide range of breeding places inherent to different regions of the
country, Aedes mosquito control should be streamlined in a planned manner through zonal mosquito
vector surveillance. Therefore, it is envisaged to strengthen the capacity of NDCU at the vertical level
and monitor Dengue control in Sri Lanka more cohesively. Infrastructure, logistics and necessary funds
for planning, implementation, monitoring and evaluation should be made available to initiate and carry
out a comprehensive and a sustainable programme.
The context of the National Action Plan 2019 - 2023 is structured in such a way by incorporating wider
perspectives of Dengue control to support the restructuring of the programme. The main mandate of
Dengue Control should focus towards the reduction of the ultimate impact due to Dengue, which is
mortality. By considering the highest ever disease burden and mortality in 2017, the overall objective
of the current programme was laid down to reduce mortality due to Dengue by reducing morbidity and
disease transmission.
Moreover, restructuring should include more innovative and novel strategies emphasizing various
aspects of prevention and control of Dengue and its consequences. Generation of early warning is
the mainstay of the entire control programme, and therefore, development of advanced surveillance
tools using geographic information system (GIS) applications and upgrading of existing mechanisms
are essential. Further, provision of effective clinical care by improving infrastructure facilities and
providing trained human resources has been highlighted.
With the expansion of the Dengue control programme, utilization of entomological data in a scientific
manner and promotion of more targeted novel vector control measures need to be emphasized. Similarly,
implementation of policy decisions beyond health sector as well as joint activities involving stakeholder
ministries, non governmental organizations (NGOs)/ community based organizations (CBOs) and

private sector are proposed for sustainable Dengue prevention. Further, starting from advocacy for
politicians and policymakers to effective communication for community empowerment, the action
points should be addressed comprehensively under social mobilization.
A functioning system for monitoring and evaluation (M & E) is vital for the success of a public health
programme. Combination of monitoring and evaluation allows understanding of the cause-and-
effect relations between implementation and impact. Hence, the establishment of M&E unit with a
comprehensive database for regular monitoring and development of valid and measurable indicators is
paramount.
Finally, when all strategic components of the Dengue Control Programme are lined up and
operationalized, a collection of evidence through timely and innovative research is essential to facilitate
evidence-informed decision making.

National Action Plan on Prevention and Control of Dengue 2019-2023
Outcome Objective:
To achieve case incidence below 100/100,000 population by the year 2023
To reduce and maintain case fatality rate below 0.1 % by the year 2023
These outcome objectives were set to reduce the transmission of Dengue so that it will be no longer a
major public health problem.
Specific Objectives:
1. To intensify epidemiological surveillance to detect and notify dengue cases real-time
2. To intensify entomological surveillance to forecast vector density and to take appropriate control
measures
3. To apply appropriate integrated vector management strategies to interrupt dengue transmission
5. To detect epidemics early and to respond to potential epidemics effectively
6. To strengthen monitoring and evaluation to ensure optimal programme implementation,

management and performance
7. To facilitate, link and conduct operational research in the prevention and management of dengue
infections
Strategies
Specific Objective 1: To intensify epidemiological surveillance to detect and notify dengue

cases real-time
1.1. Improve routine reporting system
1.2. Strengthen sentinel surveillance system
1.3. Develop the capacity to capture cases on confirmation (Special Surveillance System) at final
diagnosis or on discharge
1.4. Improve/ strengthen the utilization of surveillance data/ statistics of the hospitals for hospital
preparedness
Specific Objective 2: To intensify entomological surveillance to forecast vector density

and to take appropriate control measures
2.1. Restructure/ establish the National and Sub-national Dengue control programmes
2.2. Establishment of a systematic entomological surveillance programme

Specific Objective 3: To apply appropriate integrated vector management (IVM) strategies
to reduce dengue transmission
3.1. Adopt and implement appropriate environmental management measures to reduce vector density
and dengue transmission
3.2. Advocacy programmes to gain political commitment and to influence policy makers
3.3. Strengthen inter-sectoral collaboration among relevant stakeholders and promote joint action
3.4. Proper management of solid waste based on the National solid waste management policy
3.5. Elimination of mosquito breeding in construction sites
3.6. Active engagement of schools in strengthening environmental management
3.7. Active engagement of Tourist Hotels in strengthening environmental management
3.8. Establishment of sustainable corporate social responsibility (CSR) projects to educate the general
public on prevention and control of Dengue
3.9. Strengthen communication and empowerment of communities by developing and implementing

a communication package on prevention & control, early health care seeking and treatment by
the focal point (i.e. NDCU)
3.10. Enforcement of legislation
Specific Objective 4: To improve early diagnosis and case management
4.1. Standardize clinical management practices
4.2. Strengthen early diagnosis capacity
4.3. Develop capacity of medical doctors and supportive staff
Specific Objective 5: To detect epidemics early and to respond to potential epidemics

effectively
5.1. Further strengthen surveillance system to detect and respond to outbreaks early
5.2. Stratify the areas according to risk level (National & Sub-national level)
5.3. Establishment of laboratory surveillance mechanisms to strengthen timely and effective early
warning & confirmation of outbreaks
5.4. Prepare and communicate alerts to stakeholders at correct time

Specific Objective 6: To strengthen monitoring and evaluation to ensure optimal
programme implementation, management and performance
6.1. Establishment of effective monitoring and evaluation mechanism at National level
6.2. Establishment of effective monitoring and evaluation mechanism at the Sub-National level
6.3. Monitoring of other non-health institutions
Specific Objective 7: To facilitate, link and conduct operational research in the prevention
and management of dengue infections
7.1. Conduct operational research in the prevention and management of dengue infections

Objectives
Outcome Objectives
To achieve case incidence below 100/100,000 population and
To reduce and maintain case fatality rate below 0.1 % by the
year 2023

Specific Objective: 1
To intensify epidemiological surveillance to detect and notify dengue cases real-time
No Strategies Activities Monitoring Responsibility/

Process/ Output Indicators Means of collaboration
verification
1. 1.1. Improve routine Capacity building of both curative Percentage of institutions Routine National Dengue
reporting system & public health officials (HO, notifying through the routine Notification Control Unit
SHO, MO Public health, ICNO, surveillance system monthly System Epidemiology Unit

RE, MOOH, etc.) on routine Hosp.
surveillance (i.e. case definition Administrators
of Dengue fever and formats used
and flow of notification system)
Develop a web-based system for Number of functioning web-

routine notification in hospitals based systems in place
Develop infrastructure in
hospitals to facilitate a web-based
routine notification
1.2. Strengthen Expand sentinel surveillance Percentage of dengue cases DenSys National Dengue
sentinel surveillance system (i.e. All the base hospitals notified using real-time web- Notification Control Unit
system and above) based notification system within System Epidemiology Unit
24 hours of suspicion Hosp.
Administrators
Report suspected Dengue cases to Number of suspected cases
MOOH within 24 hours from reported to MOH within 24
admission hours from admission
Page
23
No Strategies Activities Monitoring Responsibility
Process/ Output Indicators Means of
verification
24 Page
Supervise reporting of Dengue
cases from hospitals bi-weekly/
monthly
Train Public Health staff on the

early investigation of notified
cases
Investigate all reported cases Percentage of dengue cases

within 24 hours and essentially investigated within 3 days
within 3 days
Inspect premises within the 200m

radius of index cases
Map the cases up to GN level and

identify the clusters to take
necessary action
1.3.Develop the Further enhance special disease Percentage of DHF cases among Special National Dengue
capacity to capture surveillance system in Teaching, Dengue fever patients disease Control Unit
cases on confirmation Provincial General and District surveillance Epidemiology Unit
(Special Surveillance General Hospitals system
Hospital
System) at final
diagnosis or on Administrators
discharge
Distribute special surveillance

forms to all the relevant institutes

verification
Train House Officers, Medical
Officers/ ICNOs on special
surveillance
Monitor case notification, through

trends and geographical spread

Analyse the data and identify the
nature of disease and take
necessary action
1.4.Improve/ strengthen Develop a preparedness plan for Percentage of hospitals using Notification Hosp.
the utilization of hospitals, based on surveillance surveillance data (trends charts, Register of Administrators
surveillance data/ data threshold definitions linking to hospital MO Public Health
statistics of the outbreak response planning)
National Dengue
hospitals for hospital
preparedness Percentage of hospitals with the Control Unit
annual preparedness plan Epidemiology Unit
Page
25
To intensify entomological surveillance to forecast vector density and to take appropriate control measures
No Strategies Activities Monitoring Responsibility/

Process/ Output Indicators Means of collaboration
verification
2. 2.1.Restructure/ Restructure National Dengue Ministry of Health
establish the National Control Unit as National Dengue
and Sub-national Control Programme (NDCP) to Ministry of Public

