Using information technology for resistance containment: Malaria surveillance in the future moving toward elimination strategy

Transcription

1 Using information technology for resistance containment: Malaria surveillance in the future moving toward elimination strategy By Wichai Satimai MD.,MA.,DTM&H Bureau of Vector Borne diseases Department of Disease Control Ministry of Public Health Thailand

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3 Annual Blood Examination Rate (ABER), Slide PositivityRate (SPR) and Annual Parasite Incidence (API/1,000), Thailand FY ABER & SPR / 100 pop ABER SPR API API / 1,000 pop Fiscal Year

4 Percentage Proportion of malaria parasite species, Thailand, FY P. falciparum P. vivax Fiscal Year P.falciparum P.vivax

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6 Proportion of malaria parasite species in relation to the National drug policy, Thailand, FY Percentage 100 CHL SP2 SP3 QT MSP M M CHL 1973 SP QT MSP 1990 M 1995 M+ATS ; only in Trat, Chantaburi, Tak M+ATS whole country in 2005 (2days) 2008 M+ATS 3 days Fiscal Year P.falciparum P.vivax

7 1 2 Nine Provinces as Sentinel sites for monitoring of drug resistance 1.Mae Hong Son Tak 3.Kanchanaburi 4.Ratchaburi 5.Ranong 5 6.Ubon Ratchathania 9 7.Chanthaburi 8.Trat 7

8 Tak Mef 25 mg/kg + Art 12 mg/kg for 2 days N ACPR% LTF% ETF% 1997: : : : :

9 MHS CHM 2003 TR UB TAK KB RB CHB RN M M3A12 M5A

10 Result 3: Efficacy of CQ, MH CB YL KN No. recruited Lost Withdrawn) No. analyzed % Parasitaemia Day 3 % ACPR % ETF % LCF % LPF

11 11 Implementation Areas Ubonratchathani Srisaket Surin Burirum Sakaeo Only Zone 1 areas use Atovaquone/Proguanil The rest follows the national drug policy Chanthaburi Trat Zone 1

12 Table 2 Primer pairs and specific restriction enzymes for detecting 3 polymorphisms at codon 268 Primer pairs and specific restriction enzymes for detecting 3 polymorphisms Codon 268 Type Primer pair Restriction Enzyme DNA Sequencing Outer primer Product size (base pair) CYTB1+CYTB2 939 TAT Wild type CYTB3+CYTB5 NsiI TCT Y268S CYTB2+CYTB6 AlwNI AAT Y268N CYTB2+CYTB7 SspI NsiI cuts TAT; AlwNI cuts TCT; SspI cuts TAT and TCT, but not AAT

13 Web-based malaria surveillance: Malaria surveillance in the future moving toward malaria elimination in Thailand

14 Original System: Forms are recorded, and summarized on paper

15 Detected cases are plotted on household walking map

16 Objective To provide effective management information system capable of coordination at operational staff to enable rapid and high quality implementation of malaria elimination strategy

17 3 out of 6 Core Modules in Vector-Borne Disease Control have been implemented Epidemiology Module Vector Control Module BCC Module

18 Key Features Case Management (Real time Village V.S. household level traceable) Case detection Case Investigation Case Follow up Vector Control (Effectively distributed/controlled) The most up-to-date population survey cover any risk areas LLIN /LLIHN distribution IRS action Impregnated Bed Net Distribution Behavioral Change Communication (Individual Home Visit information can be sent to the center for evaluating the awareness of residences within the target areas) Different type of reports displayed in different presentation format (table, graph,gis,etc.) Integrate into public heath routine tasks Simple and easy to interpret, and user friendly

19 Technologies Web-based synchronization technology capable of switching between offline / online mode of data entry. This terminology is benefit for the low resources area. Users can still operate in case of internet link has difficulties. Then data can be later transferred when internet is back to normal. Mobile Computing simply disseminated or received information to/from different devices in other platforms i.e. Mobile/ Tablet Geographical Information System (GIS) ready ability to toggle GIS in key element of indicators for better understanding of the situation in short term

20 Work & Data Flow MIS EP 1 FU EP 1 VIVO Not Infected Infected Case Detection EP 1 EP 3 Case investigation Treatment Day 0 Drug compliance Case follow-up Day 1,2,3 Case follow-up Pf : Day 7,14,21,28,35,42 Pv: Day 7,14,21,28,60,90

21 Data Capturing for Case Management Active Case/Passive Case Detection Location Information Diagnosis Treatment

22 Infected Cases Follow Up Schedule generated automatically

23 Cases Follow Up can be done through Tablet 7 inches Device

24 Epidemiology Summary Report

25 Epidemiology Reports can be displayed in different format (Table, Bar Chart, Pie, or Line), and different time frame (monthly, Weekly)

26 Day 0 alert will be sent using SMS on a daily basis and Summary on a weekly basis

27 Maps in Malaria GIS ( 1. Number of Malaria Cases 2. Malaria Incidence 3. Proportion of PF Malaria Receiving ACT 4. Proportion of PV Malaria Receiving chloroquine and primaquine 5. Percent of PF Malaria Receiving ACT and have DOT 6. Percent of PF Malaria Receiving ACT, DOT but Day 3 Positive 7. PF Cases Receiving ACT, DOT but Day 3 Positive (by Patient) 8. Percent of malaria cases who got investigate 9. Indigenous Case 10. Malaria Stratification Area

28 GIS can display number of Malaria Cases classified by administrative level up to village level

29 Cases Investigation captured cases which have possible same source of infection March 18, 2010

30 Day 3 Positive Cases (ACT) = = cases Cases cases

31 Conclusions New technology can become one of a major strategy to fight against Vector-Borne Disease Knowledge sharing/transferring should be strengthened among regional countries in order to exchange information across different territories Regional and Global Collaborations or networking across public health units should be initialized for the purpose of joining/sharing disease control tasks, and lead to practical integration between working units across barriers

32 Thank you