Eradication Programmes (GW) Flashcards
Define control
Reduction in incidence, prevalence, morbidity and mortality to a locally acceptable level as a result of deliberate efforts and continued intervention.
Define elimination of disease
Reduction to zero of incidence of a specified disease in a defined geographical area as a result of deliberate efforts. Continued intervention measures are required.
Define elimination of infection
Reduction to zero of the incidence of infection caused by a specific agent in a defined geographical area as a result of deliberate efforts. Continued measures to prevent re-establishment of transmission are required.
Define eradication
Permanent reduction to zero of worldwide incidence of infection caused by a specific agent as a result of deliberate efforts. Intervention measures are no longer needed.
Define extinction
The specific infectious agent no longer exists in nature or laboratories
Criteria for targeting a disease for eradication
- Biological and technical feasibility
- Costs and benefits
- Societal and political considerations
What does biological and technical feasibility entail? (7)
- Natural history of biological agents
- Non human reservoir
- Effective intervention tool
- Effective delivery strategy
- Simple and practical diagnostic
- Sensitive surveillance
- Field proven strategies
What does costs and benefits entail? (5)
- Cases averted per year
- Coincident benefit
- Intangible benefits
- Estimated annual direct global saving
- Estimated total external financing
What does societal and political considerations entail?
- Political commitment (endemic and/or industrialised countries)
- Social support (endemic and/or industrialised countries)
- Disease burden in politically unstable areas
- Core partnerships and advocates
- Technical consensus
- Donor base (number of donors of US$1 million or more
What are the World Health Assembly resolutions for disease elimination?
- Geographical eradication (local elimination)
- Elimination as a public health problem (who defines it?)
- Confusion by policy makers themselves, also different communities (entomology, livestock - rinderpest)
Key issues with guinea worm eradication programme.
- Launched during the international water decade (1980s)
- Dracunculus medinenis a macroparasite
- No vaccine, drug or diagnostic (except worm emergence)
- No animal reservoir (?)
- Eradicable
- Leadership from Carter centre, UNICEF and WHO
Components of guinea worm eradication.
Surveillance: regular reporting from health facilities.
Clean water: provision and borehole maintenance.
Filtering: potentially contaminated water.
Temephos: to kill copepods in water bodies.
Health education/community and media.
Case containment: stop cases contaminating water sources.
Monetary reward: in place/intense surveillance.
Rumour: registers/follow up within 24 hours.
Methods of reporting guinea worm cases
Phone call and cash reward
Methods of stopping transmission of guinea worm.
Cloth barriers, control of dog worms through detection and containment of disease,
Burkina Faso and Guinea Worm
No indigenous cases since 2006 although 3 imported cases detected.
Visits to 11 of 13 regions
Interview of health centres, community health workers and individuals.
92% villages had safe water-bore holes and protected wells. 70% knew of disease and how it was acquired. Health education radio slots, theatre and posters
Ministry commitment by high quality reporting, community to district to region. Registers and reward system