Dengue control coordinate all the Dengue control Administration
programmes activities (i.e. increase the cadre
at National level – Deputy
Director, CCPs, MOs
Entomologist & SPHI etc.) by
establishing specific cells with
terms of reference (Annex 1)
Create a dengue control cell/ unit Number of Medical Officers – Data on

at RDHS level to coordinate Dengue Control, SPHII etc. available
overall dengue prevention and appointed at the District/RDHS cadre
control activities at district level level positions at
(i.e. Medical Officer - Dengue RDHS level
Control, Entomologists, SPHI/
PHI etc. at RDHS level)
[Vacancies of high-risk areas to
be filled first]
Page
27
verification
28 Page
2.2.Establishment of a Develop infrastructure and Vector National Dengue
systematic improve human resource to Surveillance Control Unit
entomological facilitate entomological database Provincial /
surveillance surveillance Denys Regional Directors
programme  Recruit entomologists for all Database of Health services
districts Provincial/
 Establish entomological Regional
laboratories in high-risk districts Epidemiologists
MOOH
Develop Standard Operational Entomologists
Procedures’ (SOP's) for
entomology surveys and
standardize the application of
entomological procedures based
on SOP
Develop & distribute

standardized survey formats
Develop a comprehensive Number of districts with sentinel Insecticide

surveillance plan yearly at district sites for entomological survey Susceptibility
and divisional levels Test reports
 Identify sentinel sites from high- Number of districts conducting
risk MOH/GN areas of the routing entomological survey
district (from urban and semi-
urban or rural areas) to conduct Number of entomological
sentinel surveys (as defined in surveys (Routine/ and Sentinel)
the guideline for Integrated done per district per month
Vector Management)

verification
 Identify high risk localities to Percentage reduction of larval
conduct routine entomological vector indices
surveys (as defined in the (Breteau index, Premises index,
guideline for Integrated Container index)
Vector Management)
Percentage of premises inspected
 Conduct spot checks based on in high-risk areas

case notification, previous
notification trends or as a post
survey etc.
Map the vector (i.e. Aedes aegypti Number of MOH areas with
& Aedes albopictus) distribution vector mapping
to identify high risk localities at
divisional/ district/ provincial/
national level – for both adult and
larva
Conduct insecticide susceptibility Number of insecticide
test, cage bio essay etc. susceptibility test conducted per
year per high risk district/
Nationally
Number of cage bio essay
conducted per district per year
Page
29
verification
30 Page
Improve existing reporting Number of detailed reports
system of entomology surveys for provided within 5 days to
timely actions by providing relevant authority (i.e. MOOH,
preliminary report to relevant other relevant institutes etc.)
authorities on the same day and
the detailed report within 5 days
to relevant MOH office or the
relevant institute
Develop a web-based Number of MOH areas adopted

entomological surveillance a web-based entomological
mechanism (for routine/ sentinel/ surveillance mechanism
spot surveillance)
Use web-based timely

entomological surveillance data
for action
Supervise entomological survey Number of surveys conducted

activities for accuracy & according to the SOPs
timeliness Number of supervisions done per
month at district level

To apply appropriate integrated vector management (IVM) strategies to interrupt dengue transmission
32 Page
verification
Environmental Management, biological & chemical control
3 3.1.Adopt and Map and analyze epidemiological Number of vector control Vector National Dengue
implement and entomological data for programmes conducted Surveillance Control Unit
appropriate epidemic forecasting and for database Provincial /
following actions Number of alerts generated prior Regional Directors
environmental
 Source reduction through to an outbreak being reported in of Health services
management
environmental management localities according to risk level
measures to  Changes to human habitation or Percentage of alerts acted upon
reduce vector behaviour by applying mosquito within 7 days by the field staff
density and repellents, screening doors etc.
dengue
transmission
Develop training guidelines on Data on Provincial/

 Source reduction through routine and Regional
environmental management special Epidemiologists
 Changes to human habitation or cleaning up MOOH
behaviour (i.e. Personal campaigns Regional
protection, screening doors etc.) Entomologists
 Chemical & biological methods
for dengue vector control

verification
Develop capacity of national,
provincial, district and divisional
public health staff who are engaged
in dengue vector control measures
Conduct regular in-service training

for field staff
Map and update vector breeding Percentage of MOH areas

sites monthly updating vector breeding sites
monthly
Train field health staff (e.g. PHII,

PHM, SKS) on health education
Ensure availability of home

inspection cards in high-risk GN
divisions and do regular monitoring
by the divisional and district level
staff
Conduct routine premise (houses,

schools, construction sites etc)
inspection based on risk category of
the MOH area (priority high risk/
high risk, and low risk) according
Page
to entomological and
33
epidemiological evidence
verification
34 Page
Conduct special mosquito control
campaigns and other necessary
vector control activities in
identified priority high risk and
high risk localities
Apply appropriate IVM methods
(source reduction/ chemical/
biological methods etc.)
considering identified breeding
places in different localities (e.g.
construction sites, abandoned boats,
pineapple plantations/wells, water
storage tanks etc)
Conduct field supervision visits by
Central, Provincial, District and
MOH staff (i.e. by Central team –
Director/ NDCU, CCPs, Medical
Officers, Entomologists, PHII: By
Regional team - CCPs/ RE, MO-
Dengue Control, MOOH,
Entomologists and SPHID/SPHII/
District PHII) in all high-risk GN
divisions according to norms
Develop a policy on rational use of
insecticide based on International
guidelines

verification
Advocacy, Inter-sectoral Collaboration, Communication and Empowerment of Communities
3.2. Advocacy Advocacy for higher level Number of advocacy programmes Stakeholders of
programmes to politicians conducted at the national level per PTF
gain political [i.e. Presidential Task Force (PTF) quarter
commitment and meetings]
to influence
policy makers

Conduct stakeholder meetings with Number of advocacy programmes Stakeholders at
provincial/ district/ local political conducted at district level per provincial/ district
leadership quarter level
3.3. Strengthen Identify stakeholders and define Percentage of districts having Progress Ministry of
inter-sectoral their roles and responsibilities inter-sectoral dengue control review Provincial Council
collaboration (National & sub-national) committees meetings and and Local
among relevant minutes (e.g. Government
stakeholders and PTF) Ministry of Public
promote joint Reports Administration and
action Ministry of Home
Affairs
Conduct regular meetings with Percentage of MOH areas having MOOH

stakeholders (National & sub- inter-sectoral dengue control Ministry of
national) according to the norms committees Housing and
construction
Ministry of
Environment
Page
35
verification
36 Page
Establish district and divisional Number of inter-sectoral meetings Police
level Dengue control committees held (central, district and MOH Defence forces
level) NGOs
Convene inter-sectoral meetings Number of GN divisions taken Ministry of
weekly (in priority high-risk areas), actions to prevent an outbreak Agriculture and
bi-weekly (in high-risk areas), Lands
monthly (in low-risk areas) to Media including
discuss and coordinate dengue Radio, TV and
control activities at MOH level Newspapers
Declare and conduct National Number of National mosquito
mosquito control weeks and special control weeks conducted
cleaning up campaigns with No of special cleaning up
relevant stakeholders campaigns conducted
Engage relevant stakeholders for

rapid response activities
Enlist and empower government
and private institutions in each
MOH areas
Establish “Dengue Control
Committees” in each institutions of
MOH areas
Advocate monthly reporting of
source reduction activities of each
institution to respective MOH office

verification
3.4. Proper Conduct advocacy programmes for Number of Divisional Secretariat Ministry of
management of local level politicians areas segregating garbage Provincial Council
solid waste based and Local
on the National Government
solid waste MOOH
management PHII

policy
Develop a capacity to collect waste Number of Divisional Secretariat

in each district (e.g. Tractors, areas collecting containers
compactors etc.) regularly
Instruct to adhere to waste Number of districts with compost

segregation procedures at district sites
level
3.5. Elimination Develop a system to register new Number of major construction Ministry of
of mosquito major construction sites at MOH sites free of mosquito breeding Housing and
breeding in and Local Government before the places construction
construction sites commencement Ministry of Health
NDCU
Train contractors, building CIDA
corporations, architects, health, UDA
local government personnel on
Dengue prevention and control
Page
37
verification
38 Page
Appoint a health and safety officer
for major construction sites
Carry out regular inspection of
dengue breeding places in
construction sites
Educate & encourage the people
working at construction sites to
segregate waste before disposal
Identify and reserve suitable sites

for correct garbage disposal
Carry out regular entomological

surveillance at construction sites
and disseminate timely reports to
MOH for feedback and follow up
action
3.6. Active Engage all children and teachers in Number of cleaning up campaigns Reports sent Ministry of
engagement of Dengue prevention and control conducted in schools in a district by the schools Education
schools in activities every Friday for one hour per month Ministry of Health
strengthening in every week
environmental
management
Establish waste segregation system
at primary schools for behavioural
change

verification
Send a consolidated report by all
schools of particular MOH area
every month to relevant Medical
Officer of Health
Organize clean-up campaigns by
schools with the help of parents

before starting the school after
school vacations or before
examinations
3.7. Active Engage the tourism industry in Ministry of
engagement of clean-up and other vector control Tourism
Tourist Hotels in methods Development and
strengthening Christian
environmental Religious Affairs
management Ministry of Health
3.8. Prepare electronic and print media Ministry of Health

