DOH PROGRAM

COMMUNICABLE DISEASE PREVENTION AND CONTROL

1st line ATB for dysentery ciprofloxacin RR considered fast breathing for a child 2 12 months 50bpm Persistent diarrhea s diarrhea for for howmany days 14 days and more For treatment of dysentery, ATB is given for how many days 3 days *when suspecting for DH, what are the 2 medications that should not be given Dolan (ibuprofen) Aspirin Otic drug used for treatment of chronic ear infection quinolone otic drops Drug used for routine worm treatment/deworming mebendazole/albendazole 1st line ATB for cholera tetracycline *4 rules of home treatment Give extra fuid Give zinc supplements Continue feedng When to return Follow up visit for child with anemia 14 days Follow up visit for pneumonia 2 days

NATIONAL TUBERCOLOSIS CONTROL PROGRAM (NTP)

TUBERCULOSIS (TB) S/Sx
Cough for 2 weeks or more Fever Chest or back pains Hemoptysis or recurrent blood-streaked sputum Others:
Sweating, fatigue, body malaise and shortness of breath

NATIONAL TUBERCOLOSIS CONTROL PROGRAM (NTP)

DSSM primary diagnostic tool in NTP casefinding DOTS implemented to ensure treatment compliance Formulations of anti-TB drugs:
FDCs (fixed-dose combinations) SDF (single drug formulation)

NATIONAL TUBERCOLOSIS CONTROL PROGRAM (NTP)

Category 1
New smear positive New smear negative with extensive parenchymal lesions on CXR EPTB Sever concomitant HIV disease Treatment:
2 months HRZE (intensive phase) 4 months HR (continuation phase)

NATIONAL TUBERCOLOSIS CONTROL PROGRAM (NTP)

Category 2
Treatment failure Relapse Return after default Treatment:
2 months HRZES (intensive phase) 1 month HRZE (intensive phase) 5 months HRE (continuation phase)

NATIONAL TUBERCOLOSIS CONTROL PROGRAM (NTP)

Category 3
New smear negative PTB with minimal parenchymal lesions on CXR Treatment:
2 months HRZE (intensive phase) 4 months HR (continuation phase)

Category 4
Chronic: still smear-positive after supervised retreatment Referral to specialized facility

LEPROSY
CA: Mycobacterium leprae MOT: skin contact, droplet Early S/Sx:
Change in skin color Loss of sensation on the skin lesion Decrease/loss of sweating and hair growth over lesion Thickened and/or painful nerves Muscle weakness or paralysis of extremities Pain and redness of the eyes Nasal obstruction or bleeding Ulcers that do not heal

LEPROSY
Late S/Sx:
Loss of eyebrow (madarosis) Inability to close eyelids (lagopthalmos) Clawing of fingers and toes Contractures Sinking of the nosebridge Enlargement of breast in males (gynecomastia) Chronic ulcers

LEPROSY
Diagnosis based on clinical s/sx esp if with history of contact with PWL
SSS (slit skin smear) examination done when clinical diagnosis is doubtful

Classification:
Paucibacillary (tuberculoid and indeterminate)
Non-infectious type; treatment 6-9 months

Multibacillary (lepromatous and borderline)

Infectious type: treatment 24-30 months

LEPROSY
Treatment for PB leprosy cases (adult)
Rifampicin 600mg once a month Dapsone 100mg daily Duration of treatment: 6 blister packs to be taken monthly within a maximum period of 9 months

Treatment for PB leprosy cases (child)

Rifampicin 450mg once a month Dapsone 50mg daily Duration of treatment: 6 blister packs to be taken monthly within a maximum period of 9 months

LEPROSY
For MB leprosy cases (adult)
Rifampicin 600mg once a month Clofazimine 300mg once a month and 50mg daily Dapsone 100 mg daily Duration of treatment
12 blister packs to be taken monthly within a maximum period of 18 months

LEPROSY
For MB leprosy cases (child)
Rifampicin 450mg once a month Clofazimine 150mg once a month and 50mg every other day Dapsone 50 mg daily Duration of treatment:
12 blister packs to be taken monthly within a maximum period of 18 months

SCHISTOSOMIASIS
BILHARIASIS or SNAIL FEVER Caused by a blood fluke S. japonicum transmitted by a tiny snail oncomelania quadrasi S/Sx:
Diarrhea, bloody stools, enlargement of abdomen, spleenomegaly, weakness, anemia, inflamed liver

Treatment: PRAZIQUANTEL (BILTRICIDE)

FILARIASIS
Caused by Wuchereria bancrofti, Brugia malayi or Brugia timori Transmitted through bites from an infected mosquito, Aedes poecilius S/Sx:
Hydrocele Elephantiasis Lympedema Loss of libido

Treatment:
Diethylcarbamazine Citrate (DEC) or HETRAZAN

MALARIA
Produced by parasites of the genus Plamodium (palcifarum, vivax, ovale, malariae) S/Sx:
Recurrent chills Fever Profuse sweating Anemia Malaise Hepatomegaly Spleenomegaly SHAPE (splenomegaly, hepatomegaly, anemia, profuse sweating, elevated temperature)

MALARIA
Prevention: Chemically treated mosquito net, Larvaeeating fish, Environmental sanitation, Anti-mosquito soap/lotion, Neem trees Chemoprophylaxis CHLOROQUINE Anti-malarial drugs:
Chloroquine phosphate Sulfadoxine Quinine sulfate Quinine hydrochloride Tetracycline hyrochloride Quinidine sulfate Quinidine glucolate

