Barabanki, Uttar Pradesh

In the wake of a spike in cases of viral fever, dengue, malaria and other vector-borne diseases, including encephalitis, the Uttar Pradesh government has launched a door to door survey and an awareness campaign to identify people with fever and other symptoms and refer them to health centres for timely treatment. This week-long exercise was launched yesterday on September 8 and will continue till September 16.

“We are taking all the possible steps to control the outbreak of viral fever in the state. Door to door surveys will be conducted and medicines will also be provided to the children,” state health minister Jai Pratap Singh was quoted as saying on September 8.

Firozabad, Mathura and Agra districts in western Uttar Pradesh have been in the news for more than a week now due to the outbreak of dengue (earlier believed to be mystery fever), which has killed at least 100 people so far. Majority of those dead are believed to be children. Also, reports of malaria outbreak are pouring in from some other districts of Uttar Pradesh such as Sitapur and Badaun. Gaon Connection has been reporting on both the dengue outbreak in Firozabad and malaria outbreak in villages of Sitapur.

How door to door survey works

Barabanki district has set up 1,114 teams to conduct the door to door survey. “As part of the survey, every day we are able to cover 111,400 households. So far the district has reported a total of six dengue and 10 AES (acute encephalitis syndrome) patients,” D K Srivastava, assistant chief medical officer of Barabanki, told Gaon Connection. 

Also Read: After dengue outbreak in Firozabad, malaria raises its ugly head in rural Uttar Pradesh

Each team of ASHA/ANM has a target to cover about 65 households in a day for door to door surveillance. The survey is carried out from 9 am till 1 pm, after which all the collected data is fed into the district bulletin and updated daily.

Shadab Alam is a laboratory assistant who is tasked with overseeing the door to door survey exercise in the Belhara town  in the Fatehpur block Barabanki district. The town which has a population of 25,000 residents is situated about 60 kilometres from the state capital Lucknow.

“The door to door survey is carried out by a team of two persons, it could be either ASHA, ANM, or an anganwadi worker. The primary task of this team is to identify people with fever,” Alam told Gaon Connection. “Surveyors are also recording patients with symptoms of COVID19 by checking for cough, sneezing or difficulty in breathing. After such individuals are found, we report it to the CHC (community health centre) which follows up with the treatment,” the lab assistant added.

Also Read: Firozabad echoes with the wails of grieving mothers whose children succumbed to a mystery fever

The health workers basically ask the residents if they have any difficulties like fever or body ache and we rely on what the residents tell, Alam informed. 

“It’s true that the cases of dengue have risen in various districts. Ours is also a sensitive district and there have been incidences of AES (acute encephalitis syndrome) and JE (Japanese encephalitis) in the past and we’re taking strict measures to respond urgently,” Barabanki district magistrate Adarsh Singh told reporters on September 8. “We have launched a surveying campaign in the district to check for such cases and ensure that precautionary measures are being taken,” he added.

Survey beyond fever cases

Apart from screening and identifying rural populations for fever symptoms, the health teams conducting the door to door survey are also collecting important information on the status of COVID19 vaccination, identification of tuberculosis (TB) patients and immunisation of newborns and toddlers.

Also Read: Firozabad mystery fever: Two days of fever and stomach ache, and Manya is now just a memory

“There are 11 health teams working in Belhara. They do house to house and ask residents in case they are suffering from fever, cough or cold. Secondly, they gather information if all family members above 45 years of age have been vaccinated or not. Thirdly, they also check if kids between the age of zero and two years have been immunised or not,” Suman Mishra, the health supervisor in Barabanki’s Belhara told Gaon Connection. 

“These health teams are also educating rural people about TB symptoms and identifying such patients. TB patients are advised to visit PHC or CHC,” added Mishra.

Meanwhile, about 100 kilometres from Barabanki, in Sitapur district, a total of five persons were found to be manifesting symptoms of COVID19, two persons showed symptoms of tuberculosis, and 14 persons showed malaria-like symptoms till September 8. A total of 59,617 households were surveyed by the health workers in the entire district on the first day of the campaign, as informed by the district health bulletin.

Also Read: Battered by floods, Varanasi now hit by dengue outbreak

ASHAs still awaiting payment 

This is not the first time the state government has launched such a door to door survey of its entire rural population. In May this year, during the second wave of the pandemic, the UP government had launched a five-day campaign to screen its rural population for COVID symptoms. This survey was also conducted by ASHAs and ANMs, who had complained about lack of safety gear and payment for the additional work.

Also Read: On two legs and a prayer, without proper safety gear, ASHAs conduct door-to-door COVID screening in rural UP

This time again, ASHAs and ANMs have been roped in for another door to door survey in the state. And these frontline workers complain that they haven’t received any screening equipment like a thermometer and have received no training to conduct these surveys. 

Meena Yadav, an ASHA worker from Dariyapur village in Kasmanda block of Sitapur district, told Gaon Connection that all she has received from the administration is the order to conduct the survey. 

“We use chalk to mark the households after surveying them, even that is not provided by the government. We buy it on our own. There are no thermometers or any equipment to assess the people. We depend on the people’s word for knowing their medical condition,” Yadav said.

Rinki Devi, an ASHA worker from Bhatwa Mau village of Fatehpur block in Barabanki has been visiting 65 households daily as part of the week-long survey exercise. She said she had no information if ASHAs will get any additional payment for the survey.

“I begin the survey at nine in the morning and it continues till one in the afternoon. There is no information about how we shall be paid for this work. I haven’t yet received any payment for the survey I conducted during Corona (COVID19) in May,” the ASHA from Barabanki told Gaon Connection.

One of the ASHA workers in Barabanki was herself diagnosed of dengue sending jitters across the district administration and health officials were dispatched to the Sirauligauspur block’s Ramsahay village where Sona, the health worker tested positive. 

Sirauligauspur CHC incharge Santosh Singh told Gaon Connection that the infected ASHA is getting treated for dengue as of now. 

Mystery fever identified as D2 dengue variant

Meanwhile, the Indian Council of Medical Research (ICMR) which was tasked with probing the ‘mystery fever’ in Firozabad district, where at least 57 people have died, concluded today. As per the final report, the illness has been identified as a variant of the dengue disease known as D2 dengue variant. ICMR has stated that the strain is deadlier than usual dengue and often causes haemorrhage (internal bleeding) and results in sudden drop in the platelet count resulting in death.

“The only prevention is to stop the breeding of mosquitoes. Dengue is also a deadly disease,” ICMR chief Balram Bhargava said in a media briefing. This dengue outbreak was reported from Firozabad, Mathura and Agra in Uttar Pradesh, while mosquito-borne diseases overall are on the rise across the country, the Union health ministry said in a statement today.

Also Read: Firozabad mystery fever: Number of patients soar at the district hospital; families complain of delay in admission and treatment

“Do not take any fever lightly. Be it malaria, dengue or Covid. Our focus should not move from Covid, but dengue can be deadly too and there is no vaccination. It is also difficult to tell who is more susceptible to dengue. And then there is no vaccination,” NITI Aayog chairperson VK Paul was quoted.

With inputs from Mohit Shukla, Sitapur