Establishment of to educate the general public on NDCU
sustainable CSR prevention and control of Dengue Public-Private
projects to Partnership
educate the
general public on
prevention and
control of Dengue
Obtain sponsorships to maintain
schools, public places, religious
Page
places etc. free of mosquito
39
breeding places
verification
40 Page
Obtain sponsorships to maintain
hoardings on prevention and
control of Dengue in public places
Work in harmony with Medical

Officer of Health
3.9. Strengthen Develop a website for NDCU and Ministry of
communication update it regularly Health/ NDCU/
and HEB
empowerment of RDHS
communities by MOOH
developing and Local
implementing a Government/Minis
communication try of Provincial
package on Council and Local
prevention & Government
control, early
health care
seeking and
treatment by the
focal point (i.e. Communicate through social media
NDCU)
Identify behaviours relevant to Proportion of householders Summary data
prevention & control, early health engaged in weekly inspections for of Home
care seeking and treatment mosquito breeding inspection cards
Entomological
survey reports

verification
Develop and implement a
communication plan for prevention
and control – Specific target groups
to be defined (e.g. schools,
construction sites, factories,
religious places etc.)

Develop and implement a Number of health promotion Other reports District and
communication plan for early programmes conducted (including Divisional
health care seeking and treatment the media) Minutes and Secretariat/Ministr
reports of the y of Home Affairs
meetings held
Ministry of Media
and Information
Train National and sub-national Percentage of institutions/ schools

level responsible staff officers on implementing weekly regular
advocacy and communication inspections for mosquito breeding
Develop and disseminate task- Proportion of targeted locations

oriented, clear communication free of breeding places
material (i.e. for schools,
community etc.)
Conduct regular media workshops/ Proportion of meetings conducted

seminars to raise awareness on prevention
Page
and control of Dengue
41
verification
42 Page
Conduct educational activities Ministry of Health
among schools (children and
teachers) to raise awareness Ministry of
Education
Empower school children to clean National Institute

their own home environment of Education
(NIE)
Promote dengue free school by Stakeholders of

reporting school absenteeism PTF
through school App
Develop messages for media on
early detection, ambulatory care
etc.
Enforce regular inspection by street

committees
Empower mother’s groups, civil

societies for behavioural change
Distribute school card and

empower school children to clean
their own home environment

verification
Enforcement of Law
3.10.Enforcement Review existing legal enactments Ministry of Health
of legislation NDCU
Conduct stakeholder meetings to Number of stakeholder meetings Legal Draftsman
review and update existing laws conducted to review and update Department
and strengthen enforcement of laws existing laws Provincial /
by relevant authorities as and when Regional

necessary Directors of
Health services
Draft a joint circular for Provincial/
construction sites with relevant Regional
stakeholders based on emerging Epidemiologists
entomological evidence (roof MOOH
gutters, ponds) and disseminate it to PHII
them (e.g. Ministry of Housing and Ministry of Health
Construction, Local Government Ministry of
etc.) – Apply the rules and Housing and
regulations in the said circular for Construction
the building plans of new building
developments
Apply the rules and regulations in Ministry of

the said circular for the building Provincial Council
plans of new building and Local
developments Government
Monitoring and evaluation of
Page
implemented laws
43
To improve early diagnosis and case management

verification
4. 4.1. Standardize Review and revise clinical Percentage of consultants/ MOs/ Records/ minutes Hosp.
clinical management guidelines on dengue nursing officers trained within the Review reports/ Administrators
management past 24 months on the management minutes Epidemiology Unit
practices of dengue patients. NDCU

Disseminate the updated guidelines Number of deaths due to dengue Death audits Relevant
to all public and private hospitals Hospital sources Consultants
and General Practitioners
Establish model dengue Case fatality rate due to DF/DHF

management centres with patient
management equipment
Establish help-line for difficult Proportion of patients admitted to

cases for clinicians hospital in shock state
Collect information on all deaths Percentage of patients diagnosed
due to Dengue in public/private with DHF prior to going into shock
hospitals reported through special
surveillance
Review each suspected Dengue Percentage of hospitals (Base Hospital
death immediately and above) with OPD fever
corner/room or PCU
Percentage of BH/GH/TH with HDUs
Number of deaths reviewed within a
month
Page
45
verification
46 Page
4.2. Strengthen Establish fever screening centre at Percentage of secondary and
early diagnosis OPDs of secondary and tertiary tertiary care institution OPDs with
capacity care hospitals the capacity to perform FBC 24/7
Make FBC test available 24/7 in Percentage of hospitals/institutions

the secondary and tertiary care issue the FBC report to the patients
hospitals within one hour
Develop diagnostic and ambulatory Percentage of provincial hospitals

care facilities at primary care and above with diagnostic facilities
hospitals in high-risk areas (NS1 RDT)
Develop a management protocol to

improve the treatment-seeking
behaviour of vulnerable groups
(e.g. pregnant mothers, infants etc.)
4.3.Develop Implement continuous medical Number of training programmes Ministry of Health

capacity of education for doctors and conducted on Dengue case NDCU
medical doctors supportive staff as capacity management at secondary and Epidemiology Unit
and supportive building plan tertiary care hospitals WHO
staff
Develop training modules for World Bank

doctors and supportive staff Other Donor
Agencies
Organize training of trainers (TOT) Number of training of trainers
programme for master trainers (TOT) programmes conducted for
master trainers per year

verification
Train consultants/ medical officers/ Number of consultants/ medical
nursing officers in the management officers/ nursing officers trained
of dengue patients (Curative, both for the management of dengue
public and private sectors) patients
Carry out regular in-service training Number of in-service training

programmes conducted per year

Page
47
To detect epidemics early and to respond to potential epidemics effectively

verification
5 5.1. Strengthen Develop an early warning Percentage of MOOH conducting Routine National Dengue
surveillance system capability using the at least one entomology survey e-surveillance Control Unit
further to detect and entomological surveillance to per month DenSys surveillance Epidemiology Unit
respond to categorize risk areas Entomology Provincial /

outbreaks early surveillance Regional
Prepare an emergency response Percentage of outbreaks detected reports Directors of Health

plan with assigned task to early (clustering of five or more e-IMMR services Regional
stakeholders (both preventive and cases) Epidemiologists
curative sectors) and health and MOOH
non-health sectors
Further strengthen clinical wards Percentage of secondary and

of primary healthcare units, tertiary care institution OPDs
secondary and tertiary care with the capacity to perform FBC
institutions or establish a system 24/7
in GP and OPD by increasing Percentage of provincial hospitals
capacity to perform FBC 24/7 and above with diagnostic
facilities (NS1 RDT)
Introduce “Dengue Free Child” Percentage of schools using

school app to the general public “Dengue Free Child” APP in
and to schools and identify each high risk districts
clustering of patients for
Page
necessary action
49
verification
50 Page
5.2. Stratify the Develop a risk stratification Percentage of outbreaks
areas according to system to categorize the areas up responded within 3 days of
risk level to GN areas (priority high risk, identification
(National & Sub- high risk and low risk)
national level)
Develop operational guidelines Percentage of districts having
for rapid response activities functional rapid response teams
Predict outbreaks when the Number of patients reported

indices exceed the set baseline within the year at the national
values and communicate with level
relevant stakeholders
Prepare a risk based

communication plan to relevant
stakeholders to mitigate outbreaks
5.3. Establishment Establish sentinel surveillance Percentage of hospitals (Base

of laboratory stations for routine fever Hospital and above) with OPD
surveillance monitoring fever corner/room or PCU
mechanisms to
strengthen timely Develop a reference laboratory Number of reference laboratories
and effective early with a feedback mechanism to formed
warning & National level (serology and
confirmation of virology)
outbreaks

verification
5.4 Prepare and Establish district/ national rapid Number of high risk districts with
communicate alerts deployment teams according to rapid deployment teams
to stakeholders at need and risk level
correct time
Establish an operational room for

rapid response

Conduct inter-sectoral meetings
during the outbreak period
Conduct periodical reviews at Number of reviews conducted at

national/ sub-national level National level per year
Number of reviews conducted at
sub-national level per year
Communicate the risk and
strengthen the vector control
activities with other sectors (LG
and DS office)
Establishment of mechanism for

post outbreak needs assessment
Page
51
To strengthen monitoring and evaluation to ensure optimal programme implementation, management and performance

verification
6. 6.1. Establish a monitoring and
Establishment of evaluation unit
effective
monitoring and

evaluation
mechanism at
National level
Develop a monitoring and Number of IVM programmes MOH summary NDCU
evaluation plan carried out using environmental, reports RDHS
chemical or biological methods Meeting minutes RE
per month MOH
Development of a central database Percentage of carrying out

to monitor district level preventive monthly MOH presentations at
activities DS office meeting
Develop and update monitoring

formats
Develop a web-based data system

which could be accessible to other
stakeholders (e.g. District secretary,
Local Government Commissioner)
Page
53
verification
54 Page
Prepare annual plan for supervision
(both at national & sub-national
level)
Conduct regular supervision visits Number of supervisory visits

to high risk districts conducted by the NDCU team in
high risk districts per quarter
Conduct reviews quarterly at Number of reviews conducted at

national level national level per year
6.2.Establishment Map the cases to identify the Number of districts/ MOH areas with
of effective geographical boundaries to identify spot map
monitoring and local spread at district/ divisional
evaluation levels
mechanism at
Sub-National
level
Analyze the epidemiological data
(identify the age categories
affected, sex, GN areasetc.) and
entomological data to minimize risk
Implement vector control plan at

