Sie sind auf Seite 1von 64

THRU

ST
PROG
GROUP 3
BSN II 2

TUBERCULOSI
S CONTROL
PROGRAM

Reporter: Begaso, Jaucian,


Penaflor

Tuberculosis is a disease caused by a bacterium


called Mycobeacterium tuberculosis that is mainly
acquired by inhalation of infectious droplets containing
viable tubercle bacilli. Infectious droplets can be
produced by coughing, sneezing, talking and singing.
Coughing is generally considered as the most efficient
way of producing infectious droplets.

In 2007, there are 9.27 million incident cases of TB worldwide


and Asia accounts for 55% of the cases. Through the National TB
Program (NTP), the Philippines achieved the global targets of 70%
case detection for new smear positive TB cases and 89% of these
became successfully treated. The various initiatives undertaken
by the Program, in partnership with critical stakeholders, enabled
the NTP to sustain these targets. Nonetheless, emerging concerns
like drug resistance and co-morbidities need to be addressed to
prevent rapid transmission and future generation of such threats.
Coverage should also be broadened to capture the marginalized
populations and the vulnerable groups namely, urban and rural
poor, captive populations (inmates/prisoners), elderly and
indigenous groups.

Last 2009, the National Center for Disease Prevention and


Control of the Department of Health led the process of formulating
the 2010-2016 Philippine Plan of Action to Control TB (PhilPACT)
that serves as the guiding direction for the attainment of the
Millenium Development Goals (MDGs). Learning from the DirectlyObserved Treatment Shortcourse (DOTS) strategy, the eight (8)
strategies of PhilPACT are anchored on this TB control framework.
Moreover, these strategies are also attuned with the
Governments health reform agenda known as Kalusugang
Pangkalahatan (KP) to ensure sustainability and risk protection.

Vision: TB-free Philippines


Goal: To reduce by half TB prevalence and mortality
compared to 1990 figures by 2015

Objectives:
The NTP aims to:
1.

Reduce local variations in TB control program performance

2.

Scale-up and sustain coverage of DOTS implementation

3.

Ensure provision of quality TB services

4.

Reduce out-of-pocket expenses related to TB care

Strategies:
Under PhilPACT, there are 8 strategies to be implemented,
namely:
1.

Localize implementation of TB control

2.

Monitor health system performance

3.

Engage all health care providers, public and private

4.

Promote and strengthen positive behavior of communities

5.

Address MDR-TB,TB-HIV and needs of vulnerable populations

6.

Regulate and make quality TB diagnostic tests and drugs

7.

Certify and accredit TB care providers

8. Secure adequate funding and improve allocation and


efficiency of fund utilization

Program Accomplishments:
Significant progress has been achieved since the Philippines
adopted the DOTS strategy in 1996 and at the end of 2002-2003,
all public health centers are enabled to deliver DOTS services.
Because of the Governments efforts to continuously improve
health care delivery, there have been progressive increases in the
detection and treatment success. While a strong groundwork has
been installed, acceleration of efforts is entailed to expand and
sustain successful TB control. All stakeholders are called upon to
achieve the TB targets linked to the MDGs set to be attained by
2015. However, with the emergence of other TB threats, more has
to be done. Likewise, with the ongoing global developments and
new technologies in the pipeline, constraints will hopefully be
addressed.

The 2010-2016 PhilPACT as defined by multi-sector partners, through


broad-based collective technical inputs, underlines the key strategic
approaches towards achieving these targets at both national and local
levels. The Plan aims for universal access to DOTS including strategic
responses to vulnerable groups and emerging TB threats. Nationwide, a
wide array of health facilities are installed and equipped to provide
quality TB care to the general population. This involves participation of
private facilities (clinics, hospitals), other health-related agencies or
NGOs and other Government organizations. Coverage for DOTS services,
at least in the public primary care network has reached nearly 100% in
late 2002. Eversince, diagnosis through sputum smear microscopy and
treatment with a complete set of anti-TB drugs are given free through the
support of the Government. Training on TB care for different types of
health workers is being conducted through the regional and local NTP
Coordinators. The conclusions during the program implementation review
(PIR) done by the DOH of selected public health programs on January
2008 revealed the following:

Extent and quality of nationwide TB-DOTS


coverage have reached levels necessary for eventual
control since 2004 up to present
NTP continues to add enhancements and
improvements to TB care providers for better delivery
of services

