Transcript Prevention and improved treatment of communicable diseases

Prevention and improved treatment of
communicable diseases (HIV/AIDS
and TB), including increasing
preparedness for bioterrorism and
epidemics
Anneli Taal, Head of Public Health
department
Situation
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Epidemiological situation related to HIV/AIDS,
tuberculosis and viral hepatitis B and C has been
threatening in Estonia starting 1998.
The most burning issue is an explosive increase in
the number of HIV-positive individuals; from 0,6
cases per 100000 inhabitants in 1999 compared to
107,6 cases respectively in 2001;
Number of pregnant HIV positive women has
increased fast (35 in 2001 but 64 in 2003), by now
there are also newborns infected with HIV (5 for
2003).
Situation
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The number of newly diagnosed pulmonary
tuberculosis (TB) cases reduces (42,1 cases per
100 000 in 2003 but 55 cases per 100 000 in 2000),
but
the percentage of multi drug resistant cases of TB is
constantly high (14% in 2003) and
there is a significant number of multi drug resistantTB patients who interrupt their treatment course
(20%).
There is also the growing number of individuals
having TB and being co- infected with HIV (~20
patients for now)
In handling the CD situation Estonian
Government has:
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launched a new The Communicable Diseases
Prevention and Control Act (2003) that harmonises the
EC Decisions in the field of surveillance and control of
CD and has started to implement that.
is preparing the National Pandemic Preparedness Plan
and Bioterrorism Preparedness Plan
is implementing several national programmes (HIV/AIDS
prevention national programme for the years 2002-2006,
Drug Abuse Prevention Programme 1997-2007, the
second national programme for control of tuberculosis
2004-2007).
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When setting priorities in the area next
principles where considered
Accordance with the strategies and priority areas of the
state
Avoidance of the overlapping of different programmes
Sustainability of the project
Good value for the investment
In addition suggestions of the international audits where
taken into account (International audit made by TAIEX to
our surveillance and control system of CD already at
2001 indicated that there is an urgent need to upgrade
laboratory services)
According to the government decision there is an urgent need to
strengthen capability of the Public Health system in fighting
against serious communicable diseases in Estonia by:
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Improvement of availability and quality of laboratory
services
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renovation of diagnostic laboratories, especially in regions with
high incidence of tuberculosis, HIV/AIDS, viral hepatitis B and C
developing of reference system and elaboration of reference
methodologies
introducing high quality, evidence based and cost-effective
laboratory diagnosis, including emerging pathogens, screening
of donor blood to blood-borne pathogens (procurement of
laboratory equipment and training of laboratory staff)
introducing 4th generation tests to identify HIV
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improvement of availability and quality of preventive,
infection control and treatment services
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improving infection control in hospitals, especially in regions
with high incidence of tuberculosis, HIV/AIDS, viral hepatitis B
and C (renovation of departments for patients with
communicable diseases, including the department for
treatment of HIV infection in newborns and children and TB
departments; renovation of isolation units for providing
intensive care; training courses for hospital staff to avoid
spread of infection inside of the hospital)
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improving of availability of preventive and diagnostic services
in jails and social care institutions in providing mobile X-ray
examination service (procurement of mobile X-ray unit)
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training of general practitioners to diagnose HIV-infection and
prescribe antiviral medicines
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Providing training courses to the social workers at
local level
a) to cooperate with health care workers in finding sources
of infection, their contacts, patients with tuberculosis
who have interrupted treatment course and
b) to support persons recovered from and persons with
serious chronic CD in coping with everyday life in the
community.
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elaboration of national preparedness to
bioterrorism and communicable diseases of
international concern, including novel diseases
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upgrading laboratories to the appropriate biosafety
level needed for handling dangerous pathogens
(renovation of facilities, procurement of
contemporary equipment, diagnostics and training
of staff)
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training of personnel to collect and transport
dangerous infectious samples
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updating the national surveillance and control
system to be able to take part in the activities of
the established European Centre for Prevention of
Communicable Diseases and special networks
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establishing HIV and AIDS register, providing
facilities and IT systems according to the data
protection law, training of staff
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establishing drug abuse treatment register with
needed facilities, training the staff
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elaboration of web-site for the CD programme and
for all other ongoing programmes to improve
communication between professionals at national
and international level.
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Since co-payment is needed and public or
third sector will be the recipient, the
commitment to do the projects under the
priorities was asked from the third side.
15 organizations showed their commitment
presenting corresponding co-finance
Thank you!