MOH level and monitor the
situation daily

verification
Deploy inspection teams to Number of inspection teams
outbreak/ outbreak-prone areas deployed to outbreak/ outbreak
prone areas per quarter
Collect summary returns of

preventive and control activities
weekly at divisional level

Prepare monthly report on-field
activities
Conduct reviews monthly at district Number of reviews conducted at

level district level per year
6.3. Monitoring Conduct review meetings with Number of review meetings

of other non- other stakeholders on Dengue conducted with other stakeholders
health institutions prevention & control activities on Dengue prevention & control
activities per quarter
Send the minutes of the stakeholder Number of inter-sectoral
meetings to relevant Medical meetings conducted per quarter
Officer of Health every month
Page
55
To facilitate, link and conduct operational research in the prevention and management of dengue infections

verification
7. 7.1. Conduct Conduct consultative meeting to Availability of prioritized Final research NDCU
operational update evolving research needs and research needs reports Epidemiology Unit
research in the prioritize topics for research Publications RDHS
prevention and Policies related to Hospital Directors

management of health Universities
Dengue infection IMMR
Routine e-
surveillance
Identify and translate valid on- Number of operational research/ DenSys surveillance
going research in other parts of the projects conducted
world to match local context.
Develop research proposals for Number of reports/ publications

funding specifically addressing
programmatic gaps
Generate information on the burden Number of collaborating centres
of disease for evidence-based participating in research
decision making
Conduct operational research on Number of grants received/

laboratory diagnosis, clinical utilized
management and vector control
Page
57
verification
58 Page
Conduct research on epidemic
prediction models
Establish a collaborative network Percentage of successful

with both international and local operational research that has been
research institutions adopted by the programme for
prevention and management of
dengue infections (programme
implementation) and policy
formulation
Facilitate conduct of field trials on Number of field trials conducted

vaccine among susceptible on vaccine among susceptible
communities communities
Advocate higher officials and Number of research findings

translate vital findings to relevant translated to National policies
National policies

Monitoring & Evaluation
Framework
Key Indicators for Monitoring and Evaluation

Monitoring and Evaluation Plan
60 Page
Performance/ Results Framework of National Dengue Control Programme
Key Indicators Baseline Target
Value Year Source
Impact Indicators
Reduce the incidence of dengue below 100/100,000 198.22 2013 – 2016 Routine Surveillance below 100/100,000 by 2023
by the year 2023
Reduce case fatality of Dengue < 0.1% in by the year 0.21 2013 - 2016 Death Reviews case fatality of Dengue < 0.1% by 2023
2023
Outcome Indicators
Percentage reduction of larval vector indices
 Breteau index (BI) 8.8/2016
12.3/2017 2016 – 2017 Entomological surveys <1 BI
<1 PI
 Premises index (PI) 5.0/2016
9.6/2017
Reduction of Aedes positive discarded items to 40% 2017-2018 Entomological surveys <10%
<10% in urban settings by the year 2023
Output Indicators
Incidence of dengue 198.22 2013 – 2016 Routine Surveillance below 100/100,000 by 2023
Case fatality rate due to Dengue 0.21 2013 - 2016 Death Reviews case fatality of Dengue < 0.1% by 2023
Reduction of larval vector indices compared to
baseline value
 Breteau index (BI) 8.8/2016 2016 – 2017 Entomological surveys <1 BI
12.3/2017 <1 PI
 Premises index (PI) 5.0/2016

9.6/2017
Percentage reduction of discarded items in urban 40% 2017-2018 Entomological surveys <10%
settings

Key Indicators Baseline Target
Value Year Source
Process Indicators
No. of Special Mosquito Control Campaigns 19/20 2016/ 2017 NDCU data 14 programmes per year
conducted
No. of routine inspection programmes conducted by 2016 - 2017 District data
each district

No. of GN divisions inspected completely in each N/A 2016 - 2017 District data
district
No of entomological surveys conducted by the 100/2016 2016 - 2017 Entomological surveys 200
central entomological team per year (with quarterly 110/2017 conducted by NDCU
break down) and by premise ( i.e. residential houses, team
schools, construction sits etc)
No of entomological surveys conducted by each 250/2016 2016 - 2017 Entomological surveys 400
district per year (with quarterly break down) by 300/2017 conducted by District
premise ( i.e. residential houses, schools, teams
construction sits etc)
Percentage of dengue cases investigated within 3 33% 2018 District data More than 95 percent of the notifications
days after receiving notification to MOH (Unpublished
NDCU
Survey Data)
Percentage of Dengue cases investigated within 7 Not 2017 - 2018 Epidemiology Unit data
days from the onset of fever Available
No. of HDU’s established in base hospitals and 87 2016 NDCU data
above
No. of hospitals (Base hospitals and above) with Not 2016 - 2017 Hospital data &
FBC facilities 24/7 Available NDCU data
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61
Time Frame
(Gantt Chart)
Time Frame (Gantt Chart)
2019 2020 2021 2022 2023
Outcome Objectives:
To achieve case incidence below 100/100,000 population by the year 2023
To reduce and maintain case fatality rate below 0.1 % by the year 2023
Specific Objective: 1. To intensify epidemiological surveillance to detect and notify dengue cases real-time
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
Strategies Activities
1.1. Improve Capacity building of both curative & public √ √ √ √ √ √ √ √ √ √
routine reporting health officials (HO, SHO, MO Public health,
system ICNO, RE, MOOH, etc.) on routine surveillance
(i.e. case definition of Dengue fever and formats
used and flow of notification system)

Develop a web-based system for routine √ √ √ √ √ √
notification in hospitals
Develop infrastructure in hospitals to facilitate a √ √ √ √ √ √
web-based routine notification
1.2. Strengthen Expand sentinel surveillance system (i.e. All the √ √ √ √ √ √ √ √
sentinel base hospitals and above)
surveillance system Report suspected Dengue cases to MOOH within √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
24 hours from admission
Supervise reporting of Dengue cases from √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
hospitals bi-weekly/ monthly
Train Public Health staff on the early √ √ √ √ √ √ √ √ √ √
investigation of notified cases
Investigate all reported cases within 24 hours and √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
essentially within 3 days
Inspect premises within the 200m radius of index √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
cases
Map the cases up to GN level and identify the √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
clusters to take necessary action
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63
2019 2020 2021 2022 2023
1.3. Develop the Further enhance special disease surveillance system in √ √ √ √ √ √ √ √
64 Page
capacity to capture Teaching, Provincial General and District General
cases on confirmation Hospitals
(Special Surveillance Distribute special surveillance forms to all the relevant √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
System) institutes
Train House Officers, Medical Officers/ ICNOs on √ √ √ √ √ √ √ √ √ √
special surveillance
Monitor case notification, the trends and geographical √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
spread
Analyze the data and identify the nature of the disease √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
and take necessary actions
1.4.Improve/ Develop a preparedness plan for hospitals, based on √ √ √ √ √
strengthen the surveillance data
utilization of
surveillance data/
statistics of the
hospitals for hospital
preparedness

2019 2020 2021 2022 2023
Specific Objective: 2. To intensify entomological surveillance to forecast vector density and to take appropriate control measures
2.1.Restructure/ Restructure Dengue Control Unit as National √ √ √ √ √ √ √
establish the National Dengue Control Programme (NDCP) to
and Sub-national coordinate all the Dengue control activities (i.e.
Dengue control increase the cadre at National level – Deputy
programmes
Director, CCPs, Entomologist & SPHI etc.) by
establishing specific cells with terms of reference
(Annex 1)
Create a dengue control cell/ unit at RDHS level √ √ √ √ √ √ √ √ √
to coordinate overall dengue prevention and
control activities at district level (i.e. Medical

