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PREVENTABLEDISEASESDEATH
NEWBORN
PERTUSSISRURAL
1
2
KABAK TAMAR
SHIRISH TIWARI
SONU GUPTA
HRITUSHRIVASTAV
PURABI RATH
GR
OU
P M
EM
BE
RS
A vaccine-preventable disease is an infectious
disease for which an effective
preventive vaccine exists.(1)
25 Diseases – WHO. (2)
VACCINE PREVENTABLE
DISEASES
Diphtheria
Pneumonia
Hepatitis B
Measles
Meningitis
Mumps
Pertussis
Poliomyelitis
Rubella
Tetanus
Tuberculosis
Yellow Fever 3
A CHILD DIES EVERY MINUTE FROM PNEUMONIA IN INDIA.(3)
1.4 MN – Children dies every year globally.
1.4 MN > (AIDS + Malaria + TB).(3)
436/1000 Live births – Under-5 children mortality due to Pneumonia.(4)
PNEUMONIAWHY IT IS AN IMPORTANT ISSUE??
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CAUSES- Infectious Agents- Bacteria- Virus- Fungi
COMMON SYMPTOMS- Cough- Chest Pain- Fever- Difficulty Breathing- Diarrhea
MODE OF TRANSMISSION
- Virus & Bacteria present in nose & throat
- Cough/sneeze- Blood
WHAT IS
PNEUMONIA?
Pneumonia is an infection or
Inflammation in one or both
lungs.(6)
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WHYPNEUMONIA IS
PREVALENT?
50% of World’s Pneumonia deaths occur in Indiawhich means approximately 3.7 lakh children die of Pneumonia annually in
India.(7)
VULNERABILITY OF CHILDREN
- Undernourished Children/ Less Breastfed.(8)
- Other illness like AIDS or measles.(8)
- NO/Low vaccine coverage.- Environmental factors like
slum, crowding, parental smoking.
SOCIAL DETERMINANTS
- Region – Urban or Rural- Gender – Male < Female(8)- Mother’s Education(9)- Income Level of Family(9)- Political Stand- Community Approach
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Fig. Pneumonia Proportional Mortality in
India.
Morris SK, Bassani DG, Awasthi S, Kumar R, et al. (2011) Diarrhea, Pneumonia, and Infectious Disease Mortality in Children Aged 5 to 14 Years in India. PLoSONE 6(5): e20119. doi:10.1371/journal.pone.0020119http://www.plosone.org/article/info:doi/10.1371/journal.pone.0020119
CONTRASTING CONDITION OF PNEUMONIA IN INDIA
Gender Bias – Girls mortality is more high than the boys.(8)
Geographical Inequities –North, West and North-East, Highly prevalent.(8)
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DESPITE MANY
EFFORTS,
WHY IT STILL
PERSISTS?
WHOUNICEF
GAPPIMNCI
IAPGoI-MOHFW
KEY POINTS UNADDRESSED- Lack of Social Awareness.- Lack of Proper Primary
Prevention.- No Vaccine Coverage(UIP).- Improper Implementation of
Prevention and Treatment Guidelines issued.
- Less attention from Government
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INTEGRATED EFFORTS
• IMNCI - Integrated Management of Neonatal and Childhood Illnesses - UNICEF
• UIP – Universal Immunization Programme - MOHFW
• GAPP – Global Action Plan For Pneumonia - WHO
WHAT
NEEDSTO BE DONE?
MEASURESPREVENTIONTREATMENT
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PRIMARY PREVENTION
CARE SUPPORT
TREATMENT
INSTITUTIONAL STRENGTHENING
STRATEGIC INFORMATION
SYSTEM
LOW COST & EASY PREVENTION
- Washing hands with soap- Controlling Indoor Air Pollution- Exclusive Breastfeeding- Oral Rehydration- Zinc Supplementation- Availability of Vaccines
REC
OM
MEN
DA
TIO
N
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MEASLES
MEASLES:
CONTAINING THE
CONTAGIOUS
WHY MEASLES
NEEDS
ATTENTION?
