The NVBDCP's 'High Burden High Impact' (HBHI) malaria elimination strategy targets states with the highest malaria burden. Under this strategy, which tool combination is used as the first line in high transmission areas?

• A DDT indoor residual spraying + mass drug administration of primaquine
• B Pyrethroid-treated bed nets + chloroquine for P. vivax only
• C Biological control with Gambusia fish + Bacillus thuringiensis + SP chemoprophylaxis
• D Long-lasting insecticidal nets (LLINs) + Artemisinin Combination Therapy (ACT) + rapid diagnostic tests (RDTs) ✓

Explanation

The HBHI strategy (adopted by India from 2019 in the four high-burden states: Odisha, Jharkhand, Chhattisgarh, Madhya Pradesh) uses a package of: LLINs for vector control, universal RDT-based diagnosis for all fever cases, and ACT (Artesunate + SP or AL) as first-line treatment for P. falciparum. This is the WHO T3 (Test, Track, Treat) framework. DDT IRS is still used but not the sole strategy; chloroquine is still used for uncomplicated P. vivax.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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