HIV/AIDS
AIDS is a fatal disease caused by human immunodeficiency virus characterized by profound immunosuppression associated with opportunistic infection, the development of certain tumors (Kaposi’s sarcoma) and frequent involvement of the CNS. Strictly speaking, the term AIDS refers only to the last stage of the HIV infection.
PREVENTION AND CONTROL MEASURES
A. Treatment: There is no specific treatment for HIV/AIDS infection. Certain antiviral drugs are available- Zidovudine, gamma interferon, ribavarin etc.
B. Control: 1. Modification of human behavior regarding
a) Sexual behavior- Avoidance of sexual contact with multiple partners, avoidance of unprotected sexual intercourse, avoidance of high risk activities- anal sex, regular venereological screening for high risk group- prostitutes.
b) Blood transfusion- Screening of donated blood.
c) Contaminated needles and other equipments- Use of disposable syringe and other equipments.
d) Perinatal infection- Infected women of childbearing age should be counseled on avoidance of pregnancy through the use of contraceptives.
2. Counseling of persons found to be antibody positive- Regular medical evaluation and follow up are advised.
3. Health education- To educate the public about the modes of transfusion, to educate the public about safe sex.
C. Surveillance: Collecting and analyzing relevant data about infection in the population, the prevalence and distribution of the infection, the high risk group, patterns of behavior, community attitude to AIDS and the patients.
HIV/AIDS IS A PUBLIC HEALTH PROBLEM IN BANGLADESH
• 1st case of HIV detected in 1989.
• Since than total cumulative of 1207 cases of HIV have been confirmed as of 1st December 2007
• 365 have developed AIDS out of whom 123 died
• During 1st December 2007 to 1st December 2007 a total 333 new HIV infection recorded & reported.
• The estimated total number of people living with HIV/AIDS in Bangladesh is around 7,500
• In all 7 rounds of serological surveillance it found that HIV rates have remained below 1% in all ground except in IDUs.
• Among the IDUs prevalence reached from 1.4% in 2000 to 7% in 2006 which is a level closed to concentrated epidemic.
• 7th surveillance shows significant rated of active syphilis among FSWs (1-10%), msm (4-6%) IDUs (1-9%)
HEPATITIS B
Hepatitis B is an acute systemic infection caused by hepatitis B virus which is characterized by long incubation period and which is life threatening. Hepatitis B may occur around the year and it has no seasonal pattern.
High risk group- Surgeons, physician, dentists, nurses, blood bank and hospital personnel, recipients of blood transfusion, homosexuals, prostitutes etc.
PREVENTION AND CONTROL MEASURES
A. Diagnosis: 1. Clinical 2. Lab diagnosis- Immunoassay for HBsAg.
B. Isolation: A patient should be isolated and put on rest.
C. Treatment: No specific treatment for acute or chronic HBV infection, exists although alpha interferon hold some promise.
D. Prevention: 1. Immunization: a) Active- By hepatitis B vaccine. The vaccine consists of HBsAg, each 1 ml dose of the vaccine contains 20 microgram of HBsAg. b) Passive- By hepatitis B immunoglobulin (HBIG). It should be given for immediate protection within 24 hour or almost a week in following circumstances: i) Accidental needle puncture ii) Gross personal contamination with infected blood iii) Newborn infants of carrier mother iv) Sexual contact of acute hepatitis B virus. c) Active-Passive- By simultaneous use of Hepatitis B vaccine and HBIG at separate sites.
2. Specific control measure: i) All person donating blood should be investigated the presence of Hepatitis B virus. ii) Needle, syringe should be properly sterilized before use. iii) Best method is to use disposable syringe and needle. iv) Persons who are at risk(doctors, nurses) all of them should be given HBIG to develop passive immunization.
HEPATITIS B IS A PUBLIC HEALTH PROBLEM IN BANGLADESH
• It is indeed scary news that more than 80 per cent of the total demand of blood in Bangladesh comes from professional blood donors, most of whom suffer from various blood-borne diseases like Hepatitis, HIV and Sexually Transmitted Infections (STIs).
