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Tangerang: More than 400 Medical Crews Mobilized to Stop Pneumonia

Commonground

Commonground

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More than 400 Medical Crews Mobilized to Stop Pneumonia
Friday, 22 August, 2008 | 00:01 WIB

TEMPO Interactive, Tangerang: The Health Department for Tangerang Regency mobilized more than 400 medical crews including physicians, midwives, and nurses, to stop pneumonia in entire villages in Tangerang that had mostly attacked children under five.

?The crews are well trained to diagnose disease in babies,? said the Head of Disease Prevention Eradication and Sanitation at the Tangerang Health Department Yully Soenar Dewanti to Tempo, yesterday.

Yully explained the crews will go to forty health community centers (Puskesmas) and other clinics. The Department expected to detect the pneumonia and other diseases as early as possible.

Pneumonia has threatened Tangerang recently. Every month, more than 500 children under five are detected with pneumonia. The Health Department reported 3,328 cases were found this year alone. It included 517 cases in January, 570 in February, 598 in March, 639 in April, and 598 cases in June.

Patients with pneumonia continually increase. 5,690 cases were found in 2006 and 7,695 in 2007 while in 2008, it has already reached half of the number of cases from last year.

The cases can be detected as the Department has applied integrated management at the health community centers (puskesmas). ?We map the result of the examination,? she said. Children with pneumonia are handled directly by special physicians while children with malnutrition are treated by nutritionists.

The Health Department in Tangerang has operated 1,700 nutritional centers in 36 sub-districts to monitor the health and growth of children under five.

?The centers are built in cooperation with the regional government and community. Thirty percent of the budget comes from the community while the rest is from the regional government,? said Head of the Family Health Division at the Tangerang Health Department Reniati to Tempo.

Joniansyah
http://www.tempointeractive.com/hg/n...131952,uk.html
hat-tip Clawdia
 
Re: Tangerang: More than 400 Medical Crews Mobilized to Stop Pneumonia

(Bacterial) pneumonia, especially in young children is associated with poverty and malnutrition. You can find similar reports from other poor regions in Asia or Africa.

TB - also a poor man's disease - is the killer # 1 in many regions, including Indonesia: every day 300 die from TB in Indonesia.

Recently respiratory diseases and pneumonia in young childeren were reported from Tangerang. Health Service put 400 teams together for diagnose and treatment.

Tangerang is THE hotspot for human cases of H5N1, so definitely a region to watch. However this action of the Health Service seems not directly related to a human outbreak of H5N1, no further "circumstancial evidence".
 
Re: Tangerang: More than 400 Medical Crews Mobilized to Stop Pneumonia

However this action of the Health Service seems not directly related to a human outbreak of H5N1, no further "circumstancial evidence".
Click to expand...

I believe that the circumstances are indeed very suspicious. They have had problems with pneumonia for years. I do not ever recall 400 medical teams being deployed to any specific region, for any specific disease.

The reason I think it is suspicious is because of the history of H5N1 cases confirmed this year in Tangerang. And that is a coincidence. I don't believe in too many coincidences.
 
Re: Tangerang: More than 400 Medical Crews Mobilized to Stop Pneumonia

Apparently this pneumonia is causing illness in children under 5. I do not see mention of young adults being ill. One target age group for H5N1 are the young adults.

Without epidemiological studies and with the Indonesian government reporting H5N1 infections infrequently, rumours are beginning to abound.

This is exactly what FT predicted when the Indonesian government announced it would have a new and less frequent reporting system for human H5N1 infections.

I urge the Indonesian government - and all governments - to provide transparency regarding their current infection status of all novel influenza strains.
 
Re: Tangerang: More than 400 Medical Crews Mobilized to Stop Pneumonia

I'm fairly convinced there is something unusual about Tangerang, too. First, it was the swine in 2005 and after the relatively small culling, there isn't much more to be found on testing, etc. Then we've had all those human deaths and now the large number of kids with pneumonia.

When I saw this article, which I posted http://www.flutrackers.com/forum/showthread.php?t=77687, I wondered if there were any of these fires near Tangerang but I can't enlarge the pic enough to really tell. It does look like there are some near the area when I compared a Google map.
 
Re: Tangerang: More than 400 Medical Crews Mobilized to Stop Pneumonia

What are you thinking, mixing? Are you thinking there is more to the fires than we know??? Are they destroying evidence???
 
