GROUP A: Group A2 : Day 3 @ DHO Kubang Pasu

Date : 8 January 2012 ( Sunday )
Time : 8.00 am - 12.30 pm
Topic : Briefing on Vector Unit and Aedes Survey
Person in charge : PPKP Yusnita bin Yusoff

INTRODUCTION
Vector Control Unit of Kubang Pasu District Health Office is led by Assistant Environment Health Officer, Pn Yusnita bin Yusoff. The unit itself is under the supervision of En. Mohd Fadzil bin Shafie, the Assistant Environment Health Senior Officer. The unit is established to control, avoid and increase prevention and control activities for vector borne diseases mainly dengue fever in areas of its jurisdiction.

ORGANIZATION CHART

PROGRAMMES
1. Active case detection (ACD) especially during outbreaks
o House visits, take blood sample

2. Passive case detection (PCD)
o Data, notifications and samples are obtained from other medical and health facilities

3. Case investigations/Case follow-up
o To identify sources of infection, contact tracing

4. Spraying operations
o Thermal fogging, ULV

5. Anti-larval operations
o Abate 1.1G
o Vectobac

6. Health education
o Demonstrations
o Exhibitions
o COMBI
o Gotong-royong

7. Records and documentations
o E-dengue a centralized system in conjunction with Ministry Of Health

Additional highlights:
OUTBREAKS
-In the DHO setting, an outbreak is defined as 2 or more cases reported in a certain locality within 14 days.
-This incident mobilizes multiple task force and an organized plan as well as actions are carried out.
-When an outbreak occurs, the medical officer from the public health department is notified and he or she decides the course of action need to be taken for containment and prevention measures.
-If an outbreak is declared, the PPKP officers fill the outbreak survey form with tedious details of the cases that are reported daily. This will continue daily till the outbreak ends.
-Meanwhile, a set of team(Rapid Response Team) is organized for the outbreak control : morning team and evening team.
-The morning team involves aedes surveillance where a thorough house to house check is carried out to identify potential aedes breeding spots within the area. Enforcement takes place when officers face problems with difficult residents who refuse to cooperate. Notices and compounds are sent out.
-For the evening team, the officers are mainly responsible for fogging of a designated area. Fogging is done in less than 48 hours after notification of cases and the area of operation should cover about 450 meters radius from the patient’s residence usually, vector unit will send out 4 thermal fogging to operate first before topping up with ULV after that for a wider coverage.
-Contraindications for fogging operation includes:
o Funeral services
    o Open house party

AEDES SURVEILLANCE ACTIVITY
-It is conducted from house to house.
-There were 4 officers from the vector unit sent to Taman Siswa UUM to conduct the survey consists of 2 Pegawai Kesihatan Am; PKA and 2 Pegawai Rendah Am; PRA).
-The teams were distributed to cover different areas of the residential neighbourhood (Each house has to be visited without exception).
-In regard to the visit to the houses, certain rules and regulations apply:
    o Officers have to introduce themselves fully and briefly explain the purpose of the visit
    o Consent has to be given verbally by the resident before entering house
    o If the only resident left at home is younger than 18 years old, consent is invalid
    o If the house is not occupied, officers may enter the outside compound of the house if the gate is not locked (if the gate is locked, entering is prohibited ; a 24hrs notification letter will be given, if no respond, will enter the house with the presence of police officer.)

-Upon receiving consent, officer proceeded with acquiring data as follows:
    o The address of the house
    o The name of the owner of the house
    o The number of residents living permanently in the house
    o Is there anyone living in the house suffers from fever?
    o When was the house last inspected by officers from district health office?
-All these data were recorded in a survey form.
-Upon entering the house, officers went directly to the washroom and inspected the ‘kolah’ and also the ‘flushpot’ of the toilet for any presence of mosquito larvae.
-Inspection was done by using a special ultra-bright flashlight.
-Inspection was also done inside the house, looking at other possible places where mosquito larvae may breed.
-The next place that was inspected was the back of the house, followed the outside compound around the house.
-If there are any suspicious places(cold,dim,shady) with collection of water found, they will be medicated with Abate 1.1G.
-In the event of positive findings of mosquito larvae, sample are taken with pipette and kept in a small sealed container.
-The container is properly labelled with the date of the inspection, the address of the house, the name of the inspector and also the area where the samples are taken (i.e within the house, outside the compound of the house).
-Depending on the circumstances, the officers will either issue a ‘cleaning notice’ or a ‘compound notice’.
-If a cleaning notice is given, the resident has 7 to 14 days to properly clean the area of his/her house and make sure that there is no more breeding site found when the next visit is done.
-If compound is given, the resident has to pay the fine.

STATISTIC