Date post: | 04-Jan-2016 |
Category: |
Documents |
Upload: | adelia-simon |
View: | 218 times |
Download: | 3 times |
Study on the Association between having an Effective
Health Emergency Response to Leptospirosis and the
Presence of a Functionally Prepared Health Emergency
Response System in high risk barangays during
typhoon Ondoy
TYPHOON ONDOY
Leptospirosis Cases
Department of Health Department Memorandun No. 2009 – 0250
• Issued last Oct. 16, 2009• Doxycycline prophylaxis
– Communities that experienced flooding and have a high number of suspected cases
– Volunteers, government workers and soldiers who helped in the rescue operations
• Risk of infection and doxycycline doseRISK DESCRIPTION DOXYCYCLINE DOSE
Low Risk Single history of wading in flood or contaminated water
Absence of wounds, cuts, open lesions
2 capsules of 100mg single dose within 24 – 72 hours
Moderate Risk Single history of wading in flood or contaminated water
Presence of wounds, cuts, open lesions
Accidental ingestion of contaminated water
2 capsules of 100mg once a day for 3 – 5 days to be
started immediately within 24 – 72 hours from exposure
High Risk Continuous exposure of wading in flood or
contaminated water with or without wounds, cuts, open
lesionsSwimming in flooded water
and ingestion of contaminated water
2 capsules of 100mg once weekly until the end of
exposure
WHO: Diagnostic Services, Surveillance and Outbreak Management of Leptospirosis
• Screening methods can be used to confirm the diagnosis of Leptospirosis – Screening methods for anti-leptospira antibodies– IgM ELISA– Microscopic Agglutination Tests
• Philippine setting– Proper history taking– Clinical judgment
• Education to the public– Identification of Leptospirosis– Importance of seeking immediate treatment– How to limit exposure
• Environmental aspect– Recognize contaminated sources of water and
drain them– Control rodent population
Statement of the ProblemThis study would like to determine the presence
of an association, if any, between having an effective health emergency response to
Leptospirosis and the presence of a functionally prepared health emergency
response system in a barangay at high risk for Leptospirosis after Typhoon Ondoy
Significance of the Study
Research Hypothesis
Barangays at high risk of Leptospirosis after Typhoon Ondoy did not have a functionally
prepared health emergency response system (HERS) to mount an effective health
emergency response
Scope and Limitations
Research Objectives• General Objective
To determine the presence of an association, if any, between having an effective health emergency response to Leptospirosis and the presence of a
functionally prepared health emergency response system in barangays at high risk for Leptospirosis
after Typhoon Ondoy
• Specific ObjectivesTo determine if barangays were also able to have an
effective health emergency response to the Leptospirosis outbreak despite not having a
functionally prepared health emergency response system and to see what other factors contributed to
the effectiveness of the response
Research DesignThis case control study is designed to assess
and/or determine the presence of an association, if any, between having an effective health emergency response to
Leptospirosis and the presence of a functionally prepared health emergency
response system in flood-stricken barangays during Typhoon Ondoy
Tool for Data Collection: Interview
• Checklist• Pre-testing of the proposed interview
questionnaire will be done before the actual data collection process
Selection of Study Subjects
• Stratified random sampling– Pasig, Marikina, Cainta and Taytay– P value of 0.05– Pre-testing
Sampling Methods
Purposive Sampling
Stratified Simple Random Sampling
Variables and Operational Definitions
• Case– Barangays which were not able to mount an
effective health emergency response to the Leptospirosis outbreak
• Control– Barangays which were able to mount an effective
health emergency response to the outbreak
• Exposure– Dependent on the barangay having a functionally
prepared health emergency response system
Independent Variables• Variables that Determine a Functionally
Prepared HERS – Staff– Meetings– Trainings – Policies– Information dissemination– Other factors which the health workers think
made their HERS effective
• Staff– Two health workers for every 5,000 population in
the barangay
• Meetings– The barangay health office conducts meeting to
coordinate staff regarding treatment guidelines and planning
• Training– Pertain to the health health workers with a degree
or certification in health care ( e.g. nurse, medical technologist or midwife)
• Policies– Refers to the health center’s standard guidelines on
Leptospirosis prevention and treatment, and/or NDCC guidelines on disaster control during floods and/or Local Government policies on barangay health emergency services
• Information Dissemination– Availability of resource or teaching materials
(pamphlets, visual aids) about Leptospirosis and adequate prevention measures
• Others– Factors which the health workers think made their
HERS effective (like assistance, etc.)