Partner Organizations/Agencies:
The following are the organizations/agencies that take part in
achieving the objectives of the National TB Control Program:

Philippine Business for Social Progress

Philippine Coalition Against TB

Holistic Community Development Initiatives (HCDI)

National TB Ref Laboratory

Lung Center of the Philippines

Bureau of Jail Management and Penology (BJMP)

Bureau of Corrections

Department of Interior and Local Government (DILG)

Department of Education (DepEd)

Armed Forces of the Philippines-Office of the Surgeon General


(AFP-OTSG)

PhilHealth

Research Institute of Tuberculosis/ Japan Anti-Tuberculosis


Association Philippines, Inc. (RIT/JATA)

Philippine Tuberculosis Society Inc. (PTSI)

Kabalikat sa Kalusugan

Samahang Lusog Baga

National Commission for Indigenous Peoples

Department of National Defense-Veterans Memorial


Medical Center (DND-VMMC)
Occupational Health and Safety (OSHC); Bureau of Working
Conditions (BWC)

World Vision Development Foundation (WVDF)

International Committee of Red Cross

Korea Foundation for International Health Care (KOFIH)

World Health Organization (WHO)

United States Agency for International Development (USAID)

Committee of German Doctors for Developing Countries

And as always thanks


For listening

LEPROSY CONTROL
PROGRAM
Reporters: Jessa Mae Santos,
Trisha Anne Filomento Cris

Nationwide
implementation of
Multi- Drug
Therapy
1998
Resulted in the decrease of
prevalence rate of Leprosy.

Treatment shifted from


institutional to home care.

What is
Leprosy?

SIGNS
AND
SYMPT

EARLY S/ Sx:
* Change in skin color- either
reddish or white
* Loss of sensation on the skin
lesion
* Decrease/ loss of sweating and
hair growth over the lesion
* Thickened and/ or painful nerves
* Muscle weakness and paralysis
of extremities
* Pain and redness of the eyes
* Nasal obstruction or bleeding
* Ulcers that does not heal

LATE S/Sx:
* Loss of eyebrowsmadarosis
* Inability to close eyelids
* Clawing of fingers and
toes
* Contractures
* Sinking of the nosebridge
* Gynecomastia
* Chronic ulcers

Prolonged skin contac

METHOD OF
TRANSMISSIO
N

Droplet infection

SUSCEPTIBIL
ITY
Children
especial
ly 12
years
and
below
are

* Avoidance
of prolonged
skin- to- skin
contact
especially
with a
leprotamous
*
Good
case
personal
hygiene

PREVENTION

* Children
* BCG
should
vaccination
avoid close
contact
with active, *
untreated
Adequate
leprosy
nutrition
case
* Health
Education

MANAGEMEN
T AND
TREATMENT
Ambulatory
chemothera
py through
use of MultiDrug

Domicillary
treatment as
embodied in RA
4073 (advocates
home

Paucibacillary
PB Regimen
PB ADULT:
MONTHLY TREATMENT: Day 1
Rifampicin 600 mg
Dapsone 100 mg
Daily treatment: Days 2-28
Dapsone 100 mg
Duration of treatment:
6 blister packs to be taken monthly
within a maximum period of 9 months

PB CHILD (10-14 yrs old)


MONTHLY TREATMENT: Day 1
Rifampicin 450 mg
Dapsone 50 mg
Daily treatment: Days 2-28
Dapsone 50 mg
Duration of treatment:
6 blister packs to be taken montly
within a maximum period of 9 months

Multibacillary
MB regimen
MB adult
Monthly Treatment: Day 1
Rifampicin 600 mg
Clofazimine 300 mg
Dapsone 100 mg
Daily treatment: Days 2-28
Clofazimine 50 mg
Dapsone 100 mg
Duration of treatment
12 blister lacks to be taken monthly within
a maximum period of 18 months

MB child
Monthly Treatment: Day 1
Rifampicin 450mg
Clofazimine 159 mg
Dapsone 50 mg
Daily Treatment: Days 2-28
Clofazimine 50 mg every other day
Dapsone 50 mg
Duration of treatment:
12 blister packs to be taken monthly
within a maximum period of 18

ETION
OF
TREATM

Responsibilities of the
Nurse
Prevention
Health

education of patients, families and the


community on the nature of the disease,
symptomatology and its transmission. children
who are more susceptible to the disease should
not be exposed to untreated lepromatous cases.
Advocates healthful living through proper
nutrition, adequate rest, sleep and good personal
hygiene.
BCG vaccination especially of infants and
children.

