[Script Info]
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[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:05.01,0:00:09.00,Default,,0000,0000,0000,,In this session, we shall talk about epidemics.
Dialogue: 0,0:00:09.00,0:00:12.07,Default,,0000,0000,0000,,What do you understand by the term 'Epidemic'\Nor 'Outbreak'?
Dialogue: 0,0:00:12.07,0:00:19.07,Default,,0000,0000,0000,,An epidemic (or outbreak) is the occurrence\Nof a disease in excess of what is expected
Dialogue: 0,0:00:19.07,0:00:24.10,Default,,0000,0000,0000,,in a particular community, for a particular\Ngroup of people, within a certain period of
Dialogue: 0,0:00:24.10,0:00:27.08,Default,,0000,0000,0000,,time.
Dialogue: 0,0:00:27.08,0:00:35.03,Default,,0000,0000,0000,,Other terms related to epidemics: endemic\Nrefers to the constant presence of a disease
Dialogue: 0,0:00:35.03,0:00:40.04,Default,,0000,0000,0000,,or infectious agent within a given geographic\Narea or population group.
Dialogue: 0,0:00:40.04,0:00:46.09,Default,,0000,0000,0000,,It is the usual or expected frequency of disease\Nwithin a population.
Dialogue: 0,0:00:46.09,0:00:54.01,Default,,0000,0000,0000,,Pandemic, on the other hand refers to an epidemic\Noccurring simultaneously in multiple locations
Dialogue: 0,0:00:54.01,0:00:59.02,Default,,0000,0000,0000,,world-wide.
Dialogue: 0,0:00:59.02,0:01:04.10,Default,,0000,0000,0000,,As an example from your country, we see that\Nepidemics are the commonest Public Health
Dialogue: 0,0:01:04.10,0:01:08.06,Default,,0000,0000,0000,,emergency in our districts across the East\NAfrica region.
Dialogue: 0,0:01:08.06,0:01:15.08,Default,,0000,0000,0000,,In Uganda for example, 6 outbreaks occurred\Nin 8 months in 2007.
Dialogue: 0,0:01:15.08,0:01:23.01,Default,,0000,0000,0000,,This included Cholera, Meningitis, Hepatitis\NE, Marburg, Plague and Ebola.
Dialogue: 0,0:01:23.01,0:01:31.93,Default,,0000,0000,0000,,Can you name 5 outbreaks that have occurred\Nrecently in your district?
Dialogue: 0,0:01:31.93,0:01:39.12,Default,,0000,0000,0000,,Common epidemic prone diseases include diarrhoeal\Ndiseases including watery diarrhoea, Cholera,
Dialogue: 0,0:01:39.12,0:01:41.72,Default,,0000,0000,0000,,dysentery and typhoid.
Dialogue: 0,0:01:41.72,0:01:46.100,Default,,0000,0000,0000,,These are likely to occur in many districts\Nin the East Africa region.
Dialogue: 0,0:01:46.100,0:01:51.61,Default,,0000,0000,0000,,Outbreaks of immunisable diseases like measles.
Dialogue: 0,0:01:51.61,0:01:56.02,Default,,0000,0000,0000,,These are common because immunisation coverage\Nis low.
Dialogue: 0,0:01:56.02,0:02:03.02,Default,,0000,0000,0000,,Malaria is endemic in most parts of Eastern\NAfrica, especially in low land areas; however,
Dialogue: 0,0:02:03.02,0:02:08.08,Default,,0000,0000,0000,,outbreaks can occur in both low and highland\Nareas.
Dialogue: 0,0:02:08.08,0:02:14.10,Default,,0000,0000,0000,,In areas where Malaria is endemic, outbreaks\Noccur when the threshold far exceeds what
Dialogue: 0,0:02:14.10,0:02:20.06,Default,,0000,0000,0000,,is expected for that season.
