1 / 21

MIS Laboratory Manual and Treatment issues

MIS Laboratory Manual and Treatment issues. 10 September 2008 Lusaka. Overview. Laboratory manual components Logistics Diagnostics Treatment issues Medical referral form. Laboratory manual 1 of 4. Important issues to consider from the beginning: What combination of tests will be done?

nadine-morse
Download Presentation

MIS Laboratory Manual and Treatment issues

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. MIS Laboratory Manual and Treatment issues 10 September 2008 Lusaka RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  2. Overview • Laboratory manual components • Logistics • Diagnostics • Treatment issues • Medical referral form RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  3. Laboratory manual 1 of 4 Important issues to consider from the beginning: • What combination of tests will be done? • Malaria • RDTs – Which type/brand? • Blood smears – thick and thin smears • Same slide or different slides • Dried blood spots -on filter paper • Anemia • Hemocue RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  4. Laboratory manual 2 of 4 • Selecting participants • Children under 5 or 6 • Other populations • Taking blood / finger / heel sticks • In what order? • General procedures when taking blood • Clean, sterile testing environment • Field staff certification / registration RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  5. Laboratory manual 3 of 4 • Anemia testing • Operating Hemocue analyzers • Using microcuvettes • Reading the results • Cleaning the machines • Troubleshooting RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  6. Laboratory manual 4 of 4 • Malaria testing • How to perform the RDT • Dos and Don’ts • Interpretation of Results • Slide preparations • Materials required • Making blood films • Labeling • Fixing thin films • Staining slides • Supportive learning (show videos) RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  7. Testing supplies • Following national recommendations • Country tested / approved devices • Ordering supplies • Ordering in advance • Over ordering quantities • Field work and pre-testing activities • Using similar batch/lot numbers • Exposed to similar and ideal conditions • Back up supplies and HB machines RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  8. Logistics issues to consider • Planning for daily activities • On-hand daily supplies • Pilot/Pre-testing kinks • Detailed supplies by site or team/population • Supervision of field testing activities • Lab registration sheet / written daily log • Slide / material collection during field work RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  9. Malaria • Is RDT positive? • If positive for Pf • Check if person is pregnant woman. • If not pregnant woman: treat with Coartem • If pregnant: treat with Quinine • If less than 5kgs:treat with SP • If negative: • Do not treat for malaria Also refer or take to health facility based on clinical judgment with danger signs RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  10. Anemia • Is Hb <8g/dl in child under 6 years? • If yes, treat with • 1) Iron • 2) Mebendazole (if 1 year or older) • If no, do not give iron and mebendazole.Coartem depends on RDT results • Also refer to health facility based on clinical judgment (danger signs) RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  11. Treatment Overview • Who will be treated? • Decision rules • Treatment schedules • What about other sick people? • Referral indications RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  12. Decision rules • Things to consider • Is haemoglobin <8 g/dl? • Is the RDT positive? • Is the woman pregnant? • What is the person’s age? • Is child 1 year or older? • Are there danger signs? RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  13. Who will be treated? • People will be treated based only on the results of diagnostic tests performed, not on any other clinical assessment • Who will be treated? • Children with severe anaemia (<8 g/dl haemoglobin) • Anyone with positive RDT for malaria RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  14. All Children 6<yr & all people in every 4th Household ONLY Children 6<yr RDT (+) (-) Hemocue Pf Hg≥8g/dL Hg<8g/dL Pregnant No Treatment No Treatment No Yes Less than 5kgs Iron Quinine Coartem If Age≥1 yrs SP + mebendazole Treatment Diagram RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  15. Anaemia treatment • Mebendazole (refer to IMCI Guidelines): For children age 1 year and over: Tablet or syrup • Iron tablets or syrup: RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  16. Malaria Treatment • Coartem: (For RDT Pf positive ) • Tablets with 20 mg Artemether plus 120 mg Lumefantrine RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  17. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  18. 3. Quinine (For pregnant women and infants) Quinine 8 mg base/kg 3 times daily for 7 days RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  19. What about other sick people? • You will be approached by others in the village. • Do not use RDTs for non-participants in other households • Explain that you are there mainly for the survey and your supplies have been calculated accordingly. • refer them to the facility for treatment • Refer or transport to health facility if necessary. RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  20. Medical referral form RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

  21. Summary • Lab manual is useful for training and field referencing • Key decisions at the outset • Who will be stuck? • Which tests will be included? • Which RDT will be used? • How to deal with discordant results-RDTs vs BS • Order sufficient supplies (field work + pre-test, over order!) • Think through the transport and slide reading procedures • Documentation of the process will only help the end result (PDA results+lab registration+supervision+counter checking) • Identify the testing, diagnosis and treatment algorithm – reinforce through training! RBM-MERG Malaria Indicator Training Workshop, 9th-12th September 2008, Lusaka, Zambia

More Related