• According to World Health Organization (WHO), transfusion-transmitted infections (TTIs) remains a major public health problem in the country as the demand for blood transfusions is mostly met by unscreened contaminated blood collected from professional donors on payment.
• Poverty, poorly managed commercial blood banks (less sensitive screening and lack of quality control) and an increasing trend in drug addiction and prostitution are listed as the main causes of the prevalence hepatitis B virus (HBV) in professional donors. In 2001 WHO ranked Bangladesh in the moderate-to high-risk group of countries for HBV infection.
MEASLES
Measles is an acute inflammatory disease caused by a paramyxovirus which presents with respiratory catarrhal symptoms (fever, Koplik’s spots on buccal mucosa) and a characteristic skin rash. Maternal antibody gives protection for the first 6 months of life. Measles is a serious disease in the malnourished, vitamin deficient or immunocompromised.
PREVENTION AND CONTROL MEASURES
A. Diagnosis: Clinical: 1. Prodromal phase (Catarrhal stage): This is characterized by- Fever, Sneezing, Conjunctivitis, Coughing, Hoarseness of voice, Koplik’s spots- bright red lesions with a white, central spot that are located on the buccal mucosa and are virtually diagnostic of measles. They last for 3 or 4 days. 2. Exanthematous stage: This stage is characterized by- Dark red macular or maculopapular rash- It develops first at the back of the ears and at the junction of the forehead and the hair. Within a few hours the rash proceeds gradually down the body to the lower extremities.
Laboratory Diagnosis: a) Blood count- Leukocytosis in the early stages followed by an increase in lymphocytes. b) Sputum or urine culture- Stained smears show large multinucleate (giant) cells.
B. Isolation: All patients should be isolated for 10 days from the appearance of the rash.
C. Treatment: Antiviral therapy- Not available. Antibiotics- It should be given only if a
child has clinical signs of pneumonia or other evidence of sepsis.
D. Prevention: i) Active immunization- A children should be protected by measles intramuscularly or subcutaneously at deltoid region. ii) Passive immunization- with human gamma globulin 0.25 mg/kg is effective if given within 3 days of exposure.
MEASLES IS A PUBLIC HEALTH PROBLEM IN BANGLADESH
• In 1984 before EPI intensification 2.6 million children suffered from measles
• In 1999 number of cases dropped to 1 million
• In 2003 no of measles cases were 4505
• In 2004 no of measles cases were 10090
• In 2005 no of measles cases were 28370
• In 2007 no of measles outbreaks were 292
• Around 20,000 children died from measles complication every year until 2005.
• Measles immunization coverage is also poor which was 78% in 2006
• Global Death of Measles fell by 48% from 1999 to 2004
• Deaths reduced from 8.7 million in 1999 to 4.5 million in 2004
• 4.1 million are children out of 4.5 million died
• >95% of Measles death occurred in countries having GNI less than $1000
• 47 Countries account for about 98% of global measles deaths
HOOKWORM INFECTION
Hookworm infection is a chronic debilitating disease caused by soil transmitted helminthes A. duodenale and N. americanus, clinically characterized by anemia (microcytic hypochromic). It is more common in the countries of low socio-economic status where disposal of excreta is not sanitary. A. duodenale infection is common in Bangladesh.
PREVENTION AND CONTROL MEASURES
A. Diagnosis: 1. Clinical 2. Laboratory- a) Finding of hookworm eggs in feces b) Occult blood test- should be positive c) Blood test for anemia
B. Control: Control of hookworm infection involves 4 approaches- 1. Sanitary disposal of feces 2. Health education with community participation 3. Chemotherapy 4. Correction of anemia.
1. Sanitation and health education-
• The provision of latrine and education in their proper usage are crucial to the control of hookworm infection.
• Fecal contamination of soil must be prevented.
• Wearing of shoes to protect the feet
• Wearing of hand gloves when handling suspected things polluted with the hookworm larvae.
