Category Archives: Blog

Dengue Interventions by a small mosquito control unit

Written By: Website Administrator

31/03/2014

Article By: Vimal Deo

According to World Health Organization, preventing or reducing dengue virus transmission depends entirely the control of the mosquito vectors or interruption of human–vector contact.

In essence, the prevention and control activity for dengue fever is centred on the control of the transmitting vector or agent i.e. the mosquito.  Past research in Fiji and various published report identified Aedesaegypti mosquitoes as the most effective vector for dengue fever. The mosquito prefers to inhabit close to household and immediate vicinity of its food source (blood meal), as well as other settings (such as schools, hospitals and workplaces). Therefore, the dengue, fever Interventions are focused on eliminating or at least reducing the population of mosquitoes around areas where humans habitat.

The World Health Organization recommends an integrated vector management (IVM) as the strategic approach for vector control. IVM is defined as “a rational decision-making process for the optimal use of resources for vector control”. The Integrated Vector Management (IVM) considers five key elements in the management process, namely:

(i)         Advocacy, social mobilization and legislation

(ii)        Collaboration within the health sector and with other sectors

(iii)       Integrated approach to disease control

(iv)       Evidence-based decision-making

(v)        Capacity-building

According to a recent review on the Vector Control initiatives by a WHO Consultant (Unpublished 2014), Fiji has a long history of dealing with dengue (since 1885) and has  a leading dengue vector control program in the Melanesia and Pacific region. Whilst the consultant noted that there is a high level of knowledge and awareness of dengue amongst the health leadership and staff, there is scope to provide additional resources to increase mobility and technical capacity of the teams.

Despite limitations, the overall aim for vector control has been to eliminate all potential breeding habits of mosquitoes through effective vector reduction campaign in the high risk urban and rural areas within the operational health division’s placing greater emphasis on source reduction through basic environmental health approaches and community mobilization. This is implemented through:

(i)                 Vector reduction campaign via clean-up of compounds / backyard , overgrowth in vacant lots and blocked drains

(ii)               Cartage of refuse in dengue sensitive and high risk areas within the rural areas

(iii)             Mobilization of community to sustain clean and vector free environment

Intersectoral collaboration through a National Dengue Clean-Up Initiative which is places emphasis on destroying mosquito breeding in tyres, drums and other receptacles that can retain water.

Apart from source reduction, vector control can be achieved through good water supply and storage measures (mosquito proofing water storage containers), good solid waste management practices (ensuring that potential water retaining receptacles are properly disposed), and through the use of chemical controls. Chemical controls are usually done through spraying which ideally targets adult mosquitoes and through larviciding which targets immature mosquito larvae. In addition, entomological monitoring and surveillance through the monitoring of vector populations through larval and adult mosquito monitoring coupled with timely feedbacks are essential for dengue prevention and control.

A final tool that is available for effective dengue control is through the use of legislative advocacy and implementation of legislative authority. Simply put, imposing of fines to persons who harbour or breed mosquitoes. The limitations to such an approach are the long awaited court processes and associated court costs to resolve an eminent threat.

Finally, dengue Fever is preventable, but no prevention is 100% effective. Some of the best means of prevention starts with an individual mindset towards self-protection. Some of these prevention measures include minimizing mosquito bites, avoiding mosquito-prone areas and using of repellents. Apart from these, source reduction through elimination of mosquito breeding sites is the best course in prevention dengue.

It is only through the combination of these efforts successful dengue control can be achieved.

Reference:

1. Dengue: guidelines for diagnosis, treatment, prevention and control — New edition (2009), World Health Organization.

POLHN Boosts Continuing Professional Development for Medical Professional

Written By: Website Administrator

11/03/2013

Health professional across Fiji have begun taking Pacific Open Learning Health Net (POLHN) seriously to establish Continuing Professional development.

POLHN was created in 2003 in partnership with Pacific Health Ministries and the World Health Organisation to ensure the availability of high quality training and education resources for health professionals, in order to improve health and health services in the region through online learning.

POLHN now has 16 learning centres around Fiji Islands and operates in 12 countries, providing access to online Continuing Professional Development (CPD) courses through an expanding network of learning centres, managed by a team of POLHN Country Coordinators supported by focal points. The majority of the centres are equipped with computers connected to the Internet, printers, scanners and projectors.

Early this year 10 Ministry of Health staff in Nabouwalu, on the coastline of Vanua Levu, graduated from POLHN’s basic computer course. Staff Nurse TavaitaLomani and husband IfeiremiDau of Wainunu Nursing Station each attained more than 15 short course certificates: “The good thing about POLHN is that I can access courses anytime and from anywhere. The courses are free, so I do not have to worry about cost” said Ifeiremi.

Inspired by the couples’ story, Staff Nurse Krishneel Kumar of Lautoka Hospital followed their footsteps and completed several self paced courses from Lippincott Nursing Centre and Global Health eLearning Center. After finishing numerous courses during his night shifts; “I feel more confident in dealing with patients,” Krishneel says.

POLHN’s aim is to ensure health professionals have access to a variety of courses and digital health resources available through the Internet. POLHN believes that continuous health education is essential in order to improve the quality of health care provided to the people of Fiji and the Pacific. Many of POLHN’s courses can be completed entirely online, and for health workers who have yet to build their confidence using computers, POLHN offers basic and intermediate computer literacy training

There are more than 1000 short courses, available through the POLHN website. There are also postgraduate courses in health services management and public health, through the Fiji National University as well as a variety of specialized public health courses designed for health professionals. All POLHN courses are offered at no cost to Ministry of Health workers.

Currently, POLHN is running a Poster Competition open to everyone, to design a poster promoting POLHN and lifelong learning. The poster competition ends on 31 March, 2013 and there are 100s of free giveaways. The winner will get chance to be in the 10th year POLHN retreat, so get your creative ideas flowing and send your poster designs to yasinm@wpro.who.int / sarkisn@wpro.who.int

Stay tuned for more news from POLHN and keep learning!

Clinical Refresher on the Updated Dengue Management Guidelines

Written By: Website Administrator

31/03/2014

Infectious disease specialists from the Ministry of Health and the World Health Organization (South Pacific) recently completed a training-of-trainer program with selected clinicians from the Government and the Private health sector on the updated WHO clinical management guidelines for dengue fever.

With the surge in dengue fever case numbers in past weeks, the Ministry recognized the need to impart the updated dengue clinical management guidelines to all doctors around the country in efforts to standardize and further upscale the Ministry’s health case responses to those afflicted by dengue fever.

33 doctors and 30 senior nurses from the Ministry of Health and also 4 doctors from the Private health sector participated at the training-of-trainers workshop. The trainings were conducted for half a day on three separate days last week in The Northern divisions, the Western division and also at the Colonial War Memorial hospital in Suva.

The training focused extensively on the revised attributes of the guidelines on dengue fever clinical management espoused by WHO. The emphasis on the principles of dengue management centred on understanding the clinical course of the disease where the critical period which would require very close patient monitoring, was 24 -48 hours after the initial fever or febrile phase of the disease.

From the analysis of the post-test evaluation exercise of the training-of-trainers initiative, the Ministry is confident that the trainers are well equipped to filter key information from the updated clinical management guidelines for dengue, to their peers.

The Ministry anticipates that this training-of-trainers initiative will further enhance the management of dengue fever cases, reducing the burden of illness and also fatalities amongst afflicted individuals in our communities.