cd control program

8/9/2019 CD Control Program

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Communicable diseases

National Tuberculosis Control Program keypolicies

Case finding direct Sputum Microscopy and X-ray

examination of TB symptomatics who are negative

after 2 or more sputum exams

Treatment shall be given free and on an

ambulatory basis, except those with acute

complications and emergencies

Direct Observed Treatment Short Course comprehensive strategy to detect and cure TB

patients.


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Category 1- new TB patients whose sputum ispositive; seriously ill patients with severe formsof smear-negative PTB with extensive

parenchymal involvement (moderately- or far-advanced) and extra-pulmonary TB (meningitis,pleurisy, etc.)

Category 2-previously-treated patients with

relapses or failures.

Category 3 new TB patients whose sputum issmear-negative for 3 times and chest x-ray result

of PTB minimal


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new TB patients whose sputum is

positive; seriously ill patients with

severe forms of smear-negativePTB with extensive parenchymal

involvement (moderately- or far-advanced) and extra-pulmonary TB

(meningitis, pleurisy, etc.)


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Intensive Phase (given daily for the first 2 months)-Rifampicin + Isioniazid + pyrazinamide +

ethambutol.If sputum result becomes negative after 2 months,maintenance phase starts. But if sputum is stillpositive in 2 months, all drugs are discontinued from2-3 days and a sputum specimen is examined forculture and drug sensitivity. The patient resumestaking the 4 drugs for another month and thenanother smear exam is done at the end of the 3rd

month.

Maintenance Phase (after 3rd month, regardless of theresult of the sputum exam)-INH + rifampicin daily


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Category 2-previously-treated patients withrelapses or failures.

Intensive Phase (daily for 3 months, month 1,2 &3)-Isioniazid+ rifampicin+ pyrazinamide+ethambutol+ streptomycin for the first 2 months

Streptomycin+ rifampicin pyrazinamide+ethambutol on the 3rd month. If sputum is stillpositive after 3 months, the intensive phase iscontinued for 1 more month and then anothersputum exam is done. If still positive after 4months, intensive phase is continued for thenext 5 months.

Maintenance Phase (daily for 5 months, month4,5,6,7,& 8)-Isionazid+ rifampicin+ ethambutol


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Category 3 new TB patients whosesputum is smear-negative for 3 times andchest x-ray result of PTB minimal

Intensive Phase (daily for 2 months) Isioniazid + rifampicin + pyrazinamide

Maintenance Phase (daily for the next 2months) - Isioniazid + rifampicin


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Stop TB ; Do it with DOTS

Advocacy is a planned and continuous

effort to inform people about issue andinstigate change.Advocacy usually takesplace over an extended period of time and

includes a variety of strategies tocommunicate a specific message.

TB is the number one infectious killer inthe world.

One TB suspect can infect another 10

healthy persons


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Leprosy Control Program

WHO Classification basis of multi-drug therapy

Paucibacillary/PB non-infectious types. 6-9months of treatment.

Multibacillary/MB infectious types. 24-30 monthsof treatment.

Multi-drug therapy use of 2 or more drugs renderspatients non-infectious a week after startingtreatment

Patients w/ single skin lesion and a negative slit skinsmear are treated w/ a single dose of ROM regimen

For PB leprosy cases- Rifampicin+Dapsone on Day 1then Dapsone from Day 2-28. 6 blister packs takenmonthly within a max. period of 9 mos.


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All patients who have complied w/ MDT are consideredcured and no longer regarded as a case of leprosy, even if

some sequelae of leprosy remain. Responsibilities of the nurse

Prevention health education, healthful living throughproper nutrition, adequate rest, sleep and good personal

hygiene; Casefinding

Management and treatment prevention of secondaryinjuries, handling of utensils; special shoes w/ paddedsoles; importance of sustained therapy, correct dosage,

effects of drugs and the need for medical check-up fromtime to time; mental & emotional support

Rehabilitation-makes patients capable, active and self-respecting member of society.


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Control of Schistosomiasis a tropical diseasecaused by a blood fluke, SchistosomaJaponicum

; transmitted by a tiny snail Oncomelaniaquadrasi

Preventive measures health education

regarding mode of transmission and methodsof protection; proper disposal of feces andurine; improvement of irrigation andagriculture practices

Control of patient, contacts and theimmediate environment

Specific treatment- Praziquantel drug of

choice


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Programs on Filariasis, Malaria and DengueHemorrhagic Fever

Filariasis- a chronic prasitic infection caused bya nematode,Wuchereria bancrofti. Young andadult worms live in the lymphatic vessels and

nodes, while the micro filariae are in the blood;transmitted through bites from an infectedfemale mosquito,Aedespoecilius, that bites atnight.

Treatment: Diethylcarbamazine citrate orHetrazan

Elephantiasis andHydrocoele are handled through

surgery, prevention and supportive care


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Malaria infection caused by the bite of thefemale Anopheles mosquito, Chemoprophylaxis Chloroquine taken at weekly

intervals, starting from 1-2 weeks before entering theendemic area.

Anti-malarial drugs sulfadoxine, quiinine sulfate,

tetracycline, quinidine Insecticide treatment of mosquito nets, house

spraying, stream seeding and clearing, sustainablepreventive and vector control meas

DengueH-fever

4 oclock habit


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Programs on Measles.

Chickenpox, Mumps,Diphtheria, Pertusis, Tetanus

focused on health informationcampaigns and intensiveimmunization of children in

barangays.


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Prevention and Control Program on ParasiticInfestations ( STH e.g. Ascaris, Trichuris,Hookworm) and Paragonimiasis in communitieswhere eating of fresh or inadequately cooked crabis a practice

Management:

1. Deworming2. Health Education re:

Good personal hygiene

Use of footwear

Washing fruits and vegetables well Use of sanitary toilets

Sanitary disposal of garbage

Boiling drinking water at least 2-3 min. from

boilin oint or chlorination


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Prevention and Control on

Leptospirosis/ Weils Disease/Mud fever/Flood fever/

Spirochetal Jaundice thru contact

with the skin/ open wound with

water or moist soil contaminated

with urine of infected ratAnd Rabies


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Mgt. of Rabies

Wash wound with soap and water, betadine or alcohol

may be applied If dog is healthy observe for 14 days. If nothing

happens- no need for ttt.If it dies or shows rabies, killthen bring head for lab. Exam & consult doctor.

Active immunization body develops

Ab against rabiesup to 3 yrs.

Passive I givingAb to persons with head and neckbites, multiple single deep bites, contamination ofmucous membranes or thin covering of the eyes, lips or

mouth to provide immediate protection RPO immunization of pets at 3 mos. of age and yearly

thereafter


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Prevention and Control on STIs- Gonorrhea, Syphilis,HIV/AIDS,

Trichomoniasis,Chlamydia, Hep B ( themost serious type cause of severe cx. Eg.Massive liver damage andhepatocarcinoma

- 4 Cs in the Syndromic Mgt- 1. Compliance- 2. Counseling/ Education

- 3. Contact tracing to treat partner- 4. Condom use- Hep B vaccination- Universal precautions

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