Dependent Variables
• Variables that determine an effective Health Emergency Response System – Knowledge on Leptospirosis diagnosis, prophylaxis
and management– Referral System – Patient Education on Leptospirosis prevention
• Knowledge on Leptospirosis diagnosis, prophylaxis and management– Having adequate knowledge about the clinical
manifestations of Leptospirosis; symptoms to suspect; risk factors; management of suspected cases
• Referral System– Appropriate referrals to secondary and tertiary-
level hospitals to manage severe Leptospirosis cases
• Patient Education on Leptospirosis prevention– Properly educating or informing residents in high-
risk communities about the identification, management, and prevention of leptospirosis
Potential Biases
• Recall bias• Response Bias• Hawthorne Effect• Selection Bias
Data Collection Procedure
Data Processing
• Two Way tables – Where data collected will be encoded and
tabulated in
• One Way Frequency Tables – for descriptive interpretation
PLAN FOR ANALYSIS
Independent Variable
• The functional preparedness of the system will be measured by different factors:– Policies– Staff– Meetings– Information dissemination– Training
Dependent Variables
• The effective response to Leptospirosis will be quantified by different factors– Knowledge on Leptospirosis diagnosis, prophylaxis
and management– Referral system– Patient education on Leptospirosis prevention
Statistical / Analytical Tool of Measurement
DISEASE STATUS (Effective Health Emergency Response) Total
EXPOSURE FACTOR (Functional HERS)
Case: Barangays W/O an Effective Health Emergency Response
Control: Barangays W/ an Effective Health Emergency Response
Exposed (Barangays w/c are functionally prepared for a Health Emergency Response)
A B A + B
Unexposed (Barangays w/c are not functionally prepared for a Health Emergency Response)
C D C + D
Total A + C B + D A + B + C + D
Odds Ratio (AD/BC)
OR will be used to determine if there is an association between a functional HERS and an effective response to Leptospirosis.
Chi-Square Test• To be used to all nominal (categorical) data to determine if a
significant relationship exists b/w the variables.• Sampling population will be grouped:
– Ex. With staff/No staff With training/No training
• Set CI at 95% and α=0.05• Hypothesis Testing
Logistic Regression
• Presence of >2 independent variables• To examine the contribution of each variable in order
to mount an effective response to Leptospirosis• To find out possible interactions b/w the different
independent variables
Statistical Analysis
Will use the SPSS 17 (PASW 18) software.
Plan for Dissemination of the Results of the Study
• Baseline study:– further research needed
• The results obtained: – Government institutions– Ateneo School of Medicine and Public Health– Respondents of the study
WorkplanActivity Duration Pre-requisites
Preparation for Pretest 1 week (1st week of March) Determine pre test samples Contact barangays Fill out interview schedule table
Actual Pre Test 2 weeks Preparation for Pretest
Validation of Results 1 week Pre Test
Preparation for Actual Data Collection
1 week (April) Contact barangays Fill out interview schedule table
Actual Data Collection 3 weeks Preparation for Actual Data Collection
Analysis of Data Results 1 week (May) Completed Data Collection
Final Research Paper writing 2 weeks Completed Data Collection and Analysis
Finalization of Research Paper 1 week Completed Research Paper
BudgetITEM QUANTITY UNIT COST TOTAL COST
A4 bond paper 500 pages 50 cents Php 250.00
Ink cartridge 2 Php 500.00 Php 1,000.00
Photocopy expenses:
Questionnaire
360 pages 50 cents Php 180.00
Travel expenses: Gasoline
120L Php 40.00 Php 4,800.00
Token for barangays ˜30 Php 100 Php 3,000.00
TOTAL Php 9,230.00