Officer - Dengue Control, Entomologists, SPHI/
PHI etc. at RDHS level)
[Vacancies of high-risk areas to be filled first]
2.2.Establishment of Develop infrastructure and improve human resource to √ √ √ √ √ √
a systematic facilitate entomological surveillance
entomological  Recruit entomologists for all districts
surveillance  Establish entomological laboratories in high-risk √ √ √ √ √ √ √ √ √ √ √ √ √
programme districts
Develop Standard Operational Procedures’ √ √ √ √ √ √ √ √
(SOP's) for entomology surveys and standardize * * * *
the application of entomological procedures
based on SOP
Develop & distribute standardized survey formats √ √ √ √ √ √
Develop a comprehensive surveillance plan yearly at

district and divisional levels
√ √ √ √ √ √ √ √
 Identify sentinel sites from high-risk MOH/GN
areas of the district (from urban and semi-urban or
rural areas) to conduct sentinel surveys (as
defined in the guideline for Integrated Vector
Management)
 Identify high risk localities to conduct routine √ √ √ √ √ √ √ √
entomological surveys (as defined in the guideline
for Integrated Vector Management)
Page
 Conduct routine, sentinel & spot checks based on √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
65
case notification, previous notification trends or as
a post survey etc.
2019 2020 2021 2022 2023
Map the vector (i.e. Aedes aegypti & Aedes albopictus) √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
distribution to identify high risk localities at divisional/
66 Page
district/ provincial/ national level
Conduct insecticide susceptibility test, cage bio essay √ √ √ √

etc.
Improve existing reporting system of entomology √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
surveys for timely actions by providing preliminary
report to relevant authorities on the same day and the
detailed report within 5 days to relevant MOH office or
the relevant institute
Develop a web-based entomological surveillance √ √ √ √ √
mechanism (for routine/ sentinel surveillance)
Use web-based timely entomological surveillance data √ √ √ √ √ √ √ √ √ √ √
for action
Supervise entomological survey activities for accuracy √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
& timeliness

2019 2020 2021 2022 2023
Specific Objective 3. To apply appropriate integrated vector management (IVM) strategies to interrupt dengue transmission
3.1.Adopt and Map and analyze epidemiological and entomological √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
implement appropriate data for epidemic forecasting and for following actions
environmental  Source reduction through environmental
management measures management
to reduce vector  Changes to human habitation or behaviour by
density and dengue applying mosquito repellents, screening doors etc.
transmission
Develop training guidelines on √ √ √ √ √ √ √ √

 Source reduction through environmental
management
 Changes to human habitation or behaviour (i.e.
Personal protection, screening doors etc.)
 Chemical & biological methods for dengue vector
control
Develop capacity of national, provincial, district and √ √ √ √ √ √ √ √ √ √
divisional public health staff who are engaged in
dengue vector control measures
Conduct regular in-service training for field staff √ √ √ √ √ √ √ √ √ √
Map and update vector breeding sites monthly √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Train field health staff (e.g. PHII, PHM, SKS) on √ √ √ √ √ √ √ √ √ √

health education
Ensure availability of home inspection cards in high- √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
risk GN divisions and do regular monitoring by the
divisional and district level staff
Conduct routine premise (houses, schools, construction √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
sites etc) inspection based on risk category of the MOH
area (priority high risk/ high risk, and low risk)
according to entomological and epidemiological
evidence
Conduct special mosquito control campaigns and √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
other necessary vector control activities in
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identified priority high risk and high risk
localities
67
2019 2020 2021 2022 2023
Apply appropriate IVM methods (source reduction/ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
68 Page
chemical/ biological methods etc.) considering
identified breeding places in different localities (e.g.
construction sites, abandoned boats, pineapple
plantations/wells, water storage tanks etc)
Conduct field supervision visits by Central, Provincial, √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

District and MOH staff (i.e. by Central team –
Director/ NDCU, CCPs, Medical Officers,
Entomologists, PHII: By Regional team - CCPs/ RE,
MO-Dengue Control, MOOH, Entomologists and
SPHID/SPHII/ District PHII) in all high-risk GN
divisions according to norms
Develop a policy on rational use of insecticide based √ √ √ √ √ √ √

on International guidelines

3.2. Advocacy Advocacy for higher level politicians √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
programmes to gain [i.e. Presidential Task Force (PTF) meetings]
political commitment
and to influence Conduct stakeholder meetings with provincial/ district/ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
policy makers local political leadership
3.3. Strengthen inter- Identify stakeholders and define their roles and √ √ √ √ √ √ √ √ √ √
sectoral collaboration responsibilities (National & sub-national)
among relevant
stakeholders and Conduct regular meetings with stakeholders (National √ √ √ √ √ √ √ √ √ √
promote joint action & sub-national) according to the norms
Establish district and divisional level Dengue control √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

committees
Convene inter-sectoral meetings weekly (in priority √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

high-risk areas), bi-weekly (in high-risk areas),
monthly (in low-risk areas) to discuss and coordinate
dengue control activities at MOH level

2019 2020 2021 2022 2023
Declare and conduct National mosquito control weeks √ √ √ √ √ √ √ √ √ √
and special cleaning up campaigns with relevant
stakeholders
Engage relevant stakeholders for rapid response √ √ √ √ √ √ √ √ √ √
activities
Enlist and empower government and private √ √ √ √ √ √ √ √ √ √
institutions in each MOH area
Establish “Dengue Control Committees” in each √ √ √ √ √ √ √ √ √ √
institution of MOH areas
Advocate monthly reporting of source reduction √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
activities of each institution to respective MOH office

3.4. Proper Conduct advocacy programmes for local level √ √ √ √ √ √ √
management of solid politicians
waste based on the
National solid waste Develop a capacity to collect waste in each district (e.g. √ √ √ √ √ √ √ √ √ √ √ √ √ √
management policy Tractors, compactors etc.)
Instruct to adhere to waste segregation procedures at √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

district level
3.5. Elimination of Develop a system to register new major construction √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

mosquito breeding in sites at MOH and Local Government before the
construction sites commencement
Train contractors, building corporations, architects, √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

health, local government personnel on Dengue
prevention and control
Appoint a health and safety officer for major √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

construction sites
Carry out regular inspection of dengue breeding places √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
in construction sites
Educate & encourage the people working at √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
construction sites to segregate waste before disposal
Identify and reserve suitable sites for correct garbage √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
disposal
Carry out regular entomological surveillance at √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Page
construction sites and disseminate timely reports to
MOH for feedback and follow up action
69
2019 2020 2021 2022 2023
3.6. Active Engage all children and teachers in Dengue prevention √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
70 Page
engagement of and control activities every Friday for one hour in
schools in every week
strengthening Establish waste segregation system at primary schools √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
environmental for behavioural change
management Send a consolidated report by all schools of particular √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
MOH area every month to relevant Medical Officer of
Health
Organize clean-up campaigns by schools with the help
of parents before starting the school after school
vacations or before examinations
3.7. Active Engage the tourism industry in clean-up and other √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
engagement of vector control methods
Tourist Hotels in
strengthening
environmental
management
3.8. Establishment of Prepare an electronic and print media to educate the √ √ √ √ √ √ √ √ √ √
sustainable CSR general public on prevention and control of Dengue
projects to educate Obtain sponsorships to maintain schools, public places, √ √ √ √ √ √ √ √ √ √
the general public on religious places etc., free of mosquito breeding places
prevention and Obtain sponsorships to maintain hoardings on √ √ √ √ √
control of Dengue prevention and control of Dengue in public places
Work in harmony with Medical Officer of Health √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
3.9. Strengthen Develop a website for NDCU and update it regularly √ √ √
communication and Communicate through social media √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
empowerment of Identify behaviours relevant to prevention & control, √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
communities by early health care seeking and treatment
developing and Develop and implement a communication plan for √ √ √ √ √ √ √ √ √ √
implementing a prevention and control – Specific target groups to be
communication defined (e.g. schools, construction sites, factories,
package on religious places etc.)
prevention & control, Develop and implement a communication plan for √ √ √ √ √ √ √ √ √ √
early health care early health care seeking and treatment
seeking and Train National and sub-national level responsible staff √ √ √ √ √ √ √ √ √ √
treatment by the officers on advocacy and communication
focal point (i.e. Develop and disseminate task-oriented, clear √ √ √ √ √ √ √ √ √ √
NDCU) communication material (i.e. for schools, community etc.)
Conduct regular media workshops/ seminars √ √ √ √ √ √ √ √ √ √

