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Jordan Salmonella Report

MECIDS Annual Meeting Amman January 16-18, 2007. Jordan Salmonella Report. Disease Control Directorate Ministry of Health, Jordan. Outline. Background: Jordan Burden of Illness Study MECIDS objectives Methods Results Conclusions & Recommendations. Jordan Burden of Illness Study.

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Jordan Salmonella Report

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  1. MECIDS Annual Meeting Amman January 16-18, 2007 Jordan Salmonella Report Disease Control Directorate Ministry of Health, Jordan

  2. Outline • Background: Jordan Burden of Illness Study • MECIDS objectives • Methods • Results • Conclusions & Recommendations

  3. Jordan Burden of Illness Study • Jordan first site in Eastern Mediterranean • Burden of Salmonella, Shigella, Brucella • Burden of illness study • Population survey • Laboratory survey • Validation study

  4. Population survey

  5. Cases of Salmonella and Shigella in stool cultures* *In 24 MOH lab

  6. Comparison of laboratory survey results & MOH Reports * cultured † tested: food handlers probably included, unknown procedures

  7. Jordan Diarrhea Burden

  8. Measuring the burden of foodborne illnesses 273 infected persons in the community

  9. Estimated Burden of Foodborne Pathogens Jordan 03-04* *Only 50% of Jordan’s population seeks care in MOH facilities.

  10. Comparison of Isolation Rates of Foodborne Pathogens between Lab. Survey & Validation Study* * Jordan Aug—Sep 2003

  11. MECIDS objectives • Establish sentinel laboratory-based surveillance in Israel, Jordan, and PA • Enhance laboratory capabilities to identify Salmonella • Strengthen existing capabilities and develop new ones for characterization of Salmonella using phenotypic and genotypic markers

  12. Methods • Meetings at national and regional levels • Sentinel sites • Study population • SOPs • Training (local & regional) • Data collection forms (lab. logbooks, reporting forms)

  13. Data flow chart

  14. Training MoH Lab. Training Center, Amman, Sept 2006

  15. Data collection forms

  16. Methods • Data collection started in July 2005 • Information on specimens tested recorded routinely • Aggregated numbers sent monthly by fax to Lab. Directorate & DDC* • Data entered and analyzed at DDC using Microsoft Excel • Monthly reports sent to CMC Amman *Disease Control Directorate

  17. Specimens TestedJordan Jul 05-Nov 06

  18. Food Items TestedJordan Jul 05-Nov 06

  19. Blood Specimens TestedJordan Jul 05-Nov 06

  20. Patients Stool Specimens TestedJordan Jul 05-Nov 06

  21. Food handlers Stool Specimens TestedJordan Jul 05-Nov 06

  22. Isolation Rate of Salmonella by Type of Specimen Jordan July 05-Nov 06

  23. Isolation Rate of Salmonella by Type of Specimen Jordan July 2005-June 2006

  24. Isolation Rate of Salmonella by MonthJordan July 2005-June 2006

  25. Isolation Rate of Salmonella by Sentinel LaboratoryJordan July 2005-June 2006

  26. Percentage of Salmonella Isolates by Serogroupe S. typhimurium 5% S. enteritidis 15%

  27. Conclusions • System is useful and operates efficiently • Similar Salmonella rates in stools from patients (1.54%) & food handlers (1.53%) • Overall Salmonella rate in stool: 1.5% • Rates comparable to those of developing countries (1.8%) and tenfold lower than rates in developed countries (0.15%)* *Chaker & Baker, 1988. A review of human salmonellosis

  28. Conclusions • Higher than rates laboratory survey (0.3%), lower than rates in validation study (2.5%)* • High Salmonella burden ([64+74]*273~38,000 cases in 18 months) • High % of S. enteritidis *Jordan Burden of Illness Study

  29. Recommendations • At sentinel lab level • Continue Salmonella surveillance system • Add Shigella using same diagnostic procedures and mechanisms of reporting • Test for other entero-pathogens (Campylobacter, E. coli, etc.) • Establish electronic reporting from sentinel labs

  30. Recommendations • At reference lab level • Use PFGE • Establish electronic reporting from reference lab • At regional level • Training? • Compare & publish data

  31. Acknowledgements

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