A CHILD DIES IN EVERY FOUR HOURS IN INDIA
92,000 – Dies every year in India.
122 000 - Deaths globally.
330 deaths every day or 14 deaths every hour.
Less than 80% - First Dose Vaccine coverage.
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WHAT IS
MEASLES?
“Any person with fever ,maculo-papular rashes and coryza/cough/conjunctivitis.”- WHO
CAUSE- Myxovirus- Vitamin A deficiency- Malnourishment
SYMPTOMS- Fever- Rashes- Cough- Conjunctivitis- Diarrhea
MODE OF TRANSMISSION- Droplet, direct contact
with nasal and throat secretions.
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WHYMEASLES IS
NOT LEAVING
US?
Each year 60000-100000 children die of
measles in India.
EPIDEMIOLOGICAL DETERMINANTS
- Poor living condition.
- Poverty.
- Co-morbid disease
- Suppressed immunity
- Unvaccinated community leading to OUTBREAK
- Inaccessibility to healthcare coverage
- Onset of Winter season.
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WHATIS ITS
MAGNITUDEAND
TRENDS?
VACCINESIMMUNIZATION
PRE-VACCINATION ERA
- Prior to 1960: 8 MN children death/year
- 135 MN/year globally.
- 100-400 times - likely to cause death in developing countries than developed.
MEASLES VACCINATION PERIOD:
- Measles mortality reduces more than three-quarter in all WHO regions except SEAR.
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HOW
TO STOPMEASLES?
MEASURESPREVENTION
CONTROLSTRATEGIES
Planning and Coordination : central, state and DTF
Routine Immunizations : 9mnths of age(6mnths-outbreak)
SIA : catch-up + follow-up campaign
ACSM: multi-sectoral , NGOs , CBOs , professional bodies , religious institutions, media etc.
Human resource management : training, remuneration and capacity buildings 16
WHO STRATEGY: “CATCH-UP, KEEP-UP, FOLLOW-UP”
WHEREARE THE CHALLENGESLIES?
Lack of trained professional Lack of trust in MCV Poor health care delivery system Issues of Social Determinants Measles outbreak HARD TO REACH Population Unpredictable Funding
HOWCAN
WEMOVE
AHEAD?
Improve Vaccine coverage (quality and quantity) Effective treatment measures to prevent
complications Outbreak preparedness Targeted interventions –hard to reach
populations Ensure social equities Building trust to the communities through
multi-sectoral approaches 17
MILLENIUMDEVELOPMENTGOALS
MDG4 GOALS: FOR PNEUMONIA AND MEASLES
Reduce child mortality by two-thirds by 2015 (Vs. 1998).
More than 90% Immunization coverage.
Vaccination Coverage: 90% national and 80% district level.
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REFERENCES
1. http://www.cdc.gov/vaccines/vpd-vac/vpd-list.htm2. http://www.who.int/immunization/diseases/en/3. Times of India - http://tinyurl.com/pazhgme4. The Hindu - http://tinyurl.com/pnrl9zv5. http://www.nlm.nih.gov/medlineplus/pneumonia.html6. IAP Recommendations – Page 1. / www.iapindia.org7. WHO - http://www.who.int/mediacentre/factsheets/fs331/en/8. http://www.plosone.org/article/info:doi/10.1371/journal.pone.00201199. Pneumonia: The Forgotten Killer of Children by UNICEF (pdf)10. Indian pediatrics, vol.49-may16,201211. Global eradication of measles,WHO executive board ,126th session ,26th nov 200912. Millenium development goal India , country report 2011, www.mospi.nic.in13. Operational guidelines for measles catch – up campaign-MoHFW-GoI june 200914. Control of communicable diseases, David l heyman 18th edition p 379-385
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