Sister project in Colombia: Healthy Schools Reducing dengue and - - PowerPoint PPT Presentation

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Sister project in Colombia: Healthy Schools Reducing dengue and - - PowerPoint PPT Presentation

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Sister project in Colombia: Healthy Schools Reducing dengue and diarrheal diseases in primary schools in Colombia Maria Ines Matiz Health and Environment Institute El Bosque University Bogota, Colombia Diarrhea and Dengue (DIADEN)

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Sister project in Colombia: “Healthy Schools – Reducing dengue and diarrheal diseases in primary schools in Colombia”

Maria Ines Matiz Health and Environment Institute El Bosque University Bogota, Colombia Diarrhea and Dengue (DIADEN) Midterm Workshop 2012 25-27 January, 2012, Khon Kaen, Thailand

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*

The striking variety in temperature and precipitation results principally from differences in elevation. Temperatures range from very hot at sea level to relatively cold at higher parts of the Andes. Colombia is among the 17 mega-diverse countries according with United Nations Environment Programme UNEP . Colombia is located in the northwest of South America and has coasts on both the Caribbean Sea and the Pacific Ocean.

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  • Government: Democracy, with 4-

year presidential periods

  • Capital: Bogotá (largest city)

4°39′N 74°3′W

  • Ethnic groups: 58% Mestizo -

20% White - 14% Mulatto - 4% Afro Colombian - 3% Zambo - 1% Amerindian

  • Area: 1,141,748 km2 -
  • Population:

August 2012 estimate: 45,925,397

  • Economy: Colombia is mainly

dependent on agriculture, coffee, flowers, oil and coal.

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  • Social inequality
  • Inefficient political leadership
  • Population displaced by violence or natural disasters
  • Problems of narcotraffic, guerrilla and paramilitary
  • Communities, especially in rural areas, with unmet basic

needs

Foto: Agencia EFE Foto: El Espectador Foto: http://auracristinperez.wordpress.com

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  • Is a private university, founded by a

group of medical doctors 35 years ago, for this reason has a general emphasis on health.

  • Currently has 22 undergraduate programs,

74 graduate programs, with 6700 and 1407 students respectively

  • Research center has

7 Research Institutes 32 research groups

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International

University of Life Sciences, Norway Liverpool School of Tropical Medicine, UK London School of Hygiene and Tropical Medicine, UK Institute for Infectious Disease Control, Sweden

National

Universidad El Bosque Public Health Laboratory, Cundinamarca

Local

Lazos de Calandaima Foundation Municipality of Anapoima Municipality of La Mesa School principals Community leaders

Rural schools

Pupils Teachers Kitchen personnel

  • 3-year initiative (2010-2013)
  • Funded by the Norwegian Research Council
  • Partners at the international, national, and local levels

PROJECT OVERVIEW

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Research Team

INTERNATIONAL

Thor-Axel Stenstrom Hans Overgaard Audrey Lenhart Razak Seidu Neal Alexander

NATIONAL

Sandra Vargas Víctor Alberto Olano Juan Felipe Jaramillo Diana Sarmiento María Inés Matiz

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National support staff

  • Statistical support:

Ehidee Gómez

  • Financial statement / accounts

Olga Quimbayo Fabian Mora Grupo contabilidad Fundación Lazos de Calandaima

  • Young researchers

Sergio Salas Laura Cabezas María Fernanda Molina Ximena Roncancio

  • Field Technicians

Laura Hernández Nancy Herrera Rosa Silva Ana Cuéllar

  • Laboratory Technician

Humberto Mosquera

  • Monitoring absences

Anapoima La Mesa

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Inhabitants 27.894 Temperature average 22°C Height 1.200 masl Urban area: 2.75 Km2 Rural area: 145 Km2 Total area: 148 Km2

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Anapoima Municipality

Inhabitants: 13.659 Temperature average: 24-28C Height: 700 masl Urban Area 327.96Ha Rural Area 11636.41Ha Total Area : 11964.37Ha

