Strategies for Dengue Control Program

7/29/2019 Strategies for Dengue Control Program

1/22

Dr. Naseem Hasrat Qazi ADHO CDC

AJK


2/22


3/22

SCOPE

The Dengue Strategic Plan for the State of AJK will assist

stakeholders to enhance their outbreak preparedness and

response, and limit dengue epidemics through effective

prevention and control.Dengue does not respect national boundaries. Effective

dengue control is not possible if control efforts are limited to

one district or a few districts. It requires the adoption of a

state level approach through collaboration among districtsand sustained partnerships to enable districts to implement

evidence-based interventions and the use of best practices.


4/22

Strategic Components

I. Dengue SurveillanceII. Dengue Integrated Vector Management

III. Dengue case management

IV. Social Mobilization and Communication forDengue

V. Dengue Outbreak Response


5/22

EPIDEMICOLOGICAL

SURVEILLANCE

SOCIAL

COMMUNICATION INTEREGRATED VECTOR

MANAGEMENT

INTEGRATED

MANAGEMENTSTRATEGY

LABORATORY ENVIRONMENT

PATIENT CARE


6/22

Preparedness plan for dengue

outbreak control and response

Recent outbreaks have shown that currentresponse mechanisms are inefficient andhealth systems would be overwhelmed in

large epidemics. Lack of clinical, vector controland laboratory supplies, shortages in trainedclinical, paramedical and vector controlpersonnel and inadequate communication

strategies to reach the community in aneffective way are some of the main issues tobe targeted during dengue outbreaks.


7/22

PREPARDNESS PLAN CONTINUE

To complement IMS-Dengue there is a strongneed to develop a subregional ContingencyPlan to respond to dengue outbreak and

epidemics. This plan would streamline inter-district dengue surveillance and strengthentrans-district linkages and informationexchange. The District disaster and emergency

preparedness plans will complement this Statecontingency plan, for timely control of dengueoutbreaks.


8/22

Guiding principles

The Dengue Strategic AJK State underpins the following guiding principles:

collaboration, cooperation and National solidarity for effective and sustained

prevention and control of dengue in State of AJK;

use of existing policy frameworks and infrastructure for dengue prevention and

control programs, and integrating disease surveillance within the umbrella ofbasic health services;

use of local, multi districts, state and National partnerships to support Program

activities;

use of evidence-based interventions and best practices in developing and

implementing dengue prevention and control programs;

use of networking to optimize available resources;

adoption of evidence-based interventions that are currently available, while at

the same time recognizing the need for improved diagnostics and other

innovations for the prevention and treatment of dengue.


9/22

Dengue is the fastest-growing arbovirus infection with a rapidly evolving epidemiology.

It is among 40 emerging diseases of global importance. The increasing burden of denguein the AJK State is a matter of serious concern since the disease is spreading to new

geographical areas.

Dengue epidemics are an indication of the failure of public health systems to respond

rapidly.

Timely control of epidemics requires preparedness and capacity to undertake suitable

and effective control activities during the inter-epidemic period. Resolution of an

epidemic requires sustained high-level government commitment and strengthening of

public health infrastructure, intersectoral collaboration and community participation.

The disease was until recently predominantly urban. Dengue outbreaks do tend to

attract considerable adverse publicity and coverage in the media, whether an outbreak

has been confirmed or is only rumored. This may impact negatively .

Overview


10/22

Strategic Goals of the Program

To reduce the disease burden due to major parasitic and vector

borne diseases to such an extent that they are no longer major

public health problems

To reduce incidence rates of dengue fever and dengue

hemorrhagic fever

To increase capacity of Member States to monitor trends and

reduce dengue transmission

Circulate standard case definition to stakeholders

Support training for personnel where necessary

Agree on a dengue information system and designate district focal

points

Produce and disseminate guidelines

Support training on information system


11/22

Implementation and use of the system

Monitor performance of the system and implement corrective action as

neededIncorporate dengue surveillance (case, vector and seroprevalence) into an

integrated and strengthened disease surveillance system

Identify strengths and weaknesses of existing state diseases surveillance

systems through mapping

To increase health workers capacity to diagnose and treat patients and

improve health-seeking behavior of communities

Public awareness on dengue disease

Strengthen capacity of health care providers to diagnose, treat or refer cases

Laboratory support for case management

Establishment of the referral system

Conduct training for various target groups, starting with priority areasEarly warning system and dengue surveillance system developed

Strategic Goals of the Program (Cont.)