2. Chemotherapy-
a) Treatment strategy- Mass treatment of whole community selective chemotherapy of all those infected.
b) Drugs-
• Tab. Mebendazol (100 mg) twice daily for 3 days. Most effective for the treatment of hookworm infection.
• Tab. Albendazol (400 mg) in a single dose for all ages over 1 yr.
• Tab. Pyrantel (10 mg/kg) in a single dose for 3 days.
3. Correction of anemia- Ferrous sulphate (200 mg) thrice daily by mouth for 3 months till hemoglobin concentration has risen to 12g /100 ml.
HOOKWORM INFECTION IS A PUBLIC HEALTH PROBLEM IN BANGLADESH
• The latest evidence confirms that blood loss caused by the worms' feeding activity in the gut is a contributing factor in the development of poor iron status leading to iron-deficiency anemia.
• The World Health Organization has identified adolescent girls and women of child-bearing age as high-risk groups regarding the impact of hookworm disease.
• Treating pregnant women with anthelminthic drugs after the first trimester is very much useful to prevent future sufferings from iron deficiency anemia.
CHOLERA
Cholera is an acute diarrheal disease caused by V. cholerae classically characterized by sudden onset of profuse, effortless, watery diarrhea followed by vomiting, marked dehydration, muscular cramps and suppression of urine.
PREVENTION AND CONTROL MEASURES
A. Notification- Cholera is an internationally notifiable disease.
B. Diagnosis: i) Clinical diagnosis ii) Lab diagnosis: a. M/E of Stool- under DGI will show shooting star appearance b. Culture of the Stool
C. Isolation: All cases should be isolated in ICDDRB until at least 3 culture examination are negative.
D. Disinfection: All contaminated articles disinfected by phenols, boiling or lime.
E. Treatment: 1. Rehydration therapy: Prevention and management of dehydration-home-based fluids, ORS, IV fluids. Continued feeding. 2. Drug Treatment: Use of an effective antimicrobial drug e.g. Doxycycline, Erythromycin, Azithromycin, Newer quinolones (Cipro, Norflox) etc.
F. Prevention:
1. Personal prophylaxis and public health measures:
a. Improved sanitation- Provision of safe drinking water, satisfactory sanitary disposal of excreta, refuse & sewage, protection of Foods, house fly control measures.
b. Health education: To drink safe water from tube well, otherwise boiled water or tablet treated water, avoid hot & rotten food and raw vegetables, good hygiene should be maintained.
2. Chemoprophylaxis: Mass treatment with Tetracycline.
3. Vaccination: Cholera vaccine 50% effective in preventing disease for 3-6 months.
CHOLERA IS A PUBLIC HEALTH PROBLEM IN BANGLADESH
• Lack of safe drinking water and inadequate safe drinking water supply system.
• High density of population
• Unsatisfactory unhygienic disposal of excreta and refuse
• Cholera is endemic in Bangladesh with periodic epidemic outbreaks- does not report to WHO.
• V. cholerae infection causes the most severe form of secretory diarrheas.
• New serotype V. cholerae O139
• ICDDR,B hosts the only hospital by the name “CHOLERA HOSPITAL” that treats about 1 million diarrheal patients per year.
• About 30% of them are adults.
• During the epidemic situation more than 50% of the adults suffer from cholera.
• Can be fatal if left untreated.
• 10% develop typical severe cholera
• Case fatality: <1%>
AIDS is a fatal disease caused by human immunodeficiency virus characterized by profound immunosuppression associated with opportunistic infection, the development of certain tumors (Kaposi’s sarcoma) and frequent involvement of the CNS. Strictly speaking, the term AIDS refers only to the last stage of the HIV infection.
PREVENTION AND CONTROL MEASURES
A. Treatment: There is no specific treatment for HIV/AIDS infection. Certain antiviral drugs are available- Zidovudine, gamma interferon, ribavarin etc.