Last edited:
Re: Tangerang: More than 400 Medical Crews Mobilized to Stop Pneumonia

Siam,
I'm just wondering if the smoke was close enough to contribute to some of the current lung problems.
 
Re: Tangerang: More than 400 Medical Crews Mobilized to Stop Pneumonia

Oh Good, my imagination got carried away,thanks for clarifying that.
 
Re: Tangerang: More than 400 Medical Crews Mobilized to Stop Pneumonia

Usually, in third-world countries large number of medical squads are deployed to cope with endemic illness (ie: tb, malaria, diarrhea, etc.) The squads are also involved in polio eradication so they are aware of local health needs, population distribution, villages localization etc.

Since the pneumonia (or other upper respiratory illness with cough and fever in children) is being reported in the Tangerang area for years and in large amount, one may also feel a bit reassured for the deployment of the squads, at least there is an epidemiological surveillance on the ground and represents a sign of administrative commitment.

Hardly an epidemic of a novel emerged pathogen could pass unnoticed in a densely inhabited area with extensive international connections.

However, all the things are possible and an open media communication approach will be advisable from Indonesian health ministry or authorities.

If no hidden things exist, no problem to share with other the paediatric health situation should exist as well.
 
Re: Tangerang: More than 400 Medical Crews Mobilized to Stop Pneumonia

Evidently treating pneumonia patients in the field (at 1st level facilities) is a superior method to lower CFR:
The Lancet Early Online Publication, 19 August 2008The Lancet DOI:10.1016/S0140-6736(08)61166-6
Articles
Care at first-level facilities for children with severe pneumonia in Bangladesh: a cohort study

Enayet K Chowdhury MPH a, Dr Shams El Arifeen DrPH a , Muntasirur Rahman MS a, DM Emdadul Hoque MPH a, M Altaf Hossain MPH b, Khadija Begum MB BS a, Ashraf Siddik MSS a, Nazma Begum MSS a, Qazi Sadeq-ur Rahman MSc a, Tasnima Akter MSc a, Twaha M Haque MB BS a, ZA Motin Al-Helal MB BS b, Abdullah H Baqui DrPH c, Jennifer Bryce EdD c and Prof Robert E Black MD c

Summary

BackgroundGuidelines on integrated management of childhood illness (IMCI) for severe pneumonia recommend referral to hospitals. However, in many settings, children who are referred do not actually attend hospital, which severely limits appropriate care. We aimed to assess the safety and effectiveness of modified guidelines that allowed most children with severe pneumonia to be treated locally in first-level facilities, with referral only for those with danger signs or other severe classifications.

MethodsWe did an observational cohort study in ten first-level health facilities in Matlab, rural Bangladesh that had implemented IMCI guidelines. We assessed children with severe pneumonia who were aged between 2 and 59 months, and for whom we could obtain complete information, in two cohorts: 261 children who presented to these facilities between May, 2003, and April, 2004 (before implementation of the modified guidelines) and 1271 children between September, 2004, and August, 2005 (after full implementation). We obtained information about the characteristics and management of their illness, including referrals and admissions to hospital, from facility records. Staff visited households to obtain details of treatment, socioeconomic information, and final outcome, including mortality data.

Findings245 (94%) of 261 children who had severe pneumonia were referred to hospital before the guidelines were modified, compared with 107 (8%) of 1271 after implementation (p<0·0001). 94 (36%) children with severe pneumonia received correct management before the guidelines were modified, compared with 1145 (90%) children after implementation (p<0·0001). Before modification of the guidelines, three children with severe pneumonia who presented at first-level facilities died, with a case-fatality rate of 1·1%; after modification, seven children died, with a case-fatality rate of 0·6% (p=0·39).

InterpretationLocal adaptation of the IMCI guidelines, with appropriate training and supervision, could allow safe and effective management of severe pneumonia, especially if compliance with referral is difficult because of geographic, financial, or cultural barriers.

FundingBill & Melinda Gates Foundation, WHO's Department of Child and Adolescent Health and Development, US Agency for International Development.


Affiliations

a. International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) Dhaka, Bangladesh
b. Directorate General for Health Services, Government of Bangladesh, Dhaka, Bangladesh
c. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA


http://www.thelancet.com/journals/lancet/article/PIIS0140673608611666/abstract?isEOP=true
 
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