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Rural schools

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Anapoima

  • No. of schools: 17

Total teachers: 19 Total of Students: 262 Age: 5-16 years old Courses: 0-5 grade Altitude: El Consuelo 588 masl Palmichera 1089 masl

La Mesa

  • No. of schools: 18

Total teachers: 27 Total of Students: 459 Age: 5-16 years old Courses: 0-5 grade Altitude: La Vega 712 masl Buenavista 1610 masl

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Contribute to improved health and welfare in Colombian school children by evaluating the impact of school-based diarrhea and dengue control interventions.

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1

  • Reduce exposure to dengue risk factors in schools:
  • Reducing dengue mosquito vector populations
  • Reducing exposure to solid waste surrounding schools

2

  • Reduce exposure to diarrheal risk factors in schools:
  • Improving drinking water quality
  • Improving hand-washing practices
  • Improving hygiene

3

  • Reduce the incidence of diarrheal diseases (and potentially

dengue fever) in school children.

4

  • Reduce the number of absence episodes and length of those

due to these illnesses

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COMPONENTS

ENTOMOLOGICAL ENVIRONMENTAL HEALTH SOCIO CULTURAL

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Immature stages survey Adult mosquito survey Laboratory Identification

Aedes aegypti INFESTATION

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2011

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2011

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TEACHERS PUPILS KAP SURVEYS METODOLOGY RESULTS ABSENCES REGISTER

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KNOWLEDGE, ATTITUDES AND PRACTICES DENGUE AND DIARRHEA - TEACHERS FROM LA MESA

VARIABLE KNOWLEDGE ATTITUDES PRACTICES DENGUE Y DIARRHEA Medium High High DENGUE Medium High Medium DIARRHEA Medium High High

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KNOWLEDGE, ATTITUDES AND PRACTICES DENGUE AND DIARRHEA - TEACHERS FROM ANAPOIMA

VARIABLE KNOWLEDGE ATTITUDES PRACTICES DENGUE Y DIARRHEA Medium High High DENGUE Medium High Medium DIARRHEA Low High High

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KNOWLEDGE, ATTITUDES AND PRACTICES DENGUE AND DIARRHEA - STUDENTS FROM LA MESA

VARIABLE KNOWLEDGE ATTITUDES PRACTICES DENGUE Y DIARRHEA Medium High Medium DENGUE Low DIARRHEA Medium

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KNOWLEDGE, ATTITUDES AND PRACTICES DENGUE AND DIARRHEA - STUDENTS FROM ANAPOIMA

VARIABLE KNOWLEDGE ATTITUDES PRACTICES DENGUE Y DIARRHEA Medium High Medium DENGUE Medium DIARRHEA Medium

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Daily record

  • f absences by

the teacher The teacher establishes the reason for absence Collecting of the registers each week in 2012 Phone call with a list of symptoms

METHODOLOGY ABSENCES

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Reason for Absence. Anapoima. July-August 2011 Reason for Sickness absence. Anapoima,July-August 2011

23,8 4,8 19 25,3 20,8 6,3

INFORMANTE % MADRE

44.6

PADRE

3.6

ABUELOS

1.2

HERMANO

7.6

PRIMOS

1.2

TIOS

4.8

MISMO NIÑO

23.3

AMIGO

3.6

SIN DATO

8.4

OTRO

1.6

9 13 2 2 Gripa Otro Faringoamigdalitis Fractura 19 15 7 4 4 3 Fiebre Dolor de cabeza Diarrea Vomito Tos-mocos Dolor cuerpo

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30,5 6,6 12,9 18,8 22,8 8,4 0,0 5,0 10,0 15,0 20,0 25,0 30,0 35,0

