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One World One Health and Disease Surveillance in Bangladesh

One World One Health and Disease Surveillance in Bangladesh. Prof. Mahmudur Rahman MBBS (Chittagong), MPHM (Thailand) Ph.D. (Cambridge, U.K) Director Institute of Epidemiology, Disease Control & Research ( IEDCR) &

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One World One Health and Disease Surveillance in Bangladesh

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  1. One World One HealthandDisease Surveillance in Bangladesh • Prof. MahmudurRahman • MBBS (Chittagong), MPHM (Thailand) • Ph.D. (Cambridge, U.K) • Director • Institute of Epidemiology, Disease Control & Research ( IEDCR) • & • National Influenza Centre (NIC), Bangladesh • Ministry of Health and Family Welfare, Bangladesh

  2. Profile Bangladesh • Population: approximately 150 million • Land area of 147, 570 sq. km • Most (85%) of the population live in rural areas • Per capita annual income of less than US $621 (2009) • Average life expectancy: 66 years • Infant mortality: 52 per 1000 live births • Annual population growth rate : 1.58% • Physicians to population ration:: 2.6 : 10,000

  3. Administrative units Division - 7 • District - 64 Upazila - 481 Union– 4500(10 unions/ upazila) Ward - 40500(9 in each union) Village - 90500

  4. Multi tire Health Care System National Level Specialized Hospitals Medical College Hospitals Medical College Hospitals District Level Private Health services through Hospitals Private Health services through practioners 50-200 bedded hospital Upazila Level: 31 and above bedded hospital Health workers Community Health Clinics Health care personnel Physician, Nurse, other paramedics

  5. Collaboration • Ministry of Health & Family Welfare • Ministry of Fisheries & Livestock

  6. Areas of Collaboration • Zoonotic Diseases • Avian Influenza • Nipah • Rabies • Anthrax • Japanese Encephalitis (JE) • Food borne Illness • Unintentional Pesticide Poisoning • Waterborne Illness

  7. Example of Collaboration • Avian Influenza Outbreak

  8. Committees Formed for facing Pandemic Influenza • National Advisory Committee (NAC) • National Multi Sectoral Task Force (NMTF) • Multi Sectoral Communication Wing • Technical Committee : Health • District Multi Sectoral Coordination Committee (DMSCC) • District Influenza Management Committee (DIMC) • Upazila Multi Sectoral Coordination Committee (UMSCC) • Upazila Avian Influenza Management Committee

  9. Flow Chart on Influenza Pandemic Preparedness and Response Activity Information Coordination and Response System National Advisory committee NMTF Coordination and Secretariat TC,Health TC, LS DAIMC, LS DIMC, Health DMSCC UAIMC, LS UIMC, Health UMSCC

  10. National disease surveillance systems • Routine Disease Surveillance • EPI Disease Surveillance • Priority Communicable Disease Surveillance (Web based) 4. Surveillance through Outbreak Investigation (Event based Surveillance) 5. Institutional Disease Surveillance 6. Sentinel Surveillance

  11. Other Surveillance activities • Nipah Surveillance in 6 sites started in 2006 • Acute Meningo-Encephalitis Surveillance (AMES) started in 2007 • Hospital based Influenza surveillance in 12 centres started in 2007. Eighteen more centres to start functioning soon • Community Based Influenza Surveillance in Dhaka started in 2004 • Avian Influenza Surveillance among High Risk Groups • Among personnel in direct contact during culling started in Jan’ 2008 • Wet Market live bird handler (started on 23rd Feb’09) • Salmonella Surveillance started in 2009

  12. Outbreak investigation and Response • A total of 30 Outbreak investigations have been conducted in 2008 • 3 Nipah outbreaks • 3 outbreaks of Puffer fish poisoning • 5 outbreaks of Mass Psychogenic Illness • 4 outbreaks of Viral Encephalitis of unknown origin • First Human case of Avian Influenza was reported and investigated by IEDCR • Three different isolated clusters of Influenza Like Illness and • Food Poisoning • Chikungunya Fever in Poba, Rajshahi • Jaundice Outbreak in Tongi

  13. Outbreak investigation and Response • Seven Outbreak investigations and Response conducted in 2009 • Pesticide Poisoning in Dhamrai • H1N1 Outbreak • High Energy Biscuit consumption • Mass Psychogenic illness, Jessore • Anthrax Outbreak in Pabna and Sirajganj • Cholera in Pabna

  14. Outbreak investigation and Response • Outbreak investigation and Response: 2010 • Nipah outbreak in Bhanga, Faridpur • Pneumonia Outbreak in Cox’s Bazzar • Chicken Pox in Banderban • Jaundice in Rajshahi • Nipah in Faridpur

  15. Questions?

  16. Thank You www.iedcr.org

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