B. Control: 1. Modification of human behavior regarding
a) Sexual behavior- Avoidance of sexual contact with multiple partners, avoidance of unprotected sexual intercourse, avoidance of high risk activities- anal sex, regular venereological screening for high risk group- prostitutes.
b) Blood transfusion- Screening of donated blood.
c) Contaminated needles and other equipments- Use of disposable syringe and other equipments.
d) Perinatal infection- Infected women of childbearing age should be counseled on avoidance of pregnancy through the use of contraceptives.
2. Counseling of persons found to be antibody positive- Regular medical evaluation and follow up are advised.
3. Health education- To educate the public about the modes of transfusion, to educate the public about safe sex.
C. Surveillance: Collecting and analyzing relevant data about infection in the population, the prevalence and distribution of the infection, the high risk group, patterns of behavior, community attitude to AIDS and the patients.
HIV/AIDS IS A PUBLIC HEALTH PROBLEM IN BANGLADESH
• 1st case of HIV detected in 1989.
• Since than total cumulative of 1207 cases of HIV have been confirmed as of 1st December 2007
• 365 have developed AIDS out of whom 123 died
• During 1st December 2007 to 1st December 2007 a total 333 new HIV infection recorded & reported.
• The estimated total number of people living with HIV/AIDS in Bangladesh is around 7,500
• In all 7 rounds of serological surveillance it found that HIV rates have remained below 1% in all ground except in IDUs.
• Among the IDUs prevalence reached from 1.4% in 2000 to 7% in 2006 which is a level closed to concentrated epidemic.
• 7th surveillance shows significant rated of active syphilis among FSWs (1-10%), msm (4-6%) IDUs (1-9%)
HEPATITIS B
Hepatitis B is an acute systemic infection caused by hepatitis B virus which is characterized by long incubation period and which is life threatening. Hepatitis B may occur around the year and it has no seasonal pattern.
High risk group- Surgeons, physician, dentists, nurses, blood bank and hospital personnel, recipients of blood transfusion, homosexuals, prostitutes etc.
PREVENTION AND CONTROL MEASURES
A. Diagnosis: 1. Clinical 2. Lab diagnosis- Immunoassay for HBsAg.
B. Isolation: A patient should be isolated and put on rest.
C. Treatment: No specific treatment for acute or chronic HBV infection, exists although alpha interferon hold some promise.
D. Prevention: 1. Immunization: a) Active- By hepatitis B vaccine. The vaccine consists of HBsAg, each 1 ml dose of the vaccine contains 20 microgram of HBsAg. b) Passive- By hepatitis B immunoglobulin (HBIG). It should be given for immediate protection within 24 hour or almost a week in following circumstances: i) Accidental needle puncture ii) Gross personal contamination with infected blood iii) Newborn infants of carrier mother iv) Sexual contact of acute hepatitis B virus. c) Active-Passive- By simultaneous use of Hepatitis B vaccine and HBIG at separate sites.
2. Specific control measure: i) All person donating blood should be investigated the presence of Hepatitis B virus. ii) Needle, syringe should be properly sterilized before use. iii) Best method is to use disposable syringe and needle. iv) Persons who are at risk(doctors, nurses) all of them should be given HBIG to develop passive immunization.
HEPATITIS B IS A PUBLIC HEALTH PROBLEM IN BANGLADESH
• It is indeed scary news that more than 80 per cent of the total demand of blood in Bangladesh comes from professional blood donors, most of whom suffer from various blood-borne diseases like Hepatitis, HIV and Sexually Transmitted Infections (STIs).
• According to World Health Organization (WHO), transfusion-transmitted infections (TTIs) remains a major public health problem in the country as the demand for blood transfusions is mostly met by unscreened contaminated blood collected from professional donors on payment.
• Poverty, poorly managed commercial blood banks (less sensitive screening and lack of quality control) and an increasing trend in drug addiction and prostitution are listed as the main causes of the prevalence hepatitis B virus (HBV) in professional donors. In 2001 WHO ranked Bangladesh in the moderate-to high-risk group of countries for HBV infection.
