Tuesday, August 5, 2008

KUALA MUDA, 5.8.08, (DAY 7): SPECIFIC REPORT

Mission: Active case finding (Aedes Survey) in Taman Ria Jaya

Objective:

  • To find active case of Aedes (Positive breeding of mosquito larvae)
  • To take preventive measures by adding ABATE into water tank
  • To give awareness to public regarding Dengue fever and Aedes via pamplet

Date/Time: 5.8.08, 10.30am-12.30pm

Team: 3 teams, each team consist of PKA and 4 AIMST medical students (+1 in a team)



Law Used: Destruction of Disease Bearing Insect 1975



Tools Used: Empty sterile bottle, seal, pipet (small and large), forms, notice, ID card, Vest



Description:


Total of 88 houses were in for checking by the officers. We were divided in 3 groups and each group followed 2 officers to the specific locations.
The officers went house by house. They always introduced themselves and showed their identity to the house owners before beginning with the surveillance. The house owners followed the officers during the surveillance, as required. They checked the flower pots at the veranda, and any other containers that may contain water. Inside the house, they checked the washrooms and the toilets. They also flushed the toilets in order to check its efficacy as the spoiled flushes can be place for the mosquito breeding. If there were no larvae found, the officers add about 10g of Abate in powder form to the water in the toilet flushes and in any water containing pots or containers as a precaution.
In total of 88 houses only 3 houses were found to have larvae. In these houses, after the breeding place of the larvae found, the officers will it to house owners. They then show the empty bottles to house owners before collecting the samples as evidence that there were no foul play present. Then the samples were collected by using pipette. In both the houses 5 bottles of samples were collected each. Then the bottles were sealed and labeled with information like the date of the sample taken, the location of the sample collected and who collected it. The house owners were needed to write their identification card number and sign the label. The Pembantu Kesihatan Awam and/or the Pekerja Am witnessed these procedures. The house owners were given compound under the Act of Destruction of Disease Bearing Insect 1975, section 13. They will be required to pay RM100 each in the District Health Office by 14 days. The offenders are also given extra 7 days notice if they are not able to pay the compound within 14 days.
While in the empty houses where the owners were not present at the time, one notice was sticked in the front door to notify that the surveillance will be done the next day




Procedure:
  • Introduce ownself and show ID. Then explain the motive of survey.

  • Enter the house only if allowed, if not allowed (or no one is at home), a notice is sticked to the wall telling that survey will be doen the next day. If resident still insist not to allow health officer to enter for checking, then the act plays an important part this time. DDBIA 1975 will be used for lawsuit
  • Surrounding of the house is surveyed for potential breeding site for larvae
  • If found, a sample of AT LEAST 5 LARVAEs ARE TAKEN.

  • Resident will be explained that the bucket contains larvae and show the larvae to him/her

  • Explain to the resident that he or she has againt the law of DDBIA 1975 and a compound will be given.

  • Before sample is taken, the new sterile bottle is shown to the resident first to prove that there is no foul-play

  • At least 5 larvaes are taken by pipet

  • The bottle contain these larvaes are shown to the resident again and then the bottle is sealed

  • Bottle is labeled and compound is written.

  • ABATE (larvicides) are put in water tank or potential space of water collection (both positive and negative findings of larvae)

  • Education is given to the resident both verbally and through written materials.

  • Sample is sent to DHO lab to analyst the breed of mosquito


Discussion:


Have you ever wonder that if any larvae is found in a drain outside of a particular house, will that particular resident be compounded? If yes, how to prove that the larvae did not swim from the drain of the other house further up to that particular resident's drain?


The answer is that there no need for us to crack head. This mission is to detect any aedes larvae in a household. Aedes only breed in water holding container and not normally in the dirty stagnant drain like those of Culex.




Do you know that Dengue fever (DF) and Dengue Haemorrhagic fever (DHF) are beaten by different Aedes?


Aedes main species are Aedes Aegypti and Aedes Albopictus (Asian Tiger Mosquito). Aedes Aegypti cause DHF whereas Aedes Albopictus cause DF. Aedes Aegypti likes to breed in dark area and Aedes Albopictus can breed in clear and open space stagnant clean water. Thus, if a larvae is found in the pail just like the picture shown below, it is most likely to be Aedes Albopictus.




How to know whether it is Culcine (Aedes, Culex, Mansonia) and Anopheles by looking at the larvae sampled?


To differentiate the which is the most likely type of mosquito, there is a great explaination given in K.Park 17th ed. page 545. In this contex, we will just consider on larvae. The sampled larvae is closely observed for siphon tube. It will be whitish pale in colour which is quite similar to the colour of cartilage. The siphon is located at 8th segment of the larvae. If there is appearance of siphon, the species will be Culcine.


Besides, the way how the larvae rest just below the meniscus of water can also distinguish which type of mosquitoes. The larvae that rest inclined at an angle to water surface will be the Culcine but not anopheles. Anopheles rest parallel to the water surface.





Thumbs:






Introduction before entering the house.






Consent given. We entered the house.






Surrounding of the house is looked for potential breeding site.






Gan was hoping to see one larvae but none was found.






The 'Abate guy' entered the house.






Toilet was checked.






Water collection for bathing was checked.






Collecting plate under the refrigerator was checked.






Abate in powder form is put into water straight. The chemical effect can last for 3 months.






Health education is given via written form to make the public aware about Dengue and Aedes.






Potential breeding site.






Larvaes spotted! Many of them!






Larvae spotted by health officer.



Resident is shown the breeding site and explained the characteristic of the larvae and how to identify it in layman's term.





Sample is taken with pipet





Sample is put into sterile empty bottle.


Bigger pipet for easy sampling





At least 5 samples of larvae taken




The larvae of Aedes look like this and it is the same as those in the sample bottle.


Bottle is sealed.





Compound is written by PKA.







Video:






Reported by Gaaitheri and Gan

1 comment:

Anonymous said...

thanks for posting...


___________________
Rosey
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