2019 2020 2021 2022 2023
Conduct educational activities among schools (children √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
and teachers) to raise awareness
Empower school children to clean their own home √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
environment
Promote dengue free school by reporting school √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
absenteeism through school App
Develop messages for media on early detection, √ √ √ √ √ √
ambulatory care etc.
Enforce regular inspection by street committees √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Empower mother’s groups, civil societies for √ √ √ √ √ √ √ √ √ √
behavioural change

Distribute school card and empower school children to √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
clean their own home environment
Enforcement of Law
3.10.Enforcement of Review existing legal enactments √ √ √ √ √
legislation Conduct stakeholder meetings to review and update √ √ √ √ √ √ √ √ √ √
existing laws and strengthen enforcement of laws by
relevant authorities as and when necessary
Draft a joint circular with relevant stakeholders based √ √ √ √ √ √
on emerging entomological evidence (roof gutters,
ponds) and disseminate it to them (e.g. Ministry of
Housing and Construction, Local Government etc.) –
Apply the rules and regulations in the said circular for
the building plans of new building developments
Apply the rules and regulations in the said circular for √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
the building plans of new building developments
Monitoring and evaluation of implemented laws √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Page
71
2019 2020 2021 2022 2023
Specific Objective: 4. To improve early diagnosis and case management
4.1. Standardize Review and revise clinical management guidelines on √ √ √ √ √ √ √ √
72 Page
clinical management dengue
practices
Disseminate the updated guidelines to all public and √ √ √ √
private hospitals and General Practitioners
Establish model dengue management centres with √ √ √ √ √ √
patient management equipment
Establish help-line for difficult cases for clinicians √ √
Collect information on all deaths due to Dengue in √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

public/Private hospitals
Review each suspected Dengue death immediately √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
4.2. Strengthen early Establish fever screening centre at OPDs of secondary √ √ √ √ √ √ √

diagnosis capacity and tertiary care hospitals
Make FBC test available 24/7 in the secondary and √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
tertiary care hospitals
Develop diagnostic and ambulatory care facilities at √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
primary care hospitals in high-risk areas
Develop a management protocol to improve the √ √
treatment-seeking behaviour of vulnerable groups (e.g.
pregnant mothers, infants etc.)
4.3.Develop capacity Implement continuous medical education for doctors √ √ √ √ √ √ √ √ √ √
of medical doctors and supportive staff as capacity building plan
and supportive staff Develop training modules for doctors and supportive √ √ √ √ √ √
staff
Organize training of trainers (TOT) programme for √ √ √ √ √ √ √ √ √ √
master trainers
Train consultants/ medical officers/ nursing officers in √ √ √ √ √ √ √ √ √ √
the management of dengue patients (Curative, both
public and private sectors)
Carry out regular in-service training √ √ √ √ √ √ √ √ √ √

2019 2020 2021 2022 2023
Specific Objective: 5. To detect epidemics early and to respond to potential epidemics effectively
5.1. Strengthen Develop an early warning capability using the √ √ √ √ √ √
surveillance system entomological surveillance to categorize risk areas
further to detect and
Prepare an emergency response plan with assigned task √ √ √ √ √
respond to outbreaks
to stakeholders (both preventive and curative sectors)
early
and health and non-health sectors
Further strengthen clinical wards of primary healthcare √ √ √ √
units, secondary and tertiary care institutions or
establish a system in GP and OPD by increasing
capacity to perform FBC 24/7
Introduce “Dengue Free Child” school app to the √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

general public and to schools and identify clustering of
patients for necessary action
5.2. Stratify the areas Develop a risk stratification system to categorize the √ √ √ √ √ √ √ √ √
according to risk areas up to GN areas (priority high risk, high risk and
level (National & low risk)
Sub-national level) Develop operational guidelines for rapid response √ √ √ √ √ √ √
activities
Predict outbreaks when the indices exceed the set √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
baseline values and communicate with relevant
stakeholders
Prepare a risk communication plan to mitigate √ √ √ √
outbreaks
5.3. Establishment Establish sentinel surveillance stations for routine fever √ √ √ √
of laboratory monitoring
surveillance
Develop a reference laboratory with a feedback √ √ √ √ √ √ √ √ √ √ √
mechanisms to
mechanism to National level (serology and virology)
strengthen timely and
effective early
warning &
confirmation of
outbreaks
Page
73
2019 2020 2021 2022 2023
5.4 Prepare and Establish district rapid deployment teams according to √ √ √ √
communicate alerts need and risk level
74 Page
to stakeholders at Establish an operational room for rapid response √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
correct time
Conduct inter-sectoral meetings during the outbreak √ √ √ √
period
Conduct periodical reviews at national/ sub-national √ √ √ √ √ √ √ √ √ √
level
Communicate the risk and strengthen the vector control √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
activities with other sectors (LG and DS office)

2019 2020 2021 2022 2023
Specific Objective: 6. To strengthen monitoring and evaluation to ensure optimal programme implementation, management and performance
6.1. Establishment of Establish a monitoring and evaluation unit √ √ √ √
effective monitoring
and evaluation Develop a monitoring and evaluation plan √ √
mechanism at National
level
Development of a central database to monitor district level √ √ √ √ √ √ √
preventive activities
Develop and update monitoring formats √ √ √ √ √ √
Develop a web-based data system which could be √ √ √ √ √ √ √ √

accessible to other stakeholders (e.g. District secretary,

Local Government Commissioner)
Prepare annual plan for supervision (both at national & √ √ √ √ √ √ √ √
sub-national level)
Conduct regular supervision visits to high risk districts √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
6.2.Establishment of Map the cases to identify the geographical boundaries to √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

effective monitoring identify local spread at district/ divisional levels
and evaluation Analyze the epidemiological data (identify the age √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
mechanism at the Sub- categories affected, sex, GN areas etc.) and entomological
National level data to minimize risk
Implement vector control plan at MOH level and monitor √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
the situation daily
Deploy inspection teams to outbreak/ outbreak-prone areas √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Collect summary returns of preventive and control √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √

activities weekly at the divisional level
Prepare monthly report on-field activities √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Conduct reviews monthly at the district level √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
6.3. Monitoring of Conduct review meetings with other stakeholders

other non-health regarding Dengue prevention & control activities
institutions
Send the minutes of the stakeholder meetings to relevant √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Medical Officer of Health every month
Page
75
2019 2020 2021 2022 2023
Specific Objective: 7. To facilitate, link and conduct operational research in the prevention and management of dengue infections
7.1. Conduct Conduct consultative meeting to update evolving √ √ √ √
76 Page
operational research research needs and prioritize topics for research
in the prevention and Identify and translate valid on-going research in other √ √ √ √ √ √ √ √ √ √
management of parts of the world to match local context.
dengue infection Develop research proposals for funding √ √ √ √ √ √ √
Generate information on the burden of disease for √ √ √ √ √ √ √ √ √ √
evidence-based decision making
Conduct operational research on laboratory diagnosis, √ √ √ √ √ √ √ √ √ √
clinical management and vector control
Conduct research on epidemic prediction models √ √ √ √ √ √ √ √
Establish a collaborative network with both √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
international and local research institutions
Facilitate conduct of field trials on vaccine among √ √ √ √ √ √ √ √ √ √
susceptible communities
Advocate higher officials and translate vital findings to √ √ √ √ √
relevant National policies

Budget Summary
Budget Summary
78 Page
Specific Objectives 2019 2020 2021 2022 2023 Total for 5
years
Amount Amount Amount Amount Amount Amount
Rs: Rs: Rs: Rs: Rs: Rs:
Specific Objective: 1. To intensify 4,150,000 3,250,000 3,265,000 265,000 280,000 11,210,000
epidemiological surveillance to detect and
notify dengue cases real-time
Specific Objective: 2. To intensify 4,000,000 3,100,000 3,100,000 3,100,000 100,000 13,400,000
entomological surveillance to forecast vector
density and to take appropriate control
measures
Specific Objective 3. To apply appropriate 218,137,500 216,337,500 244,411,250 243,461,250 271,585,000 1,193,932,500
integrated vector management (IVM) strategies
to interrupt dengue transmission
Specific Objective: 4. To improve early 118,350,000 117,350,000 120,865,000 119,915,000 123,480,000 599,960,000
diagnosis and case management
Specific Objective: 5. To detect epidemics 875,000 425,000 462,500 462,500 515,000 2,740,000
early and to respond to potential epidemics
effectively
Specific Objective: 6. To strengthen monitoring 5,037,500 4,137,500 4,441,250 4,441,250 4,441,250 22,498,750
and evaluation to ensure optimal programme
implementation, management and performance
Specific Objective: 7. To facilitate, link and 3,037,500 3,037,500 3,041,250 3,041,250 3,045,000 15,202,500
conduct operational research in the prevention
and management of dengue infections
Grand total 353,587,500 347,637,500 379,586,250 374,686,250 403,446,250 1,858,943,750