MEASLES
Measles is an acute inflammatory disease caused by a paramyxovirus which presents with respiratory catarrhal symptoms (fever, Koplik’s spots on buccal mucosa) and a characteristic skin rash. Maternal antibody gives protection for the first 6 months of life. Measles is a serious disease in the malnourished, vitamin deficient or immunocompromised.
PREVENTION AND CONTROL MEASURES
A. Diagnosis: Clinical: 1. Prodromal phase (Catarrhal stage): This is characterized by- Fever, Sneezing, Conjunctivitis, Coughing, Hoarseness of voice, Koplik’s spots- bright red lesions with a white, central spot that are located on the buccal mucosa and are virtually diagnostic of measles. They last for 3 or 4 days. 2. Exanthematous stage: This stage is characterized by- Dark red macular or maculopapular rash- It develops first at the back of the ears and at the junction of the forehead and the hair. Within a few hours the rash proceeds gradually down the body to the lower extremities.
Laboratory Diagnosis: a) Blood count- Leukocytosis in the early stages followed by an increase in lymphocytes. b) Sputum or urine culture- Stained smears show large multinucleate (giant) cells.
B. Isolation: All patients should be isolated for 10 days from the appearance of the rash.
C. Treatment: Antiviral therapy- Not available. Antibiotics- It should be given only if a
child has clinical signs of pneumonia or other evidence of sepsis.
D. Prevention: i) Active immunization- A children should be protected by measles intramuscularly or subcutaneously at deltoid region. ii) Passive immunization- with human gamma globulin 0.25 mg/kg is effective if given within 3 days of exposure.
MEASLES IS A PUBLIC HEALTH PROBLEM IN BANGLADESH
• In 1984 before EPI intensification 2.6 million children suffered from measles
• In 1999 number of cases dropped to 1 million
• In 2003 no of measles cases were 4505
• In 2004 no of measles cases were 10090
• In 2005 no of measles cases were 28370
• In 2007 no of measles outbreaks were 292
• Around 20,000 children died from measles complication every year until 2005.
• Measles immunization coverage is also poor which was 78% in 2006
• Global Death of Measles fell by 48% from 1999 to 2004
• Deaths reduced from 8.7 million in 1999 to 4.5 million in 2004
• 4.1 million are children out of 4.5 million died
• >95% of Measles death occurred in countries having GNI less than $1000
• 47 Countries account for about 98% of global measles deaths
HOOKWORM INFECTION
Hookworm infection is a chronic debilitating disease caused by soil transmitted helminthes A. duodenale and N. americanus, clinically characterized by anemia (microcytic hypochromic). It is more common in the countries of low socio-economic status where disposal of excreta is not sanitary. A. duodenale infection is common in Bangladesh.
PREVENTION AND CONTROL MEASURES
A. Diagnosis: 1. Clinical 2. Laboratory- a) Finding of hookworm eggs in feces b) Occult blood test- should be positive c) Blood test for anemia
B. Control: Control of hookworm infection involves 4 approaches- 1. Sanitary disposal of feces 2. Health education with community participation 3. Chemotherapy 4. Correction of anemia.
1. Sanitation and health education-
• The provision of latrine and education in their proper usage are crucial to the control of hookworm infection.
• Fecal contamination of soil must be prevented.
• Wearing of shoes to protect the feet
• Wearing of hand gloves when handling suspected things polluted with the hookworm larvae.
2. Chemotherapy-
a) Treatment strategy- Mass treatment of whole community selective chemotherapy of all those infected.
b) Drugs-
• Tab. Mebendazol (100 mg) twice daily for 3 days. Most effective for the treatment of hookworm infection.
• Tab. Albendazol (400 mg) in a single dose for all ages over 1 yr.
• Tab. Pyrantel (10 mg/kg) in a single dose for 3 days.
3. Correction of anemia- Ferrous sulphate (200 mg) thrice daily by mouth for 3 months till hemoglobin concentration has risen to 12g /100 ml.
