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DENGUE EPIDEMIOLOGY AND CONTROL PROGRAM IN MALAYSIA

DENGUE EPIDEMIOLOGY AND CONTROL PROGRAM IN MALAYSIA. DR ROSE NANI MUDIN DISEASE CONTROL DIVISION MINISTRY OF HEALTH 13 JAN 2009. OUTLINES OF PRESENTATION. Epidemiology of Dengue in Malaysia Dengue Mortality Control Activities Strategies Conclusion.

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DENGUE EPIDEMIOLOGY AND CONTROL PROGRAM IN MALAYSIA

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  1. DENGUE EPIDEMIOLOGY AND CONTROL PROGRAMIN MALAYSIA DR ROSE NANI MUDIN DISEASE CONTROL DIVISION MINISTRY OF HEALTH 13 JAN 2009

  2. OUTLINES OF PRESENTATION Epidemiology of Dengue in Malaysia Dengue Mortality Control Activities Strategies Conclusion

  3. INCIDENCE RATE OF REPORTED DENGUE CASES IN MALAYSIA (1981 - 2008)

  4. NUMBER OF REPORTED DENGUE FEVER AND DENGUE HAEMORRHAGIC FEVER CASES IN MALAYSIA, 1995 – 2007

  5. DISTRIBUTION OF REPORTED DENGUE CASES IN MALAYSIA BY EPIDEMIOLOGY WEEK (2006–2008) Epid. Week 5

  6. COMPARISION OF DENGUE CASES BY STATE (2007 & 2008) NO. OF CASES 2008 6 2007 6

  7. THE DENGUE INCIDENCE RATE BY STATE (2008) 78 86 80 150 33 LABUAN 150 179 157 62 88 408 141 WPKL 334 110 MALAYSIA 178 cases/100,000population 118

  8. PATTERN OF DENGUE CASES

  9. RATIO OF DHF : DF IN MALAYSIA 1998 – 2008 DHF : DF RATIO 9

  10. PERCENTAGE DISTRIBUTION OF DENGUE CASES BY LOCALITY IN MALAYSIA (1998 – 2008) 10

  11. % 11 11

  12. DHF AND DF FATALITY RATES FOR MALAYSIA (1990-2008)

  13. DISTRIBUTION OF DENGUE DEATH CASES BY AGE GROUP (1997 – 2007) NO. OF CASES YEAR

  14. FINDINGS OF DENGUE CASES ANALYSISFOR 2008 14

  15. DISTRIBUTION OF DENGUE CASES BY GENDER 15

  16. DISTIRBUTION OF DENGUE CASES BY AGE GROUP 16

  17. FINDINGS OF VEKPRO ANALYSIS FOR 2008 (Epid wk 1- 49) 17

  18. DENGUE MORTALITY ANALYSIS2008 18

  19. DENGUE MORTALITY 112 dengue deaths reported for 2008 (98 cases in 2007 Only 62 cases were reviewed by the state mortality review committee 19

  20. DISTRIBUTION OF DENGUE MORTALITY BY AGEGROUP 20

  21. DURATION BETWEEN TIME OF ONSET AND ADMISSION 21

  22. DURATION BETWEEN TIME OF ADMISSION AND DEATH 22

  23. CAUSE OF DEATH DIAGNOSIS OF MORTALITY CASES 23

  24. CONTRIBUTING FACTORS FOR DENGUE MORTALITY 24

  25. CONTRIBUTING FACTORS FOR DENGUE MORTALITY 53% of the death were preventable 25

  26. Key Components of Dengue Control Strategy Early diagnosis and treatment Training of frontliners Health education to public on importance of early diagnosis and treatment Active case detection in outbreak localities Prompt notification Within 24 hours By phone Nearest District Health Office Case Investigation within 24 hours Prompt vector control response Within 24 hours of notification Fogging within 200 m radius 400 m if outbreak locality Quality Assurance Program -Dengue Outbreak Control Index (DOCI): 100% outbreak controlled within 14 days

  27. Key Components of Dengue Control Strategy Proper Case Management CPG- The Management Of Dengue Infection In Adult/Children (2nd Edition) All dengue death are audited immediately. Appropriate remedial actions are taken by the relevant parties and report to be sent to the Disease Control Division within 2 weeks Health Education And Community Mobilization Production of health materials/ mass media Guidelines on health education and community mobilization activities in outbreak localities Guidelines on COMBI For Dengue Prevention and Control

  28. CHALLENGES IN THE DENGUE PREVENTION ACTIVITIES Health seeking behavior of the dengue patient: Only 4% of cases were from the clinic and majority from hospital 50% of the dengue mortality cases were admitted on day 4 or 5 after onset - delay in seeking treatment 47% of dengue mortality cases came in already ill Difficult to break the dengue virus transmission: Only 35% of patient diagnosed within 3 days from the onset of illness Only 19% of dengue cases’ residence were fogged within 5 days of onset of illness Thus other patients infected with the dengue virus may still transmit the disease 28

  29. CHALLENGES IN THE DENGUE PREVENTION ACTIVITIES Low index of suspicion of dengue cases by the attending doctors: Delayed notification Delay in giving appropriate treatment Lack in community cooperation and participation in the dengue prevention and control activities 29

  30. CONCLUSION-1 To strengthen the implementation of dengue prevention and control measure (to be alert and responsive) Ensure effective and efficient performance of the control activities through: Monitoring & supervision Analysis of data at district, state, and MOH level

  31. CONCLUSION-2 Strengthen the prevention and control activities at district and state level Facilitate training for healthcare workers to increase knowledge and skills on the dengue management and vector control Continuous monitoring of dengue status and mortality at all levels, as to address uncontrolled situation of the disease

  32. THANK YOU FOR YOUR ATTENTION

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