Dialogue: 0,0:02:20.06,0:02:26.00,Default,,0000,0000,0000,,Other epidemic prone diseases include Sexually\NTransmitted Infections including HIV/AIDS,
Dialogue: 0,0:02:26.00,0:02:36.05,Default,,0000,0000,0000,,Syphilis, Gonorrhea, and others, Plague, Hepatitis\NE, a massive chemical poisoning, especially
Dialogue: 0,0:02:36.05,0:02:43.05,Default,,0000,0000,0000,,from illicit alcohol, which has become a common\Npublic health problem in Eastern
Dialogue: 0,0:02:43.05,0:02:45.04,Default,,0000,0000,0000,,Africa.
Dialogue: 0,0:02:45.04,0:02:50.01,Default,,0000,0000,0000,,Let us look at a case study 1.
Dialogue: 0,0:02:50.01,0:02:57.05,Default,,0000,0000,0000,,Refer to the word document on your CD.
Dialogue: 0,0:02:57.05,0:03:03.03,Default,,0000,0000,0000,,The questions: Is this a scenario that could\Noccur in your district? And how did the district
Dialogue: 0,0:03:03.03,0:03:08.00,Default,,0000,0000,0000,,authorities establish that there is an outbreak?
Dialogue: 0,0:03:08.00,0:03:14.07,Default,,0000,0000,0000,,In detecting an outbreak, we have to obtain\Ninitial notification of the outbreak.
Dialogue: 0,0:03:14.07,0:03:20.03,Default,,0000,0000,0000,,We receive information about the likelihood\Nof an outbreak from the community, and from
Dialogue: 0,0:03:20.03,0:03:23.10,Default,,0000,0000,0000,,cases coming to health units, and from local\Nleaders.
Dialogue: 0,0:03:23.10,0:03:32.05,Default,,0000,0000,0000,,We therefore have to have an effective early\Nwarning system that is linked to the communities.
Dialogue: 0,0:03:32.05,0:03:40.00,Default,,0000,0000,0000,,The golden rule in detecting outbreaks is\Nthat every rumour must be investigated.
Dialogue: 0,0:03:40.00,0:03:46.01,Default,,0000,0000,0000,,In detecting an outbreak, we must have a case\Ndefinition for the diseases and this should
Dialogue: 0,0:03:46.01,0:03:52.04,Default,,0000,0000,0000,,be known by the frontline health workers and\Nthen they must also be made for a community
Dialogue: 0,0:03:52.04,0:03:53.08,Default,,0000,0000,0000,,case definition.
Dialogue: 0,0:03:53.08,0:04:01.08,Default,,0000,0000,0000,,Secondly, there must be an un-expected rise\Nin new cases of these diseases beyond the
Dialogue: 0,0:04:01.08,0:04:05.10,Default,,0000,0000,0000,,threshold.
Dialogue: 0,0:04:05.10,0:04:13.01,Default,,0000,0000,0000,,You look at the word document station activities\Nand read the standard case definitions for
Dialogue: 0,0:04:13.01,0:04:16.04,Default,,0000,0000,0000,,some academic prone diseases.
Dialogue: 0,0:04:16.04,0:04:26.08,Default,,0000,0000,0000,,For instance, what is the standard case definition\Nfor polio, measles, cholera, bola, and bacterial
Dialogue: 0,0:04:26.08,0:04:28.08,Default,,0000,0000,0000,,meningitis?
Dialogue: 0,0:04:28.08,0:04:34.02,Default,,0000,0000,0000,,Case definitions may be changed according\Nto the locality and the nature of the symptoms
Dialogue: 0,0:04:34.02,0:04:39.10,Default,,0000,0000,0000,,presenting in a particular outbreak situation.
Dialogue: 0,0:04:39.10,0:04:46.10,Default,,0000,0000,0000,,The District Rapid Reaction Team (RRT) can develop a working case\Ndefinition where there is no standard case
Dialogue: 0,0:04:46.10,0:04:53.07,Default,,0000,0000,0000,,definition depending on common symptoms and\Nrisk factors related to the syndrome that
Dialogue: 0,0:04:53.07,0:04:56.00,Default,,0000,0000,0000,,has broken out.
Dialogue: 0,0:04:56.00,0:05:00.00,Default,,0000,0000,0000,,Can you suggest a case definition for the\Nfollowing?