References
1. Epidemiology Unit, Ministry of Health, Nutrition and Indigenous Medicine, Sri Lanka 2018.
http://www.epid.gov.lk/web/index.php?option=com_casesanddeaths&Itemid=448&lang=en
2. National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Kingdom
of Cambodia, 2018. National Action Plan for Dengue and Other Arboviral Disease Prevention
and Control 2018 – 2020
3. National Dengue Control Unit, Ministry of Health, Nutrition and Indigenous Medicine, Sri
Lanka. 2017. Intensive Inter-sectoral Programme for the Prevention and Control of Dengue;
www.dengue.health.gov.lk
Lanka, 2011, Strategic plan for Prevention and Control of Dengue Fever/ Dengue Haemorrhagic
Fever in Sri Lanka, 2011-2015
Lanka, 2016, Strategic plan for Prevention and Control of Dengue Fever/ Dengue Haemorrhagic
Fever in Sri Lanka, 2016-2018
Lanka, 2016. Guidelines for Aedes Vector Surveillance and Control
7. World Health Organization, 2012. Global Strategy for dengue prevention and control, 2012–
2020. https://www.who.int/denguecontrol/resources/9789241504034/en/
8. World Health Organization, 2017. Western Pacific Regional Action Plan for Dengue Prevention
and Control–2016
https://iris.wpro.who.int/bitstream/handle/10665.1/13599/9789290618256-eng.pdf

Annexures
Annex I
Presidential Task Force on Dengue Prevention & Control and Inter
Presidential Task Force on Dengue Prevention & Control and Intersectoral Coordination
The Presidential Task Force was appointed by H.E.Annex
the President
III to str
Presidential Task Force on Dengue and implementation
Prevention & Controlofand
strategies at theCoordination
Intersectoral National/Provincial/District leve
The Presidential Task Force was appointed by H.E. the President to strengthen multisectoral collaboration
The Presidential Task Force was appointed by H.E. the President to strengthen multisectoral collaboration
and implementation of strategies at theonNational/Provincial/District
25. 05.2010 chaired by H.E. the The
levels. President.
first meeting was
and implementation of strategies at the National/Provincial/District levels. The first meeting was convened
convened on 25. 05.2010 chaired by H.E.Predicting the Dengue outbreak experienced in the year 2017 the Presid
the President.
on 25. 05.2010 chaired by H.E. the President.
Mayin2017.
Predicting
Predicting the Dengue
the Dengue outbreak
outbreak experienced
experienced in the
2017 theyear 2017 the Task
Presidential Presidential Taskreinstated
Force was Force wasinreinstated
May in
2017. May 2017. An action plan was prepared by the National Dengue Control Unit in
Anplan
An action action plan
was was prepared
prepared by theTask
by the National Force,
National
Dengue withControl
Dengue
Controlthe
Unitobjective
inUnit of prevention
in collaboration
collaboration and
with
with the thecontrol of dengue in
Presidential
Presidential
Task with
Task Force, Force,the
with the objective
objective of prevention
minimize
of prevention and control
dengue
and control of dengue
fatality.
of dengue in identified
in identified different
different localities
localities andand to
minimize
to minimize dengue
dengue fatality.
fatality.
Structure of the Presidential Task Force on Dengue Pr
Structure
Structure of the Presidential
of the Presidential Task on
Task Force Force on Dengue
Dengue Prevention
Prevention & Control
& Control
HE the PRESIDENT HE the PRESIDENT
Ministry of Health and other relevant ministries *

Ministry of Health and other relevant ministries
Inter- Ministerial collaboration

Inter- Ministerial collaboration
Provincial Committees
Provincial Committees
District Committees
District Committees
Divisional Committees
Divisional Committees
*Stakeholders of the Presidential Task Force
-Ministry of Health
Village/street Committees
-Ministry of Provincial Councils & Local
Government
-Ministry of Home Affairs *Stakeholders of the Presidential Task Force
-Ministry of Education
-Ministry of Health
-Ministry of Defence Village/street Committees
-Ministry of Law and Order
-Ministry of Provincial Councils & Local
-Ministry of Media Government
-Ministry of Environment -Ministry of Home Affairs
-Ministry of Disaster Management -Ministry of Education
-Ministry of Finance -Ministry of Defence
-Ministry of Public Administration etc.
-Ministry of Law and Order
-Ministry of Media
-Ministry of Environment
-Ministry of Disaster Management
-Ministry of Finance
-Ministry of Public Administration etc.

Key Tasks of the Presidential Task Force on Prevention and Control of Dengue
• To prepare strategic/action plans and programmes to implement effective Integrated Vector

Management in collaboration with the National Dengue Control Unit.
• To promote collaboration among other national health agencies and major stakeholders to
implement dengue programmes.
• To address programmatic issues and gaps.
• To adopt an enabling policy environment in implementing regulatory legislation for effective

dengue prevention and control.
• To develop coordinated actions for sustainable dengue vector management within and outside
of the health sector.
• To increase visibility and sustainability by providing greater opportunities to decision-making

on vector control with the participation of local communities.
• Setting up a core task force at Provincial, District and Divisional levels with multidisciplinary
expertise.
ROLES & RESPONSIBILITIES OF STAKEHOLDERS
Ministry of Health
• Optimum clinical management of Dengue patients
• Prevent spread of epidemics
• Coordinate with other relevant government & non-government sectors to carry out dengue
control /prevention activities
Ministry of Education
• Maintain all government, private schools, “Pirivenas”, training colleges, “Vidya Peeta”, free
of mosquito breeding
• Inculcate a behavioural change in school children to keep the environment free of mosquito
breeding
• Collaborate with respective Medical Officer of Health and staff to maintain schools,
surrounding premises free of mosquito breeding
• Provide necessary guidance through school children to keep their home environment free of
mosquito breeding

Ministry of Provincial Councils & Local Government
• Proper solid waste management including disposal of non-biodegradable items.
• Cleaning of drainage systems and maintaining them properly to prevent water collections
• Maintain area of public places without mosquito breeding
• Active involvement in dengue control/ prevention activities
• Strengthen legal activities
Ministry of Home Affairs
• Maintain all government & private institutions free of mosquito breeding
• Active involvement and mobilizing of the district, divisional and village level officers coming
under the ministry in dengue control and preventive activities.
Ministry of Defense & Ministry of Law & Order
• Maintain all institutions coming under the ministry, free of mosquito breeding
• Active involvement of tri-forces and police personnel in dengue control and prevention
activities
Ministry of Mass Media & Information
• Free of charge telecast/ broadcast of advertisements in relation to dengue including clinical

features, treatments and prevention & control (Under the technical guidance of the National
Dengue Control Unit of Ministry of Health)
Ministry of Disaster Management
• Provide support to control and prevent dengue outbreak situations.
Ministry of Environment
• Formulation and implementation of policies for proper disposal of solid waste
• Active involvement in dengue control/ prevention activities
Inter-ministerial collaboration for effective and synchronized activities from multiple disciplines,
towards prevention and control of Dengue in Sri Lanka.

Annex II
Development of the capacity of field workforce

to augment elimination of mosquito breeding places
Introduction
Integrated Vector Management (IVM) which is defined as “a rational decision-making process for the
optimal use of resources for vector control” is the mainstay of prevention and mitigation of Dengue
outbreaks. Environment management which includes premise inspection and elimination of mosquito
breeding places has been identified as a major component of Integrated Vector Management. However,
the lack of a dedicated workforce to facilitate such grass-root level activities was regarded as a huge
drawback for sustained Dengue control activities in Sri Lanka.
Justification
The need for a trained workforce to augment field activities is a timely policy initiative taken to develop
the capacity of field teams at the district/ divisional levels since Dengue is a priority public health
problem. Recruitment of committed field staff to implement prevention and control activities at the
community level is a necessity.
Objective
To establish a trained field workforce to augment Dengue prevention and control activities
Methodology
A dedicated field team “Sakya Karya Sahayaka” (SKS) / “Field Assistants Mosquito Control” was
recruited on contract basis to implement prevention and control activities at the community level.
A total of 1500 SKSs were approved and recruited in a phased manner during 2017 and 2018 island
wide based on the risk level. Those recruited as SKSs to the Ministry of Health were assigned to the
National Dengue Control Unit (NDCU) for initial training and followed up by further extensive training
of 12 weeks conducted at selected regional level health offices.
A training curriculum was developed which included theoretical components targeting development
of knowledge on the mosquito and breeding sites, environmental management including modification
and manipulation of potential breeding sites, handling chemicals and insecticides including fogging,
cultivation and distribution of larvivorous fish, handling and maintenance of vector surveillance and
control equipment, provision of health education, Personal Protective Equipment, feedback returns and
formats and administrative procedures within the Ministry of Health. Practical sessions in the field for
hands-on skills development were also conducted.