12/22

INTEGRATED MANAGEMENT STRATEGY FOR DENGUE PREVENTION AND

CONTROL Of AJK REGION

Reduce the social, economic and health impacts caused by

dengue in the State of Azad Jammu & Kashmir.

IMS

Management

Epidemiological Surveillance

Social Communication

Clinical Case Management

Laboratory

Entomology


13/22

IMS

Results Indicators Verification Sources Assumptions

1-Control Morbidity

and Mortality

caused by Dengue

by effective

coordination ofDistricts by IMS.

Incidence rate of

Dengue fever

Weekly

Epidemiological

Reports from each

District to DHS CDC

AJK.

District Focal

Persons (DFPS) will

be appointed.

2-Strengthening

and integration of

Dengue

Surveillance system

in the present

health reporting

system at all levels

keeping in view the

available resources.

Incidence rate of

Dengue fever and

Dengue Shock

Syndrome DSS.

Department of

Health AJK


14/22

Management

Results Indicators Verification Sources Assumptions/Risks

1-State IMS Dengue

Network

established with

activeparticipations of

the Districts

Number of Districts

reporting weekly

the epidemiological

and lab .data to theDHS CDC

Surveillance

Record, Outbreak

Investigation

reports.

Entomological

Reports.

Political

Commitment.

Surveillance Systemestablished and

operating.

Functional

Communication

System.


15/22

Epidemiological Surveillance

Results Indicators Verification Sources Risks/ Assumptions

Dengue

epidemiological

surveillance system

for timely alert and

opportuneresponse to

outbreaks

implemented in the

Districts of AJK.

Number of Districts

reporting to DHS

CDC and System.

%age of sitesreporting weekly to

the DHS CDC AJK.

Number of

Outbreaks detected

and reported.

Surveillance

records.

Outbreak Reports.

Epidemiological

Reports.

Political

Commitment.

Surveillance System

established andoperating.

Functional

Communication

System.


16/22

Social CommunicationResults Indicators Verification Sources Risks/ Assumptions

State

Communication

Framework to

obtain behavior

change associated

with DengueMorbidity.

Communication

Framework in AJK .

Minutes of Meeting

Disbursement.

DHS will

communicate the

situation and feed

back.

Communicationframework

submitted to

relevant

authorities.(

Secretary Health,

Minister HealthAJK)


17/22

Activities to be Taken for

Communication

Develop Communication Channel, radio talks,

press briefings and cable network messages.

ASK for technical support to NGOS AND

INGOS.


18/22

Clinical Case Management

Expected Results Indicators Verification Sources Assumptions

Reduce Morbidity

associated with

Dengue.

Reported Cases Hospital Statistics Availability of

Human, material

and financial

resources.


19/22

Activities for Clinical Case

Management

All District Headquarter hospitals including

AIMS and Sheikh Khalifa Hospitals should have

a contingency plan, updated manual of

contingency plan, clinical case managementupdated, medical supplies for treatment of

patients.


20/22

Laboratory


Laboratory capacity

is strengthened to

support

surveillance and

outbreakinvestigation for a

timely response to

clinicians and public

health officials.

Number of

hospitals that can

conduct or access

serological testing

in AJK.

Guidelines for

laboratory

diagnosis and

annual reports.

Human and

financial resources

available

Reporting ResultsWeekly.


21/22

Entomology


Integrated Vector

Management for

dengue prevention

implemented to

reduce vectorpopulations only in

prioritized districts

i.e.; Bhimber,

Mirpur, Pallandri,

Bagh,

Muzaffarabad.

Number of training

courses in IVM

completed

Aedesentomological

indices if applicable

and available.

IVM Training

Manual

Entomological

Surveys/reports

Minutes of Annual

meetings

Standard Operating

Procedures

Intra and Inter

district

commitment for

developing plans to

reduce breedingsites.

Community

Participation.

Availability of manpower, equipments

in quality and

quantity.


22/22

Thank You

Documents

Strategies for Dengue Control Program