INFORMANTE % MADRE 34 PADRE 3 ABUELOS 3 HERMANO 9 PRIMOS TIOS 2 MISMO NIÑO 22 AMIGO 2 SIN DATO 25 OTRO 2 Reason for Absence La Mesa. Julio-Agosto 2011 Reason for Sickness absence. La Mesa, July-August 2011

7 28 1 1 2 14 48 10 20 30 40 50 Diarrea Gripa Faringoamigdalitis Fractura Eruptiva infancia Otro Dato perdido

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Microbiological analysis Physiochemical analysis

Water

Criteria Results

School condition s

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Total coliforms (CFU/100 ml)

  • E. coli

(CFU/100 ml)

Lev el Bacterial counts I 1 – 10 II 11 – 100 III 101 – 1000 IV 1001 – 10000 V > 10000

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Item / Criteria

  • Water source
  • Water supply frequency
  • Albercas (Type of Low Tank)
  • Tanks Covered
  • Internal water treatment
  • Sinks
  • Toilets
  • Toilets cleaning
  • Waste water disposal
  • Solid waste disposal
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Max 75,6 Min 13,8 Media 47,1 Mediana 35,4

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Max 70,6 Min 20,0 Media 49,0 Mediana 53,2

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Diarrhea Dengue Dengue & Diarrhea Control

Ø

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Covering tanks pyriproxyfen

Rubbish collection campaign

Immature forms

Curtains impregnated with insecticide

Adult forms

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WATER

Filter Cover and clean tanks

HYGIENE

Handwashing Cleaning bathroom s

DIARRHEA INTERVENTION STRATEGIES FOR THE PREVENTION OF DIARRHEA

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  • Educational program

integrating aspects

  • f

health,water,sanitati

  • n and hygiene

Education

  • Establishing

mechanisms for community participation and surveillance

Social mobilizatio n

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Diana Patricia Rojas Álvarez, Grupo enfermedades transmitidas por vectores, Subdirección de vigilancia y control en salud pública, Instituto Nacional de Salud(2011

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Fuente: SAA oficina de epidemiologia SSC

Incidencia de casos notificados como probables: 42 X100.000 habitantes

Registro histórico de los Casos notificados de dengue

11 58 25 69

10 20 30 40 50 60 70 80 2007 2008 2009 2010

Casos de dengue, Anapoima 2007-2010

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Descripción de los casos de dengue notificados. 2010

Dengue 95.7% (66) dengue grave 4.3 % (3) Edad: 15 a 44 años 60.9% (42), 45 y más años 29.% (20), 5 a 14 años 8.7% (6) 1 a 4 años 1.4% (1) Sexo: femenino 60.9% y masculino 39.1% Procedencia de los casos: cabecera municipal 71%, centro poblado 14.5 % rural disperso 14.5%.

Fuente:http://www.google.com.co/imgres?imgurl=http://elpoderdemiami.com/wp-content/uploads/2008/09 http://www.google.com.co/imgres?imgurl=http://www.culsans.com.ar/wp-content/uploads/2009/03/dengue_charata05.jpg&imgrefurl http://www.google.com.co/imgres?imgurl=http://www.talcualdigital.com/imagesbank/avances/27720102527200.jpg&imgrefurl

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Cabecera municipal: 71% Centro poblado Inspecciones: 14.5 % Rural: 14.5% Descripción de los casos de dengue notificados. 2010

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Número de casas positivas x 100%

Número de casas inspeccionadas

VIGILANCIA ENTOMOLÓGICA

INDICES DE INFESTACION LARVARIOS

Número de depósitos positivos x 100%

Número total de depósitos inspeccionados

Índice de vivienda Número de depósitos positivos x 100 casas

Número total de casas inspeccionadas

Índice de Breteau Índice de depósito

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INTERPRETACION EPIDEMIOLÓGICA

INDICE RIESGO BAJO ALTO

VIVIENDA < 4% ≥ 4% DEPOSITO <3% ≥ 3% BRETEAU <5 ≥ 5

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THANK YOU