Preventing Chikungunya In Low Resource Practice Settings: Michelle D Kelly
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Preventing Chikungunya in Low Resource Practice Settings
Michelle D Kelly
10/17/09
1
Agenda
10/17/09
Overview Who What Where How Summary
2
Who?
Sub Saharan Africans
1 to 1.4 million new cases
French territory India Sri Lanka Italy
Adults Children and infants Health workers
10/17/09
3
What Arbovirus Chikungunya Aedes mosquitos Human to Human New strains
10/17/09
4
Where Geographical distribution of Chikungunya cases 2001-2007
Weekly epidemiological record (WER) No. 47, 2007, 82, 409�416.
10/17/09
5
10/17/09
6
How Global
warming
Travel Exported
goods Evolving Genome
10/17/09
7
Summarize What is known Vaccines not in pipeline Lab testing - PCR not credible Populations at risk Evidence of higher AR & CFR Maternal-child transmission Health workers at risk
10/17/09
8
Guidelines World Health Organization Clinical Management of Chikungunya Malaria Epidemics: Forecasting, Prevention Early Detection Malaria Control in Complex Emergencies
10/17/09
9
Gap in Guidelines
10/17/09
Based on mosquito borne principles in WHO guidelines
Educate and empower village health workers on chikungunya
10
Recommendation
Prevent Chikungunya at the Village level
10/17/09
11
INTERVENTIONS AND PRACTICES CONSIDERED
1.
Risk Assessment
2. Primary Prevention
3.
10/17/09
Secondary Prevention
12
MAJOR OUTCOMES CONSIDERED
u
Prevent Morbidity
u
Empower community level health workers
u
Reduce chikungunya DALYs
10/17/09
13
Risk Assessment assessment
environment vector occupations and activities that expose persons migration/ market movement patterns
10/17/09
14
Primary Prevention mosquito
habitat- standing
water barriers to mosquito bites vaccination establishing surveillance case definition community awareness 10/17/09
15
Secondary Prevention Screen surveillance data and mapping PCR testing
10/17/09
16
Next Steps
Assess for stakeholders
MOH, non-governmental, WHO, Eurosurveillance
Current prevention activities
10/17/09
ｷ assess level of knowledge & traditional positive prevention behaviors
17
Evaluation and Monitoring Examples of prevention metrics:
Number of: communities informed of chikungunya risk prevention activities carried out before rainy season health workers attending prevention workshop households visited without mosquito breeding areas presumed chikungunya cases identified bed nets distributed to households at risk
10/17/09
18
Prevent Morbidity Empower health workers Reduce impact of chikungunya
Michelle D Kelly
10/17/09
1
Agenda
10/17/09
Overview Who What Where How Summary
2
Who?
Sub Saharan Africans
1 to 1.4 million new cases
French territory India Sri Lanka Italy
Adults Children and infants Health workers
10/17/09
3
What Arbovirus Chikungunya Aedes mosquitos Human to Human New strains
10/17/09
4
Where Geographical distribution of Chikungunya cases 2001-2007
Weekly epidemiological record (WER) No. 47, 2007, 82, 409�416.
10/17/09
5
10/17/09
6
How Global
warming
Travel Exported
goods Evolving Genome
10/17/09
7
Summarize What is known Vaccines not in pipeline Lab testing - PCR not credible Populations at risk Evidence of higher AR & CFR Maternal-child transmission Health workers at risk
10/17/09
8
Guidelines World Health Organization Clinical Management of Chikungunya Malaria Epidemics: Forecasting, Prevention Early Detection Malaria Control in Complex Emergencies
10/17/09
9
Gap in Guidelines
10/17/09
Based on mosquito borne principles in WHO guidelines
Educate and empower village health workers on chikungunya
10
Recommendation
Prevent Chikungunya at the Village level
10/17/09
11
INTERVENTIONS AND PRACTICES CONSIDERED
1.
Risk Assessment
2. Primary Prevention
3.
10/17/09
Secondary Prevention
12
MAJOR OUTCOMES CONSIDERED
u
Prevent Morbidity
u
Empower community level health workers
u
Reduce chikungunya DALYs
10/17/09
13
Risk Assessment assessment
environment vector occupations and activities that expose persons migration/ market movement patterns
10/17/09
14
Primary Prevention mosquito
habitat- standing
water barriers to mosquito bites vaccination establishing surveillance case definition community awareness 10/17/09
15
Secondary Prevention Screen surveillance data and mapping PCR testing
10/17/09
16
Next Steps
Assess for stakeholders
MOH, non-governmental, WHO, Eurosurveillance
Current prevention activities
10/17/09
ｷ assess level of knowledge & traditional positive prevention behaviors
17
Evaluation and Monitoring Examples of prevention metrics:
Number of: communities informed of chikungunya risk prevention activities carried out before rainy season health workers attending prevention workshop households visited without mosquito breeding areas presumed chikungunya cases identified bed nets distributed to households at risk
10/17/09
18
Prevent Morbidity Empower health workers Reduce impact of chikungunya
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