DHF
S/Sx:
1st 4 days: (febrile r invasive stage) high fever, abdominal pain, headache, which may be accompanied by vomiting, conjunctival infection, and epitaxis 4th-7th day: (toxic or hemorrhagic stage) lowering temp, sever abdominal pain, vomiting and frequent bleeding on GIT, unstable BP, PP narrowing and shock 7th 10th day: (convalescent or recovery)generalized flushing, appetite regained, BP stable SHAME (Shock, High fever and headache, Abdominal pain, Melena, Epistaxis)

DHF
Classification
Severe, frank type with flushing, high fever, severe hemorrhage followed by sudden drop of temp, shock and terminating in recovery or death Moderate high fever but less hemorrhage, no shock Mild slight fever, with or without petechial hemorrhage

DHF
Etiologic agent: Dengue virus type 1, 2, 3, 4 and Chinkungunya virus Source is a vector mosquito: Aedes Aegypti Diagnostic test:
Torniquet test
(+) if there is 20 or more petechiae per 2.5cm square or 1 inch square

MEASLES
S/Sx:
Fever, rashes and symptoms referable to upper respiratory tract Koplik spots: grayish pecks found on the inner surface of the cheeks

Period of communicability: 4 days before and 5 days after rashes appear

CHICKEN POX (VARICELLA)

S/Sx:
Fever, muco-papular rash to vesicular lesions for 3-4 days that leave granular scabs

Period of communicability
Not more than 1 day before and more than 6 days after appearance of 1st crop of vesicles

MUMPS (EPIDEMIC PAROTITIS)

S/Sx:
Painful swelling in front of ear, angle of jaws, and down the neck Fever Malaise Loss of appetite Orchitis in some boys

DIPTHERIA
Acute febrile infection of the tonsil, throat, nose larynx, or a wound marked by a patch or patches of grayish membrane C.A Corynebacterium Diptheriae (KlebsLoeffler bacillus) Source of infection: discharges and secretions from mucus surface of nose and nasopharynx and skin and other lesions

DIPTHERIA
MOT: direct contact with infected patient or with articles soiled with discharges Incubation: 2-5 days or longer Period of communicability: until secretions and lesions disappear

WHOOPING COUGH (PERTUSSIS)

Acute infection of the respiratory tract characterized by development of paroxysms of cough ending in characteristic whoop, vomiting may follow CA: Hemophilus pertussis or Bordet Gengou Bacillus or Bordetella pertussis or Pertussis bacillus Source of infection: discharges from laryngeal and bronchial mucus membrane of infected persons

WHOOPING COUGH (PERTUSSIS)

MOT: direct contact Incubation:7-10 days not exceeding 21 days Period of communicability: 7 days after exposure to 3 weeks after onset of typical poxysms

TETANUS
Acute disease induced by toxin of tetanus bacilli growing anearobically in wounds characterized by muscular contractions CA: Clostridium tetani Source of infection: soil, street dust, animal and human feces MOT: contamination of unhealed wound or umbilical stump Incubation: 7-14 days (varies from 3 days to 1 month)

CHOLERA (EL TOR)

Acute serious illness characterized by sudden onset of acute, profuse diarrhea (rice stools), vomiting CA: Vibrio cholerae MOT: oral-fecal route, contaminated food and water Incubation: few hours to 5 days Period of communicability: 7-14 days after onset

TYPHOID FEVER
CA: Salmonella typhosa S/Sx: fever, rash/red spot on abdomen(roe spots) Source of infection: feces and urine of infected persons MOT: direct or indirect contact, vehicles are food and water Incubation: 1-3 weeks Period of communicability: from appearance of symptoms to convalescence

BACILLARY DYSENTERY (SHIGELLOSIS)

CA: dysentery bacillus Source of infection: feces of infected persons MOT: ingestion of contaminated food or water Incubation: 1-4 days Period of communicability: until microorganism disappear from feces, persons may become a carrier for a year or 2

SOIL TRANSMITTED HELMNTHIASES (STH)

Major causes: Ascaris lumbricoides, Trichuris trichiura, Hookworm (Ancylostoma duodenale and Nicator americanus) S/Sx: anemia, malnutrition, stunted growth, decreased physical activity, impaired mental development MOT: oral, walking barefoot Treatment: antihelmithic, mebendazole

HEPATITIS A
CA: Hepatitis A virus Incubation: 15-50 days MOT: oral-fecal, contaminated food and water S/Sx: influenza-like, malaise and easy fatigability, aneroxai, abdominal discomfort, nausea and vomiting, fever, lymphadenopathy, jaundice accompanied by pruritus Bilirubinemia with clay-colored stools Treatment: Chloramphenicol, Gamma globulin

PARALYTIC SHELLFISH POISONING

Syndrome of characteristic symptoms predominantly neurologic which occur within minutes or several hours after ingestion of poisonous shellfish S/Sx: numbness of the face especially around mouth, vomiting and dizziness, headache, tingling sensation, paresthesia and eventual paralysis of hands and feet, weakaness, tachycardia, difficulty speaking and swallowing Respiratory arrest and death in severe cases

LEPTOSPIROSIS
CA: Leptospira interrogans Main host: RAT Incubation: 7-19 days MOT: direct contact of open wounds with water, moist soil or vegetation with urine of infected host/vector Treatment: penicilins, tetracyclines, erythromycin

RABIES
CA: rhabdovirus MOT: bite of a rabid animal Incubation: 2-8 weeks Period of communicability: 3 days throughout the duration of the disease S/Sx: headache, fever, sensory changes of site of bite, muscle spasm, hydrophobia, paralysis, delirium, convulsions

SCABIES
CA: Sarcoptes scabiei Characterized by eruptive lesions produced from burrowing of the parasite into the skin MOT: direct contact or contact with soiled articles or clothing Incubation: 24 hours from original contact S/Sx: itching, burning sensation on skin, burrowing tracts on skin