HOOKWORM INFECTION IS A PUBLIC HEALTH PROBLEM IN BANGLADESH
• The latest evidence confirms that blood loss caused by the worms' feeding activity in the gut is a contributing factor in the development of poor iron status leading to iron-deficiency anemia.
• The World Health Organization has identified adolescent girls and women of child-bearing age as high-risk groups regarding the impact of hookworm disease.
• Treating pregnant women with anthelminthic drugs after the first trimester is very much useful to prevent future sufferings from iron deficiency anemia.
CHOLERA
Cholera is an acute diarrheal disease caused by V. cholerae classically characterized by sudden onset of profuse, effortless, watery diarrhea followed by vomiting, marked dehydration, muscular cramps and suppression of urine.
PREVENTION AND CONTROL MEASURES
A. Notification- Cholera is an internationally notifiable disease.
B. Diagnosis: i) Clinical diagnosis ii) Lab diagnosis: a. M/E of Stool- under DGI will show shooting star appearance b. Culture of the Stool
C. Isolation: All cases should be isolated in ICDDRB until at least 3 culture examination are negative.
D. Disinfection: All contaminated articles disinfected by phenols, boiling or lime.
E. Treatment: 1. Rehydration therapy: Prevention and management of dehydration-home-based fluids, ORS, IV fluids. Continued feeding. 2. Drug Treatment: Use of an effective antimicrobial drug e.g. Doxycycline, Erythromycin, Azithromycin, Newer quinolones (Cipro, Norflox) etc.
F. Prevention:
1. Personal prophylaxis and public health measures:
a. Improved sanitation- Provision of safe drinking water, satisfactory sanitary disposal of excreta, refuse & sewage, protection of Foods, house fly control measures.
b. Health education: To drink safe water from tube well, otherwise boiled water or tablet treated water, avoid hot & rotten food and raw vegetables, good hygiene should be maintained.
2. Chemoprophylaxis: Mass treatment with Tetracycline.
3. Vaccination: Cholera vaccine 50% effective in preventing disease for 3-6 months.
CHOLERA IS A PUBLIC HEALTH PROBLEM IN BANGLADESH
• Lack of safe drinking water and inadequate safe drinking water supply system.
• High density of population
• Unsatisfactory unhygienic disposal of excreta and refuse
• Cholera is endemic in Bangladesh with periodic epidemic outbreaks- does not report to WHO.
• V. cholerae infection causes the most severe form of secretory diarrheas.
• New serotype V. cholerae O139
• ICDDR,B hosts the only hospital by the name “CHOLERA HOSPITAL” that treats about 1 million diarrheal patients per year.
• About 30% of them are adults.
• During the epidemic situation more than 50% of the adults suffer from cholera.
• Can be fatal if left untreated.
• 10% develop typical severe cholera
• Case fatality: <1%>
• Can kill an adult in 2-4 hours
MALARIA
Malaria is a disease of wide distribution caused by sporozoa of the genus plasmodium characterized by paroxysmal fever with periods of latency, enlargement of spleen and secondary anaemia.
There are 4 species of malarial parasites which infect humans:
• P. falciparum. This species, predominant in Africa, produces the most severe symptoms and is responsible for most malaria deaths.
• P. vivax. This species, found mostly in tropical areas of Asia, produces less severe symptoms but can remain in your liver and cause relapses for up to three years.
• P. malariae. This species found in Africa, can cause typical malaria symptoms, but on rare occasions it can remain in bloodstream.
• P. ovale. This species is found mostly in West Africa. Although rare, it can also cause relapses.
PREVENTION AND CONTROL MEASURES
A. The individual: Chemoprophylaxis: the antimalarial available for chemoprophylaxis are proguanil, Chloroquine, Maloprim, Mefloquine.
B. The Vector: attempted in two ways- 1. Adult mosquito Control: by insecticides varies from area to area. 2. Prevention of mosquito breeding by larval control: heavy oiling with antimalarial oil &insecticides, spraying with 5 % DDT.
