Download National Committee for Communicable Diseases Control Secretariat

Dr Nyphonh Chanthakoummane
Chief of Diseases Surveillance and Response Division
Department of Disease Control
Ministry of Health , Lao PDR
The 1st round:
The 2nd round:
The 3rd round:
January-March, 2004
July, 2006
February-March, 2007
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Health education campaign
Poultry killed/eggs destroyed
Close surveillance both in human and
animal (RRT)
Sample taken ( human and animal )
Training health center staffs
Culling take place in affected villages, Namma
Village, Long District Luangnamtha
Compensation paid
immediately
Organization chart
National Committee
for Communicable Diseases Control (NCCDC)
National Committee
for Communicable Diseases Control Secretariat
National Committee for Communicable Disease
Control Office (NCCDCO)or = (NAHICO)
Director /
Deputy Director
NAHICO
Coordination/
Collaboration Unit
Planning/
Financing Unit
Monitoring/
Evaluation Unit
The Plan is based on 5 strategies
Strategy 1
Strategy 2
Strategy 3
Strategy 4
Strategy 5
Animal Health. Development of disease free avian influenza
management, under leadership of MAF. FAO as lead support
agency
Human Health. Disease surveillance and response in
humans during outbreak, under leadership of MoH.
WHO as lead support agency
Human Health. Laboratory and Curative Care, under
leadership of MoH. WHO as lead support agency
Information, Education and Communication. Health
Education and Community Action, under leadership of
Ministry of Information and Culture (MIC). UNICEF as lead
support agency
Project coordination, project management and regulatory
framework, including strengthening of Institutional and
Legal Frameworks
Provincial Coordinating Committee on
CDC Chaired by Governor/Vice Governor
Members: Health, Agriculture, Information, Trade, Tourism, Transport,
Interior, Mass Organizations
Provincial CDC
Secretariat
Ad Hoc
Committee
Chaired by Health
Department/Agriculture
on AHI during
outbreak
Strategy 1
Strategy 2
Strategy 3
Strategy 4
Strategy 5
IEC Taskforce: Health, Agriculture, Information, Trade,
Tourism, Transport, Interior, Mass Organizations
Advocacy, motivate
community
participation in
reporting
deadmanpower
bird
Mobilize
for
mass bird culling
Compensation
Control animal
movement
Assess, report to
Provincial CDC, National
CDC Sec
Members: Health, Agriculture, Information, Trade,
Tourism, Transport, Police, Military, Mass Organizations
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WHO Pandemic alert phase 4 to first case
detected in Lao PDR = 7 weeks
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Allowed preparation time
Response in five areas:
1.
2.
3.
4.
5.
Co-ordination and Decision Making
Surveillance and Response
Clinical Management and Infection Control
Risk Communication
Public Health Interventions
National CDC committee
National Center for
Laboratory &
Epidemiology/MoH
National Emerging
Infectious Diseases
Coordination Office
(NEIDCO)
National Pandemic Plan
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NEIDCO an effective coordinating body
High level political support
Cooperation between National Health Authorities
International Cooperation
Other Ministries
Technical partners
◦ Indicator-based: Used existing surveillance
notification mechanism for nationally notifiable
diseases
 Frequency: Weekly  Daily
 Syndromes reported:
 Acute Respiratory Illness (ARI)
 Influenza Like Illness (ILI)
◦ Event Based Surveillance
 from HCW and community (‘166 hotline’)
 Severe illness /death
 Cluster of ILI cases from same village ( local investigation)
◦ Sentinel hospital sites for ILI and SARI labsurveillance
◦ Daily integrated reporting and feedback
Flow chart: National Surveillance of
Notifiable Selected Diseases
MOH
DHP/CDC Task Force
NEIDCO
Feed-back report
National Center for Laboratory
and Epidemiology
Weekly
Capital City / provincial Section
for Hygiene and Epidemiology
report
Weekly
District Health Office
District Section for Hygiene
report
and Epidemiology
Fax/phone
Ports / Immigration Check Points
Weekly/
monthly
Dispensaries/Village Health Posts
Supplementary
surveillance
(Active case search)
Active Surv
Passive Surv
Natl / Prov
Hospitals
Private Clinics
District Hosp
Active Surv
Passive Surv
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Training on Pandemic (H1N1) CM and infection
control (IC) throughout country
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On-call duty system for clinicians from provincial
hospitals and for National authorities
- Advice on Pandemic (H1N1) CM and IC
- Outbreak support
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Development of Lao specific Pandemic (H1N1) CM
and IC guidelines
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Set-up of screening systems and isolation rooms in
hospitals
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Limited Tamiflu and PPE stockpile and distribution
◦ Tamiflu for severely ill patients and high risk groups
Referral of patients to designated
area in OPD if ILI symptoms
• Designated Screening Room
• Isolation and cohorting of in-patients
 Availability of PPE and IEC material
 Regular cleaning and disinfection
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IEC material for public and HCW
Press releases, TV and radio spots
Workshops for journalists and those involved in
media briefing
◦ Isolation of patients
 home isolation of mild cases
 hospital isolation of severe cases
◦ Border control & International travel
 Health information and advice
 Screening: thermal scanners and entry form
 isolation implemented when positive cases identified
◦ School closures
 Some school closures but recent national decision not to
close schools
◦ Mask Use for sick people, front-line HCWs and
care givers
Thank you very much
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Limited human and physical resources to develop an effective control program to
eliminate HPAI from the country.
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Lack of the veterinarians and the skills on disease control of the available personnel
are still weak and moreover the veterinary institute within the country is also not
available.
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The infrastructure and facilities for disease reporting, early warning diagnosis as
well as for the surveillance and concerned plan of the all level are not developed
effectively.
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Inadequate operational fund.
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The production system and management of the farmer is almost underdeveloped;
the knowledge and the understanding of the farmers about the animal disease is
very low.
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Strong political commitment and a forum for open
dialogue are crucial
Strong teamwork & partnerships lead to efficiency
and progress e.g. Govt, International groups, NGOs
Pandemic Preparedness Plans should not only be
developed but actually used
Epidemiology and Laboratory should not be seen as
separate entities
Public health risk communication is a cross-cutting
strategy that should increase awareness but not
fear e.g. H1N1 situation
Ongoing small group activity oriented training is
better than large group didactic training