Dialogue: 0,0:05:00.00,0:05:05.05,Default,,0000,0000,0000,,1. An outbreak of sudden alcohol related illness\Nand deaths in zone X
Dialogue: 0,0:05:05.05,0:05:16.06,Default,,0000,0000,0000,,2. An outbreak of dysentery in camp Y\N3. An outbreak of sudden food-related illness
Dialogue: 0,0:05:16.06,0:05:21.01,Default,,0000,0000,0000,,and deaths in a village Z
Dialogue: 0,0:05:21.01,0:05:27.00,Default,,0000,0000,0000,,Some epidemic prone diseases exist in the\Ncommunity even without an outbreak.
Dialogue: 0,0:05:27.00,0:05:33.01,Default,,0000,0000,0000,,An example is malaria, which is prevalent\Nin many parts of Eastern Africa.
Dialogue: 0,0:05:33.01,0:05:39.08,Default,,0000,0000,0000,,For an outbreak to be declared, there must\Nbe a sharp rise in cases beyond the expected
Dialogue: 0,0:05:39.08,0:05:44.01,Default,,0000,0000,0000,,threshold for a particular season.
Dialogue: 0,0:05:44.01,0:05:50.00,Default,,0000,0000,0000,,Some epidemic prone diseases do not exist\Nnormally in the community.
Dialogue: 0,0:05:50.00,0:05:54.05,Default,,0000,0000,0000,,The occurrence of just one confirmed case\Nis considered an outbreak.
Dialogue: 0,0:05:54.05,0:05:58.04,Default,,0000,0000,0000,,An example is cholera.
Dialogue: 0,0:05:58.04,0:06:01.01,Default,,0000,0000,0000,,Some epidemic prone diseases are rare and\Nhighly deadly when they occur.
Dialogue: 0,0:06:01.01,0:06:06.08,Default,,0000,0000,0000,,We do not have to wait for confirmation of\Na case.
Dialogue: 0,0:06:06.08,0:06:10.06,Default,,0000,0000,0000,,Just one suspected case is enough to consider\Nan outbreak.
Dialogue: 0,0:06:10.06,0:06:13.08,Default,,0000,0000,0000,,An example is ebola.
Dialogue: 0,0:06:13.08,0:06:18.06,Default,,0000,0000,0000,,Therefore, thresholds differ from disease\Nto disease.
Dialogue: 0,0:06:18.06,0:06:21.06,Default,,0000,0000,0000,,In cholera, just one confirmed case.
Dialogue: 0,0:06:21.06,0:06:24.02,Default,,0000,0000,0000,,In ebola, one suspected case.
Dialogue: 0,0:06:24.02,0:06:31.01,Default,,0000,0000,0000,,In measles, a cluster of 5 or more suspected\Ncases OR at least 3 confirmed positive cases
Dialogue: 0,0:06:31.01,0:06:37.02,Default,,0000,0000,0000,,in a catchment area of a health facility occurring\Nin one month.
Dialogue: 0,0:06:37.02,0:06:44.02,Default,,0000,0000,0000,,For malaria, because it is embedded in many\Nparts of Eastern Africa, an outbreak occurs
Dialogue: 0,0:06:44.02,0:06:53.04,Default,,0000,0000,0000,,when there is a sharp seasonal rise in cases\Nbeyond the usual number of expected cases.
Dialogue: 0,0:06:53.04,0:07:04.06,Default,,0000,0000,0000,,Let us look at the second case study, which\Nis one of the documents on the CD.
Dialogue: 0,0:07:04.06,0:07:11.06,Default,,0000,0000,0000,,Let us read through this case study, and the\Nquestions for general discussion are: How
Dialogue: 0,0:07:11.06,0:07:17.03,Default,,0000,0000,0000,,do you think the District and Ministry of\NHealth officials went about investigating
Dialogue: 0,0:07:17.03,0:07:19.08,Default,,0000,0000,0000,,this particular outbreak?
Dialogue: 0,0:07:19.08,0:07:25.00,Default,,0000,0000,0000,,What do you understand by the term 'early\Nresponse'?
Dialogue: 0,0:07:25.00,0:07:37.70,Default,,0000,0000,0000,,Steps in investigating an outbreak: Step 1.\NInitial response and confirmation of outbreak.