Implementation
SKSs were allocated to all 25 districts prioritized according to the risk level for dengue. Accordingly,
nearly half of the workforce was deployed
to the Western Province. Within the district, SKSs were stationed in all high-risk Medical Officer of
Health (MOH) units or District Health offices.
The assigned responsible officers and supervising officers at different levels are as below;
Level Responsible officers Supervising officers

National Director/NDCU Consultant Community Physicians, Medical
Officers, Entomologists, Public Health Inspectors
(PHII)
Provincial Provincial Director of Health Consultant Community Physicians
Services
Regional Regional Director of Health Consultant Community Physicians, Regional

Services Epidemiologists, Medical Officer Vector Control,
Regional Malaria Medical Officer (RMO),
Entomologists, Supervising Public Health
Inspector-District, Supervising Public Health
Inspector (SPHI)
Divisional Medical Officer of Health/ SPHI, PHII

Additional Medical Officer of
Health
The main duties of SKSs are;
• Inspection of premises around each reported dengue patient to identify mosquito breeding places
and assisting the community to eliminate them
• Regular house to house inspection and removal of breeding places in high-risk areas
• Educating the public on mosquito breeding and prevention activities including distribution of
health education materials under the direct supervision of area PHII
• Promoting the public on waste segregation and disposal
• Assisting technical officers for vector control
• Assisting in entomological surveys
• Fogging under the guidance and supervision of technical officers and
• Maintaining relevant documents (i.e. daily records and summary reports).
Way forward
It is proposed to absorb SKSs into the government service after successful completion of required
standards of the National Vocational Qualification Level 3, as stipulated by the Ministry of Skills
Development and training after the contract period.

Annex III
Organizational Structure of the National Dengue Control Unit Proposed Organizational Structure at
Provincial/ Regional level
86 Page
Secretary Health
Provincial Secretary
Additional Secretary (PHS)
Director General of Health Services
Epidemiology
Unit Deputy Director General of Health Services (PHS-I) Provincial Director of Health Services
Director – National Dengue Control Unit Regional Director of Health

Services (RDHS)
Deputy Director Provincial

f Consultant
Epidemiologist
Disease Surveillance, Training & Communication & Vector Surveillance Monitoring & Consultant Community Physician (CCP)/
Coordinate Case Mx Review Social Mobilization & IVM -Vector Evaluation
Unit - CCP Unit - CCP and Inter-Sectoral Control Unit - CCP Unit - CCP Regional Epidemiologist
Coordination
Unit - CCP
MOs MOs MOs MOs MOs Medical Officer of Dengue Control

Disease & Vector Surveillance, MOOH/
MO-Health Informatics MO-Health Informatics
Monitoring & Evaluation AMOOH
RDHS Office
Finance Branch
Entomologist Accountant Entomologist
Establishment
Branch AO Vector Surveillance
DO DEO PHI DO DO PHII DO HEO DO PHII DEO DO & MA DO & MA HEO SPHI/ PHII– Dengue PHI
Disease Surveillance
Drivers
Dengue Control Team at Regional Level (RDHS Office)
Administrative supervision SMO SMO
Technical Supervision
CCP: Consultant Community Physician MOs- Medical Officers
DO: Development Officer MA: Management Assistant SKS SKS SKS SKS
MOOH Medical Officers of Health PHII – Public Health Inspectors
AO – Administrative Officer DEO –Data Entry Operator

HEO - Health Entomological Officer SMO – Spray Machine Operator
SKS –“Saukaya Karya Sahayaka”
Annex IV
Annex IV
Summary of Proposed Cadre Revisions at Central Level
Summary of Proposed Cadre Revisions at Central Level Annex IV
Summary
Designation of Proposed Cadre Revisions
ApprovedatCadre Central Level
Available Cadre to be
Designation Approved Cadre Cadre
Available filled
Cadre to be
Director 1 1Cadre filled
Deputy
DirectorDirector 01 01 1
Consultant Community
Deputy Director 40 (one post – pending 20 21
Physicians
Consultant Community approval)
4 (one post – pending 2 2
Medical Officers
Physicians 9+2*
approval) 4+1* 5+1*
Entomologists
Medical Officers 29+2* 24+1* 5+1*
Supervising
EntomologistsPublic Health 32 32 1 SPHI
Inspectors/
SupervisingPublic
PublicHealth
Health (2PHII
3 + 1 SPHI) 3 1 SPHI
Inspector
Inspectors/ Public Health (2PHII + 1 SPHI)
SHEO/HEO
Inspector 7 7 --
SHEO/HEO (1
7 SHEO + 6 HEO) 7 --
SKS 15
(1 SHEO + 6 HEO) 15
*SKS
Medical Officer-Health Informatics
15 15
* Medical Officer-Health Informatics
Summary of Proposed Cadre Revision for Dengue Control Cell at
District/ Regional Level
Designation Approved Available Cadre to be filled
Designation Cadre
Approved Cadre
Available Cadre to be filled
Medical Officer Dengue 0Cadre 0Cadre 1
Control
Medical Officer Dengue 0 0 1
Entomologists
Control 1 0/ 1 1 (If entomologist
Entomologists 1 0/ 1 is notentomologist
1 (If available)
Supervising Public Health 0 0 1is SPHI (Class 1)
not available)
Inspectors/
SupervisingPublic
PublicHealth
Health 0 0 11 PHII
SPHI (Class 1)
Inspector
Inspectors/ Public Health 1 PHII
Health Entomological
Inspector 0 0 2 HEOO
Officers
Health Entomological 0 0 2 HEOO
(HEOO)
Officers
Development
(HEOO) Officers 0 0 1
Spray MachineOfficers
Development Operator 00 00 31
Saukya Karya Sahayaka
Spray Machine Operator 00 00 53
Saukya Karya Sahayaka 0 0 5

Public Health Complex
555/5, Elvitigala Mawatha Narahenpita, Colombo 05, Sri Lanka.
Tele : 011-2368416, 011-2368417 ISBN 978-955-3666-16-1
Fax : 011-2369893
E-mail : [email protected]
Web : www.dengue.health.gov.lk

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National Action Plan

Prevention and Control of Dengue in Sri Lanka

National Dengue Control Unit

National Dengue Control Unit

National Dengue Control Unit, Ministry of Health, Nutrition and

Published in April 2019

National Dengue Control Unit

Tele : 011-2368416, 011-2368417

Printed by : Nanila Publication (Pvt) Ltd.

ii Page National Dengue Control Unit

Country Sri Lanka

1. To intensify epidemiological surveillance to detect and

National Dengue Control Unit Page iii

Dr. Rajitha Senaratne

National Dengue Control Unit Page v

The partnership and resources of members of the Presidential Task Force

The plan emphasizes coordinated actions among multisectoral partners for

Through the effective implementation of its many components, this plan is

Mrs. Wasantha Perera

vi Page National Dengue Control Unit

This publication will be a useful reference document for programme managers

Dr. Anil Jasinghe

National Dengue Control Unit Page vii

In order to achieve the sustainable implementation of strategies and activities

Dr. Hasitha A. Tissera

viii Page National Dengue Control Unit

MEMBERS OF THE NATIONAL DENGUE CONTROL UNIT

EDITED AND COORDINATED BY

National Dengue Control Unit Page ix

Independent experts facilitated by the World Health Organization (WHO) and

x Page National Dengue Control Unit

BH Base Hospital MOOH Medical Officers Of Health

CCP Consultant Community Physician NDCU National Dengue Control Unit

CIDA Construction Industry NGO Non Governmental Organization

DHF Dengue Haemorrhagic Fever OPD Out Patient Department

GP General Practitioner SHEO Supervising Health Entomological

National Dengue Control Unit Page xi

National Dengue Control Unit Page xiii

● To achieve case incidence below 100/100,000 population by the year

1. To intensify epidemiological surveillance to detect and notify dengue cases

2. To intensify entomological surveillance to forecast vector density and to take

4. To improve early diagnosis and case management

5. To detect epidemics early and to respond to potential epidemics effectively

6. To strengthen monitoring and evaluation to ensure optimal programme

7. To facilitate, link and conduct operational research in the prevention and

In order to track the progress of implementation and evaluate programme

National Dengue Control Unit Page 3

As the central level organization responsible for coordination of control and

● Monitoring Disease Surveillance

● Vector Surveillance and Integrated Vector Management (IVM)

● Providing Facilities for Evidence-based Clinical Care

● Inter-sectoral Coordination and Social Mobilization

● Risk Communication and Outbreak Preparedness and Response

Aforementioned strategies are elaborated in this action plan developed by national

National Dengue Control Unit Page 5

6 Page National Dengue Control Unit

National Dengue Control Unit Page 7

8 Page National Dengue Control Unit

National Dengue Control Unit Page 9

Figure 2: Dengue incidence in Sri Lanka in 2017 and 2018