C. The community: Active community participation is important. The measures to be applied by locally recruited and trained workers include- residual spraying, larviciding, mass drug administration.
D. Prevention:
• There's no effective vaccine against malaria.
• In countries where the disease is endemic, prevention involves keeping mosquitoes away from humans. This has included the use of insecticide-treated mosquito netting and spraying indoor walls with insecticide.
• Most drugs used to treat malaria are also used to prevent it. Doctors sometimes use the antibiotic doxycycline to prevent malaria. Tips to prevent malaria: The CDC also recommends the following measures to help prevent malaria:
• Use repellent. Spray DEET insect repellent on exposed skin, and use flying-insect spray to kill mosquitoes in your sleeping area. • Wear protective clothing. During active mosquito times, usually from dusk to dawn, wear pants and long-sleeved shirts. • Use netting. If you're staying in a place that doesn't have screens or air conditioning, sleep under mosquito netting that's been treated with an insecticide called permethrin. This netting is available in many travel and camping supply stores and online.
MALARIA IS A PUBLIC HEALTH PROBLEM IN BANGLADESH
• In Bangladesh, it is mainly caused by the female Anopheles mosquitoes.
• The disease restricted to areas where the females Anopheles mosquitoes can bread.
• Malaria is now on the increase due to emergence of drug resistance.
• Presence of extra human reservoir of infection.
• Common border of Bangladesh & India: disease agent can cross the border & cause malaria of the people of the border area.
• Hilly areas are covered with dense forest where operation could not carried out properly.
• Migratory habit of the people
• Poor standard of environmental sanitation.
TYPHOID FEVER
Typhoid is an infectious and communicable disease caused by gram negative bacillus Salmonella typhi, characterized by headache, high fever, malaise, anorexia, abdominal discomfort and pt. is very much toxic. The disease is also known as Enteric fever - as because, it affects gastrointestinal tract. The disease also affects Liver, Kidneys, Lungs, Heart, and Lymph nodes & Glands.
PREVENTION AND CONTROL MEASURES
A. Notification
B. Diagnosis: i) Clinical ii) Laboratory- a. Blood culture: in MacConkey’s agar media- Positive at 1st week b. Stool culture: in MacConkey’s agar media, DCA-Positive from 2nd or 3rd week c. Urine culture: in MacConkey’s agar media- Positive in 2nd, 3rd or 4th week d. Serological test: Widal test - Positive during 2nd week e. Phage typing of isolated strains f. Routine blood test: TC - Leucopenia, DC - Neutropenia
C. Isolation: Case should be isolated till “3” negative stools and urine culture reports are obtained on three separate days.
D. Disinfection: Stools and urine should be disinfected with 5% cresol.
E. Treatment: Ciprofloxacin is now a days the drug of choice.
F. Follow-up: Stool and Urine examination should be done for detection of S. typhi, 3 to 4 months after discharge of the patient.
G. Prevention: 1. Community measure: Ensure Safe water supply, ensure safety food, proper disposal of human excreta and garbage, health education. 2. Immunization: a. Ty21a Vaccine(Vivotif Berna, Swiss Serum and Vaccine Institute) 1 capsule by mouth 4 doses @ 2 days alternate b. ViCPS (Typhim Vi, Pasteur Merieux) Injection single dose
TYPHOID IS A PUBLIC HEALTH PROBLEM IN BANGLADESH
• Typhoid fever is very common in Bangladesh, where this pathogen thrives in areas where disasters have compromised sanitation with the typical tropic zone.
• Preliminary results from recent studies conducted in Bangladesh by ICDDR,B show an incidence of approximately 2000 per 100 000 per year.
• Typhoid is a curable as well as preventable disease, and socio-economic impact is huge, so it is in consideration and concern of public health.
• Typhoid fever is common in Bangladesh because water supplies and sanitation are sub-standard.