Dialogue: 0,0:07:37.70,0:07:45.04,Default,,0000,0000,0000,,It is important to assemble a team and prepare\Nfor an initial field visit as soon as possible.
Dialogue: 0,0:07:45.04,0:07:51.08,Default,,0000,0000,0000,,Two, it is important to choose a working case\Ndefinition and confirm cases.
Dialogue: 0,0:07:51.08,0:07:54.08,Default,,0000,0000,0000,,Three, find cases systematically.
Dialogue: 0,0:07:54.08,0:08:01.00,Default,,0000,0000,0000,,Four, confirm whether there is an outbreak\Nby comparing occurrence of cases with thresholds.
Dialogue: 0,0:08:01.00,0:08:07.08,Default,,0000,0000,0000,,And five, describe who is affected, when and\Nwhere?
Dialogue: 0,0:08:07.08,0:08:14.08,Default,,0000,0000,0000,,Step 2: Manage and identify cases.
Dialogue: 0,0:08:14.08,0:08:22.02,Default,,0000,0000,0000,,Establish a district task force and allocate\Nthem their responsibilities.
Dialogue: 0,0:08:22.02,0:08:30.02,Default,,0000,0000,0000,,Use the working case definition to find cases\Nand set up a treatment centre.
Dialogue: 0,0:08:30.02,0:08:34.58,Default,,0000,0000,0000,,Step 3: Set up immediate control measures.
Dialogue: 0,0:08:34.58,0:08:38.08,Default,,0000,0000,0000,,Treat cases to interrupt transmission and\Nreduce deaths.
Dialogue: 0,0:08:38.08,0:08:45.02,Default,,0000,0000,0000,,Consider vaccination, disinfection and protective\Nwear.
Dialogue: 0,0:08:45.02,0:08:48.06,Default,,0000,0000,0000,,Provide health education to those at risk.
Dialogue: 0,0:08:48.06,0:08:53.08,Default,,0000,0000,0000,,Communicate clearly to reduce panic and prevent\Nspread of the disease.
Dialogue: 0,0:08:53.08,0:08:57.06,Default,,0000,0000,0000,,Step 4: Address the resource gaps.
Dialogue: 0,0:08:57.06,0:09:02.01,Default,,0000,0000,0000,,Ensure adequate medical supplies and logistics\Nto handle cases.
Dialogue: 0,0:09:02.01,0:09:07.06,Default,,0000,0000,0000,,Look for additional resources to address the\Ngaps and contact Ministry of Health and partner
Dialogue: 0,0:09:07.06,0:09:12.02,Default,,0000,0000,0000,,agencies in case the resources are inadequate.
Dialogue: 0,0:09:12.02,0:09:19.08,Default,,0000,0000,0000,,Step 5: Determine responsible factors for the \Noutbreak and make a report.
Dialogue: 0,0:09:19.08,0:09:24.01,Default,,0000,0000,0000,,Analyse available information to establish\Nthe risk factors.
Dialogue: 0,0:09:24.01,0:09:29.06,Default,,0000,0000,0000,,Prepare a report and ensure that it is disseminated\Nto those who need to know and those who need
Dialogue: 0,0:09:29.06,0:09:30.07,Default,,0000,0000,0000,,to take action.
Dialogue: 0,0:09:30.07,0:09:48.03,Default,,0000,0000,0000,,On the report, you ought to recommend and\Nimplement priority control measures.
Dialogue: 0,0:09:48.03,0:09:42.01,Default,,0000,0000,0000,,And Step 6: Be on your guard.
Dialogue: 0,0:09:42.01,0:09:49.02,Default,,0000,0000,0000,,Strengthen the existing surveillance system\Nto find cases actively and learn from this
Dialogue: 0,0:09:49.02,0:09:52.07,Default,,0000,0000,0000,,outbreak to respond better in future.
Dialogue: 0,0:09:52.07,0:09:58.08,Default,,0000,0000,0000,,Put in place measures to prevent similar outbreaks\Nin the future.
Dialogue: 0,0:09:58.08,9:59:59.99,Default,,0000,0000,0000,,Thank you for listening.