National Dengue Prevention and Control Program

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National Dengue Prevention and Control Program
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Goal of the Program

• Reduce morbidity and mortality from dengue
  infection by preventing the transmission of the
  virus from the mosquito vector to human.

National Center for Disease Prevention and
Control, DOH
3
Objectives

• Reduce the incidence to 10 cases per 100,000
  population.
• Reduce the Case Fatality Rate to less than 1.

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Components

• Dengue Surveillance
• Dengue Integrated Vector Management
• Dengue Case Management
• Social Mobilization Communication for Dengue
• Dengue Outbreak Response
• Research

National Center for Disease Prevention and
Control, DOH
5
Dengue Surveillance

• New dengue case definition should now be adopted
  case fatality rate standardized
• Mechanisms for sharing timely and accurate data
• Incorporate dengue surveillance (case, vector and
  seroprevalence) into an integrated and
  strengthened disease surveillance system

National Center for Disease Prevention and
Control, DOH
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Dengue Surveillance-National
National Center for Disease Prevention and
Control, DOH
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Surveillance/prov/mun

• Dengue Cases_Region I_2012VI20_1.ppt

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Region Cases Cases Cases
Region 2012 2011 Change
I 891 1503 -40.72
II 645 1537 -58.04
III 5194 4828 7.58
IV-A 3866 4455 -13.22
IV-B 134 342 -60.82
V 493 323 52.63
VI 1124 1031 9.02
VII 2089 2031 2.86
VIII 94 468 -79.91
IX 1081 481 124.74
X 833 756 10.19
XI 1892 1048 80.53
XII 621 923 -32.72
ARMM 104 130 -20.00
CAR 388 353 9.92
CARAGA 358 484 -26.03
NCR 6809 7683 -11.38
Total 26616 28376 -6.20
As of May 12, 2012
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Dengue Integrated Vector Management

• Vectors fully described and vector indicators
  regularly monitored
• IVM as a strategy
• Evidence based strategies to control vector
  populations adopted
• Facilitate community involvement for vector
  control
• Rationale use of insecticide for vector control,
  WHOPES guidelines on pesticide management
• Vector resistance monitoring

National Center for Disease Prevention and
Control, DOH
10
Dengue Case Management

• Capacity of health professionals to diagnose,
  treat or refer cases
• Laboratory support for case management
• Referral network system in public and private
  sectors
• Public awareness on warning signs and actions to
  be taken

National Center for Disease Prevention and
Control, DOH
11
Social Mobilization Communication for Dengue

• Communication for Behavioral Impact (COMBI)
  approach disseminated and promoted
• Development implementation of COMBI plan
  supported
• Partnerships set up with private sector / and
  other multi-stakeholders

National Center for Disease Prevention and
Control, DOH
12
Dengue Outbreak Response

• National Early warning system/dengue surveillance
  system.
• Coordination mechanisms within DOH and with other
  programs, LGU and other sectors
• Ability of health workers to respond to the
  dengue outbreak

National Center for Disease Prevention and
Control, DOH
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Research

• Disease burden
• Evaluation of tools strategies for dengue
  control and case management

National Center for Disease Prevention and
Control, DOH
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Advocacy

• Intensified year long campaign on dengue
  prevention control
• Developed produced prototype materials
• Production, reproduction distribution of IEC
  materials
• Advocacy to LGUs LCEs
• Media advocacy

National Center for Disease Prevention and
Control, DOH
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Aksyon Barangay Kontra Dengue

• Objectives
• To reinforce clean-up drive against Dengue
• To mobilize all sectors for clean-up drive
  (search and destroy)

National Center for Disease Prevention and
Control, DOH
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STANDARD MESSAGE

• Search and destroy breeding sites
• Cover all water containers (jars, drums, cans,
  etc.)
• Regularly change water in flower vases
• De-clogging of roof gutters
• Fill-up surface water with soil where feasible
• Vacant lots in villages, housing areas with
  stagnant water and potential mosquito breeding
  areas
• Used tires seen at vulcanizing shops
• Self-protection
• Wear long sleeved shirts and long pants
• Use mosquito repellants every 4 hours

National Center for Disease Prevention and
Control, DOH
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STANDARD MESSAGE

• 3. Seek early advise/consultation at the nearest
  health center
• Fever, pain behind eyes, joint pains, etc.
• 4. Say YES to fogging when there is an impending
  outbreak (hotspots)
• Fogging only in hotspot areas as evaluated by the
  health officers

National Center for Disease Prevention and
Control, DOH
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RAPID ASSESSMENT

• Monitoring and Evaluation by Local Health Offices
  and DOH regional offices
• Weekly reporting of
• mobilization activities
• Dengue cases
• Deaths

National Center for Disease Prevention and
Control, DOH
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Other Activities

• Tri-media campaigns on mobilizing ABKD from all
  sectors
• - IEC leaflets reproduction
• - Information and education should be
  integrated in health classes by DepEd
• - DILG memorandum to all LGUs on ABKD
• - Liga ng Barangays to mobilize for ABKD and
  local ordinances
• - TV and Radio spots by media partners
• - Continuous advocacy (daily print ads)
• Fogging operations in defined hotspot areas
• - DOH CHDs in coordination with LGUs

National Center for Disease Prevention and
Control, DOH
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COMPARATIVE TOXICITIES OF SOME INSECTICIDES

• INSECTICIDES USED IN
• DENGUE CONTROL
• Fogging
• a. Permethrin-4000 mg/kg
• b. Deltamethrin-2940 mg/kg
• c. Cyfluthrin-1200 mg/kg
• d. Pirimiphos methyl-1200 mg/kg
• e. Malathion-2100 mg/kg
• Larviciding
• a. Temephos-8000 mg/kg
• b. Altosid-34000 mg/kg
• c. Bacillus thuringiensis- non-toxic

ACUTE ORAL LD50 mg/kg
SLIGHTLY TOXIC
HIGHLY TOXIC
MODERATELY TOXIC
References 1969 Gaines RT, Acute Toxicity of
pesticides. Toxicology and Applied Pharmacology
1995 WHO. Duidelines for
Dengue Surveillance and mosquito Control.
Western Pacific Education Series. No.8 104p.
1998 DOH-National Dengue
Prevention and Control Program. Basic Training
on dengue Prevention and Control. Module1. 60p.
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Classification of Pesticides Based on Toxicity
and Hazard
Category and Signal Word Color Brand Symbol Signal Word Acute Oral LD50 (Rat) Acute Oral LD50 (Rat) Acute Oral LD50 (Rat) Aculte Dermal (mg/Kg BW)
Solid Liquid Solid Liquid
Category I Danger Poison Red Poison 50 or less 200 or less 100 or less 400 or less
Category II Yellow Yellow Warning 50-500 200-2000 100-1000 400 4000
Category II Caution Blue Caution 500-2000 2000-3000 Over 1000 Over 4000
Category IV Green Over 2000 Over 3000 N/A N/A