Responsibilities of the
Nurse
Casefinding

Recognize

early signs and symptoms of leprosy


and refers suspects to the RHU physiscians or
skin clinic for diagnosis and treatment.

Takes patient and family history and fills up


patients records.

Conducts epidemiological investigation and


report findings to MHO.

Assists physicians in physical examination of


patients in the clinic/home.

Responsibilities of the
Nurse
Assesses

health of family members


and other household contacts.
Performs/assists in examination of
contacts.
Integrates casefinding of leprosy
cases in other activities such as
MCH, EPI, inspection/examination of
school children and other programs

Responsibilities of the
Nurse
Management and Treatment
Promotes

healthful living by teaching the


value of good personal hygiene, proper
nutrition, adequate rest and sleep.
Helps patient/family understand and
accept the problems brought about by the
illness and assess their capacities to deal
with them.
Provides and arranges for provision of
nursing care of patients at home.

Responsibilities of the
Nurse
Prevents

secondary injury by teaching leprosy


patients/family to protect cases from burns and
rough/sharp objects. Use of pads and wooden
handles of utensils are advised to protect hands
and special shoes with padded soles should be
worn to protect the feet. Any injury to hands, feet
and eyes should be treated early to prevent
deformities.

Guides and support patients/family throughout the


treatment phase by giving them information on the
importance of sustained therapy, correct dosage,
effects of drugs and the need for medical check-up
from time to time.

Responsibilities of the
Nurse
Gives

mental and emotional support


by encouraging self-confidence and
self-reliance on the part of the
patient/family and by maintaining an
understanding and objective
attitude.
Refers patient to other health and
allied workers as the physician,
dentist, social worker,
physiotherapist, mental hygienist,

Responsibilities of the
Nurse
Rehabilitation
Helps create a congenial atmosphere
essential to progressive recovery.
Must be kind and maintain attitude of
professional concern and interest.
Encourage patient's participation in
occupational activities suited to his interest,
experience and capacity.
Refers patient to other persons/agencies who
can help in his/her physical, mental and
social rehabilitation.

Family Health
Promotes family health by:
Providing

information education to
patient and his/her family on family
planning and nutrition.
Encouraging utilization of available
family planning and nutrition service.
Providing counseling and guidance
aimed at improving health of every
member of the family.

Community Health
Participates

in community assemblies
and shares information on leprosy and
its management.
Participates in
seminars/workshops/consultative
meetings of other GOs and NGOs on
leprosy control.
Participates in tri-media dissemination
of leprosy fats and NLCP-MDT program.

Training, Supervision and


Research
Conducts

orientation of student
nurses, midwives and other
students on leprosy and the
control program.
Participates in orientation of new
RHU/BHS staff on leprosy and its
control.
Participates in studies on leprosy
and its management.

National Rabies Prevention


and Control Program
By. Tamondong, Wendy C.

GOAL:

Human Rabies is eliminated in the Philippines and the country is declared


rabies free.

OBJECTIVES
GENERAL:
To reduce the incidence of Human Rabies from 7 per million to 1
per million population by 2010, and eliminate human rabies by 2015

SPECIFIC:

To conduct information campaign on Responsible Pet


Ownership (RPO) among 75% of households.
To immunize 80% of the dog population in identified priority
areas.
To strengthen rabies surveillance system
To enhance local implementation of the program
Manpower Development:
Training of health workers veterinarian and laboratory
technicians on management of animal bite cases.

Social Mobilization:
Organizational meetings
Networking with other sectors

Local Program Implementation:


Establishment/Reactivation of Local Rabies Control Committees
Enactment/Enforcement of Ordinance on Dog Control Measures
Dog Immunization:
Pre-Vaccination Activities
- Identification of priority areas
- Procurement/Distribution of dog vaccines
- Social Preparation
Conduct of Dog Vaccination
Post-Immunization Evaluation

Strategies/Activities:
Information/ Education/Communication Campaign
Provision of Post-Exposure Treatment
Rabies Surveillance

RABIES
(Hydrophobia, Lyssa)
Reporter: Krissabela Corteza

RABIES (HYDROPHOBIA, LYSSA)

Rabies is an acute viral encephalomyelitis


caused by the rabies virus, a rhabdovirus
of the genus lyssavirus.
There are two kinds: urban or canine
rabies is transmitted by dogs while
sylvatic rabies is a disease of wild
animals and bats which sometimes
spread to dogs, cats and livestock.
The Philippines is one of the highest
prevalence rate of rabies in the world.