TUBERCULOSIS
Tuberculosis is a chronic infectious and communicable infectious disease caused by Mycobacterium tuberculosis. This disease primarily affects lungs but it may affect other organs also e.g. Intestines, Bones, Joints, Lymph glands and others.
PREVENTION AND CONTROL MEASURES
The control of tuberculosis can be considered at the six levels of prevention:
A. General health promotion: Adequate housing, good nutrition, health education.
B. Active immunization: By BCG (Bacille Calmette Guerin) vaccine at birth in a single dose (0.1 ml) intradermally which is a live attenuated vaccine.
C. Early diagnosis and treatment: 1. Screening- Tuberculin test, Staining of sputum, Chest X-ray. 2. Isolation- Patient should preferably be isolated from young children. 3. Drug treatment: The overall goal for treatment of tuberculosis- a. To cure the individual patient b. To minimize the transmission of Mycobacterium tuberculosis to other persons. The anti tubercular drugs are- Isoniazid, Rifampicin, Pyrazinamide, Ethambutol, and Streptomycin. • Regimen for new smear-positive patients and other severely ill patients: 2HRZE/4H3R3 • Regimen for relapses and failures: 2SHRZE/1REHZ/5R3E3H3 • Regimen for smear-negative and extra-pulmonary patients: 2HRZ/4H3R3
D. Rehabilitation
E. Surveillance: The source of data will include- Notification of cases, post mortem reports, record of BCG immunization, housing- data about overcrowding. F. Control strategy: Tuberculosis control means reduction in the prevalence and incidence of disease in the community. DOTS is a control strategy which ensures - • Sustained Political Commitment • Case Detection through Quality assured Sputum microscopy • Uninterrupted supply of Drugs • Standardized treatment regimen • Standardized recording and reporting system
TUBERCULOSIS IS A PUBLIC HEALTH PROBLEM IN BANGLADESH
• Tuberculosis is a major public health problem in Bangladesh. In 2006, World Health Organization (WHO) ranked Bangladesh 6th among the world's 22 high-burden TB countries.
• In Bangladesh, More than 319,000 new cases, including 143,000 sputum smear-positive (SS+) pulmonary TB cases and 70,000 TB-related deaths occur annually.
• WHO declared TB as a global emergency and recommended DOTS strategy. Bangladesh introduced this strategy in 1993 and it is expanded all upazilas by 1998.
1 comment:
I'm here to give my testimony how I was cured from HIV, I contacted my HIV via blade. A friend of my use blade to peel of her finger nails and drop it where she use it, so after she has left i did know what came unto me i looked at my nails, my nails were very long and I took the blade which she just used on her own nails to cut of my finger nails, as i was maintaining my names, i mistakenly injured myself. I did even bother about it, so when I got to the hospital the next week when i was ill the doctor told me that I am HIV positive, i wondered where did i got it from so i remembered how I use my friend blade to cut off my hand so i feel so sad in my heart to the extent that i don’t even know what to do, so one day i was passing through the internet i met a testimony of a lady that all talk about how she was cured by a doctor called DR Imoloa so i quickly emailed the doctor and he also replied to me and told me the requirements which i will provide and I do according to his command, he prepare a herbal medicine for me which I took. He message me the following week that i should go for a test which i did to my own surprise i found that i was HIV negative. He also have cured for all kinds of incurable diseases like: Huntington's disease, back acne, chronic kidney failure, Addison's disease, Chronic Disease, Crohn's Disease, Cystic Fibrosis, Fibromyalgia, Inflammatory Bowel Disease, Fungal Nail Disease, Paralysis, Celia Disease , Lymphoma, Major Depression, Malignant Melanoma, Mania, Melorheostosis, Meniere's Disease, Mucopolysaccharidosis, Multiple Sclerosis, Muscle Dystrophy, Rheumatoid Arthritis, Alzheimer Disease and so many. Thanks to him once more the great doctor that cured me dr. Imoloa so you can also email him via drimolaherbalmademedicine@gmail.com or what'sapp him on +2347081986098.. God Bless you Sir.
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