Malaria Management for Oil/Gas Workers: A Comprehensive
Transcripción
Malaria Management for Oil/Gas Workers: A Comprehensive
Malaria Management for Oil/Gas Workers: A Comprehensive Malaria Control Project on Bioko Island, Equatorial Guinea Susan Rynard, Rynard MSPH Epidemiology & Population Health Marathon Oil Company Malaria in Africa One million deaths per year 90% are children under 5; accounts for half of infant mortality Heavy burden on healthcare systems – 25–35 percent of outpatient visits – 20–45 percent of hospital admissions – 15–35 percent of hospital deaths Huge economic impact – $12 Bn per year, or 1.3% of GDP – Up to 25% of net income 2 DRAFT Tracking Info Here Malaria Prevalence Entomological Inoculation Rate (EIR) and Malaria Prevalence in Africa Equatorial Guinea Spielman et al (pre-investment study estimates) Annual EIR Source: 3 DRAFT Tracking Info Here Project Business Case 2001-2002 Morbidity/Mortality, EG 1999-2003 Malaria Prevalence, Workers 40.0% % off Sickness 35 0% 35.0% 30.0% 25.0% Philippi nes 14% Europa/ SA 3% Other 1% US 4% 20 0% 20.0% 15.0% India 17% 10.0% 5 0% 5.0% E.Guine E Guine a 61% 0.0% Malaria Respiratory Diarrheal Disease Disease Corporate Social Responsibility Opportunity Prevalence, P l Vi Virulence l ≈ High Hi h Ab Absenteeism, t i L Low P Productivity d ti it 4 DRAFT Tracking Tracking InfoInfo HereHere Project Partners Business Government NGOs OWDG Ministerio de Sanidad y Bienestar Social Academia 5 DRAFT Tracking Info Here Malaria Control Interventions Inside the plant Screening Fogging Protective clothes Chemoprophylaxis (non-resident workers) Island-wide Indoor residual spraying since 2004 Improved case management (RDTs, ACTs, IPT)) Bednet promotion and distribution since 2007 IEC campaigns p g 6 DRAFT Tracking Tracking InfoInfo HereHere Monitoring and Evaluation 18 sentinel sites/106 traps Daily D il catches t h ffor number/species Sporozoite rates text Marathon clinic records (workers) Annual A lh household h ld survey Spray history All All-cause cause child mortality Maternal morbidity Knowledge/attitudes Parasitemia/anemia P it i / i 7 DRAFT Tracking Tracking InfoInfo HereHere Capacity building and integration Detailed integration strategy developed with Ministry of Health in 2004 97% of all staffs are EquatoGuinean All operations run by EquatoGuineans – MOHSW doctors, nurses, lab techs and pharmacists – IRS teams National Malaria Control managers trained and supplied p with computers Support to development of national Health Information System Cuadro A-1: Diagrama de Riesgo-Influencia-Impacto Suficiencia de Apropiaciones Presupuestales (18) Indicadores de Desempeno del Componente de Eficacia del Sistema de Aprovisionamiento, 100% Control de Vector (2) Almacenaje, y Distribucion (8) 90% Salud y Seguridad en el Trabajo (2) Adquirir y Procesar Data (7) 80% 70% de Recursos Humanos (2) 50% 40% e Mantenimeinto (2) DRAFT Tracking Info Here Suficiencia del Plan de Ent 30% 20% 10% cidad id d AAnalitica liti (2) C tid d/C lid d dde EEntt Cantidad/Calidad 0% on Intra-sectoral (2) Suficiencia de Informacion os Sistemas Logisticas (2) Equidad de Acceso (4) Pertinencia del Curiculo (4) Relaciones con la Comunidad (3) Suficiencia de Monitorear y Supervisar (4) Suficiencia del Sistema de Control de Calidad (3) Capacidad del Sistema de Evaluacion del Desempeno (4) Riesgo 8 Cantidad y Calidad de Recursos 60% Influencia Impact Vector Control Results, Island 9 DRAFT Tracking Info Here Malaria Incidence by Quarter, Workers 95% of cases were diagnosed with an RDT Most M t episodes i d were caused d by b Plasmodium Pl di ffalciparum l i Fig 1: Malaria cases registered in Punta Europa clinic, Bioko Island 1999-2007 180 160 140 120 cases 100 80 60 40 20 quarter 1 2 3 4 5 Spray rounds 10 DRAFT Tracking Info Here 6 22007-3 22007-1 22006-3 22006-1 22005-3 22005-1 22004-3 22004-1 22003-3 22003-1 22002-3 22002-1 22001-3 22001-1 22000-3 22000-1 1999-3 0 7 Malaria Incidence by Month, Workers malaria case es/200,000 M MH Monthly malaria incidence rate among AMPCO workers Bioko Island workers, Island, 2004 2004-2006 2006 16 14 12 10 8 6 4 2 0 Jan Feb Mar Apr May Jun 2006 11 Jul 2005 DRAFT Tracking Info Here Aug Sept Oct 2004 Nov Dec Key Project Results, Island Reduced malaria infectivity among mosquitoes it 3.00 Reduced malaria infectivity among Children 50% 45% 2.50 ‐49% 40% 35% ‐99% 2.00 30% 1.50 25% 20% 1.00 15% 0.50 10% 5% 0.00 Pre‐Spraying Post Spray Round 1 (2004) Post Spray Round 2&3 (2005) Post Spray Round 4&5 (2006) Post Spray Round 6&7 Average number of infected mosquitoes caught in homes per 100 nights 12 0% P S Pre‐Spraying i 2005 S 2005 Survey 2006 S 2006 Survey 2007 S 2007 Survey 2008 S 2008 Survey Percentage of children on Bioko Island with malaria parasites in their blood DRAFT Tracking Info Here Questions 13 DRAFT Tracking Info Here