MODE OF TRANSMISSION

Usually by bites of a rabid animal whose


saliva has the virus. The virus may also
be introduced into a scratch or in a fresh
breaks in the skin (very rare).
Transmission from man to man is
possible. Airborne spread in a cave with
millions of bats have occurred, although
rarely. Organ transplant (corneal) taken
from person dying of diagnosed CNS
disease have resulted in rabies in the

PERIOS OF COMMUNICABILITY

In dogs and cats, for 3 to 10


days before onset of clinical
signs (rarely over 3 days) and
throughout the duration of
the disease.

SUSCEPTIBILITY AND RESISTANCE

All warm-blooded
mammals are susceptible.
Natural immunity in man is
unknown.

SIGNS AND SYMPTOMS IN MAN

Sense of apprehension
Headache
Fever
Sensory change near site of animal
bite
Spasms of muscles of deglutition on
attempts to swallow (hydrophobia)
Paralysis
Dellirium and convulsions

MANAGEMENT

The wound must be immediately and


thoroughly washed with soap and
water. Antiseptics such as povidone
iodine or alcohol may be applied.
The patients may be given antibiotics
and anti-tetanus immunization.

MANAGEMENT
Post-exposure treatment is given to
persons who are exposed to rabies. It
consists of local wound treatment,
active immunization (vaccination)
and passive immunization.
*Passive immunization is the process
of

MANAGEMENT
Post-exposure treatment is given to
persons who are exposed to rabies. It
consists of local wound treatment, active
immunization (vaccination) and passive
immunization.
*Passive immunization is the process of
giving an antibody to persons with severe
bites in order to provide immediate
protection against rabies which should be
administered within the first seven days

RESPONSIBLE PET OWNERSHIP

Have pet immunizes at 3 months of


age and every year thereafter.
Never allow pets to roam the streets.
Take care of your pet: bathe, feed
them regularly with clean and
adequate food, provide them with
clean sleeping quarters,
Your pets action is your
responsibility.

NATIONAL RABIES PREVENTION AND


CONTROL PROGRAM
GOAL: Human rabies is eliminated in the
Philippines and the country is declared rabiesfree.
OBJECTIVES
General:
To reduce the incidence of Human Rabies from
7 per million to 1 per million population by
2010, and eliminate human rabies by 2015.
To reduce the incidence of canine rabies from
70 per 100,000 to 7 per 100,000 dog by 2010,
and eliminate canine rabies by 2015.

NATIONAL RABIES PREVENTION AND


CONTROL PROGRAM
Specific:
To conduct information campaign on
Responsible Pet Ownership (RPO) among
75% of households.
To immunize 80% of the dog population in
identifies priority areas.
To provide free Post Exposure Treatment
(PET) to 100% of high risk and technicians
working in Rabies Diagnostic
Laboratories,
To strengthen rabies surveillance system

NATIONAL RABIES PREVENTION AND


CONTROL PROGRAM

To train 80% of government


physicians and nurse in management
of animal bites cases and
government veterinarians and
technicians on rabies control and
diagnosis
To enhance local implementation of
the program

MANPOWER
DEVELOPMENT

Training of health workers


veterinarian and laboratory
technicians on management of
animals bite cases,

SOCIAL MOBILIZATION

Organize meetings
Networking with other sectors

LOCAL PROGRAM
IMPLEMENTATION

Establishment/Reactivation of Local
Rabies Control Committees
Enactment/Enforcement of Ordinance
on Dog Control Measures

DOG IMMUNIZATION

Pre-Vaccination Activities
Identification of priority areas
Procurement/Distribution of dog vaccines
Social Preparation

Conduct of dog vaccination


Post-Immunization Evaluation

STRATEGIES/ACTIVITIES

Information/Education/Communication
Campaign
Production/Distribution of IEC materials
Tri.Media Campaign
Public Fora

Provision of Post-Exposure Treatment


Procurement/Distribution of Immunizing Agents

against Rabies
Management of Animal Bite Cases

Rabies Surveillance
Establish/Upgrade Animal Diagnostic Laboratories
Data collection/Analysis