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An Epidemiological Approach of Avian Influenza as an Alternative Concept in Indonesia

An Epidemiological Approach of Avian Influenza as an Alternative Concept in Indonesia. Siti Pariani Pirlina Umiastuti. BACKGROUND INDONESIA  AGENT OF DISEASE : H5N1  -highly pathogenic avian influenza (HPAI) - Rapid mutations - Difficult to detect

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An Epidemiological Approach of Avian Influenza as an Alternative Concept in Indonesia

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  1. An Epidemiological Approach of Avian Influenza as an Alternative Concept in Indonesia Siti Pariani Pirlina Umiastuti

  2. BACKGROUND • INDONESIA  • AGENT OF DISEASE : • H5N1  -highly pathogenic avian influenza (HPAI) • - Rapid mutations • - Difficult to detect • 2. GEOGRAPHIC AND VECTOR FACTORS: • - Island • - wild bird transsito • - poultry • - butcheriy pig

  3. 3. POPULATION: - Mobile - Health behaviour (Knowledge, attitude, Practice)4. DATA: - Poultries in 23 Provinces H5N1 + - 14 patients H5N1 + 5. CLINICAL & ENVIRONMENT APPROACH: - Pasive approach+ investigation model - Surveillance epidemiology ? - Poultry vaccination? - Culling down chicken?

  4. PROBLEMS: Prevent and control the avian Influenza OBJECTIVE: Epidemiological approach concept to prevent and control avian influenza in Indonesia SPECIFIC objectives: Data collection Data management Data analysis Data dessimination

  5. CRITICAL APPRAISAL:1.Available and or reliable data of deseases? - Number of cases - Incidence rate - Case fatality rate

  6. 2. Rapid assesssment of host, agent, environment? • Host: -Health behaviours of people • Personal hygienes of poultry breeder, care givers and • sellersand bird market • - direct or indirect contact of vectors and agent • -distribution of diseases by demographic variables of • patients, timing of deseases (dry or rainy season), • mapping place of patients etc • Agent: where, when, how human contact with the agent • Environment: Hygiene Sanitation

  7. 3. Disease Management ?1) Epidemiological method into practice : - Analysis - Evaluation - Communication - Management and teamwork - Consultation - Presentation skills2) Public health action : - Collection of pertinent data : -regular -frequent -timely - Orderly consolidation, evaluation and description interpretation - Distribution of the finding

  8. WHAT SHOULD WE DO IN INDONESIA SURVEILLANCE EPIDEMIOLOGY A. DATA COLLECTION 1. “Active” Surveillance -timely but simplicity, acceptability and sensitivity 2. “passive” surveillance Continuesly but simple, acceptable and flexible 3. Sentinel approach, used provokated avian to detect H5N1

  9. B. QUALITY OF DATA1. DATA INPUT high quality Who provided the data How confirm the data  specificitas and sensitivitas2. MANAGEMEN DATA Clean data Retrieved and verified3. DATA ANALYSIS AND DATA OUTPUT relevant, reliable and acurat4. DATA ARCHIEVEDC. DISSEMINATION: interdisipline and intersectoral

  10. INVESTIGATION THREE ELEMENTS: (a) Notification of essential people and organization (b) Identification of materials needed (c) Travel planning

  11. STEPS: 1. Determine the existence of an avian influenza epidemic2. Confirm of diagnosis3. Define and count the cases4. Orient the data in terms of time, place and person5. Determine who is at risk of having avian influenza6. Develop and test an explanatory hypothesis7. Compare the hypothesis with the proven facts8. Plan a more systematic study9. Prepare a written report10.Propose measures for control and prevention

  12. Point of Important about data • DATA COLLECTIONS: • SIMILAR SYMPTOM  counted • LAB SPECIMEN • 2. CALCULATION OF DATA COLLECTION • 3. EVALUATION OF THE SOURCE of INFECTION • 4. ESTABLISHED an INFORMAL ASSOSSIATION: • 1) Continuing support • 2) An effective continuing education opportunity • 3) A mutually supporting and efficient method

  13. (6) Providing examples of simple indicators and methods of recording, aggregating, and analyzing data to obtain useful information(7) Providing guidelines on budgeting, cost, analyzing and cost control(8) Providing guidelines on the technical issues, including appropriate ways of controlling the avian influenza

  14. B. Data collection and analysis about : Population: morbidity, mortality, behaviours, etc Environment: Hygiene sanitation, poultry & buchery pig environments, etc Agent:specificity and sensitivity of indikators Health care system: establishing continuesly system; train providers, etc C. Research Indikator

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