Transcript Current national emerging infectious disease

Current national emerging
infectious disease threadsBangladesh perspective
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Introduction
• An infectious disease
- is a clinically evident illness resulting from the presence of pathogenic
microbial agents, including pathogenic viruses, pathogenic bacteria, fungi,
protozoa, multi cellular parasites, and aberrant proteins known as prions.
- are also called communicable diseases or transmissible diseases due to their
potential of transmission from one person or species to another by a
replicating agent.
• Infectious Diseases responsible for 15 million (26%) of 57 million
annual deaths in a global population of 6·2 billion
• The prevention and control of communicable diseases represent a
significant challenge to those providing health-care services in
Bangladesh.
• Sound knowledge on the disease epidemiology is a must for the health
service providers in various levels.
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Factors involved in infectious
disease emergence
• International trade and commerce
• Human demographics and behavior
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Human susceptibility to infection
Poverty and social inequality
War and famine
Breakdown of public-health measures
Technology and industry
• Changing ecosystems
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Climate and weather
Intent to harm
Lack of political will
Microbial adaptation and change
Economic development and land use
Morens MD Lancet ID 2008
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Common ID in Bangladesh
The Bangladesh population is namely affected by
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diarrheal diseases,
cholera,
hepatitis A & E,
Malaria,
Mycobacterial Disease like Tuberculosis and Leprosy,
Dengue,
Japanese encephalitis,
Nipah virus infection, etc.
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Factors associated with
transmission
In Bangladesh the following factors are associated
with transmission of Infectious diseases:
– Crowding,
– poor access to safe water,
– inadequate hygiene and toilet facilities,
– unsafe food preparation and handling
practices
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Malaria
• Malaria risk
Bangladesh.
exists
throughout
the
year
in
• Thirteen out of 64 administrative districts are
high malaria endemic areas. 98% of all malaria
cases reported are from these districts, which are
mainly located in the border areas of India and
Myanmar.
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Tuberculosis
• Tuberculosis still remains as a major public health
problem, which ranks Bangladesh fifth among the
high-TB burden countries in the world.
• The present revised National Tuberculosis Program
(NTP) was launched and field implementation of
DOTS (Directly Observed Treatment short course)
was started in 1993.
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Leishmaniasis or Kala Azar
• Leishmaniasis or Kala Azar is endemic in
Bangladesh and has an incidence of 175 per
100,000 per annum.
• It is caused by a protozoa which is transmitted
from the bite of infected sand fly and may
present
in
cutaneous
or
visceral
forms
(particularly common in Bangladesh).
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Filariasis
• Filariasis is a mosquito borne parasitic disease
causing swelling of limbs, urogenital organs,
breast, etc. with long arm disability.
• In Bangladesh, it is endemic in 23 districts,
mostly the bordering ones.
• About 20 million people are already infected,
most of whom are incapacitated.
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Endemic Status of Filarisis in BD
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Leprosy
• Leprosy has been a major health problem in
Bangladesh for a long time.
• Bangladesh was considered a high endemic
country and was listed among ten countries with
high case load(1992).
• Leprosy situation has changed globally after 1981
when the Multi Drugs Treatment (MDT) were
introduced.
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Newly detected cases of Leprosy
(January – December 2008)
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Hepatitis
• Hepatitis A virus infection is common in
Bangladesh with a prevalence of about 2% to
7%.
• Prevalence of hepatitis C virus infection is less
than 1%. Sporadic outbreak is often seen caused
by hepatitis E virus infection; but presence of
hepatitis D infection is not exactly known.
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Polio
• Polio free status prevailed from 2001 until now
(June 2009) except a small window period in
2006 when 18 cases of child polio were seen in
boarder areas of Bangladesh.
• It is assumed that these cases were imported
from India.
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Dengue
• Dengue fever/Dengue haemorrhagic fever (DF/
DHF) is a viral disease transmitted by the Aedes
aegypty mosquito.
• It is on the increase in South East Asia.
• Bangladesh reported 100,000 cases in 2005.
However case fatality rate (CFR) remained <1%
up to 2006.
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Source: Dengue Program, DGHS, Mohakhali, Dhaka
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Diarrhea
– The Diarrheal disease is endemic in all countries of the
South East Asia Region that includes Bangladesh.
– The diseases causes the bulk of the under five mortality
in Bangladesh.
– The main cause of death from acute diarrhea is
dehydration resulting from loss of fluids and electrolytes.
– The diarrhoeal diseases are of two types eatery diarrhea
and bloody diarrhea (dysentery).
– Several microorganisms cause the disease, but major
organisms responsible for the disease are V. cholera and
Shigella.
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Diarrhoeal Report by Division and by Year (2001-2008)
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Nipah Encephalitis
• Nipah is a zoonotic viral disease first identified in Nipah
village of Malaysia in 1998-1999.
• In Bangladesh, Nipah emerged as a new killer disease from
2001.
• It may be manifested as a mild form of viral fever to severe
form causing encephalitis or severe respiratory distress
syndrome.
• Nipah experience in Bangladesh shows that the disease is a
highly fatal one. So far 7 outbreaks have been recorded in
Bangladesh.
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Suspected Nipah outbreak in Bangladesh
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HIV/AIDS
• Since 1989 a total cumulative of 1495 cases of HIV/AIDS
have been confirmed and reported as end of November
2008.Of which 476 have developed AIDS out of whom 165
have since died.
• December 2007 to November 2008 a total of 288 new HIV
infection recorded and reported, of which 111 new AIDS
cases identified of whom 42 died. The estimated total
number of people living with HIV/AIDS is around 7,500 as
of December 2006.
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Yearly Cases of HIV-AIDS (2003 to 2008)
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Avian Influenza (Bird flu)
• Avian Influenza or "Bird flu" is a contagious disease of animals
caused by viruses that normally infect only birds and less commonly
pigs.
• Avian influenza viruses are highly species-specific, but on rare
occasions cross the species barrier to infect humans.
• So far one Avian Influenza case has been identified in Bangladesh on
22 May 2008, but the person is still surviving.
• Total case reported to WHO till 11 February 2009 is 407. Total
numbers of deaths are 254.
• Case Fatality is calculated as 63%.
• Since the detection of the first case in our country, Bangladesh is
kept in Pandemic Alert Period.
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Source: Bangladesh Bureau of Statistics (population) and WHO Global Tuberculosis Report (2009)
(other indicators)
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