Pandemic preparedness and response to H1N1 2009 in the Solomon Islands
スポンサーリンク
概要
- 論文の詳細を見る
Background: The emergence of a novel strain of the influenza virus A (H1N1) in April 2009 focused attention on influenza surveillance capabilities worldwide. In consultations before the 2009 outbreak of influenza subtype H1N1, the World Health Organization had concluded that the world was unprepared to respond to an influenza pandemic, due in part to inadequate global surveillance and response capacities2. Several studies described a sentinel surveillance system that could enhance the quality of influenza epidemiologic and laboratory data and strengthen a country's capacity for seasonal, novel, and pandemic influenza detection and prevention3.General Objective: To assess the Solomon Islands National Influenza Pandemic Preparedness and Response Plan for H1N1 2009 outbreak.Methodology: A descriptive study aims to look at the influenza pandemic preparedness and response plan for the AH1N1 2009 infection outbreak in the Solomon Islands. The study process focuses on what was planned and what happened during the response effort, identifies key issues and lessons learned, and makes recommendations for improvements.1. Firstly, to review, compare the SINIPPRP with the WHO recommended essentials and desirable elements a country should consider when creating a pandemic preparedness plan for emergencies and find the differences between the two; make recommendations for improvements. We will use the WHO flu checklist tool to find discrepancies in the current level of the Solomon Islands' plan by using a table to see if the SINIPPRP has included these elements in their plans. We use matching tables and compare them to the WHO table by marking an X under the columns to find the difference. The "X" mark means that an element is present in SINIPPRP; the "no" mark means that it is not included but needs to be recommended for improvement and inclusion in the next review of the plans.2. Secondly, to identify and make recommendations for improvements from lessons learnt and problems found during the H1N1 outbreak response of the country, mainly in the essential elements such as surveillance, infection control, communication and training, testing the plans, and clinical management of the patients. This will be accomplished by searching all secondary data, and information will come from Ministry of Health Solomon Islands WPRO-SPC, policy papers, publications and reports, the minutes of meetings, international conference papers, journal articles, and the authors' observations and personal experiences, and reports and lessons learned. The main searches in the details of this paper will be surveillance, infection control, communication, and the training and testing of the plans.Results: There was a Solomon Islands National Influenza Pandemic Preparedness Response Plan developed in response to SARS and avian influenza in 2006 as the threat of a global influenza pandemic became increasingly imminent. Its major goal is to prevent, protect against, control, and provide a national public response to the local and international spread of disease in ways that are commensurate with and restricted to public health risks (IHR 2005 Article 2), avoiding unnecessary interference with international traffic and trade with five main objectives and action plans to be implemented. The Solomon Islands continues to experience an outbreak of an influenza-like illness. Total clinic consults remain high in all centers since August 2009. This places pressure on human resources at the clinic level with many clinics working overtime. The initial testing of specimen (swabs) is done in the country and for confirmation they are sent to the WHO reference laboratory in Melbourne, Australia for H1N1 testing. Most of the nasal pharyngeal swabs (NPS) indicated Influenza A and B. In the Solomon Islands in 2004, ARI was responsible for 41.4% of new cases of diseases in infants younger than one year-old, more than a third (36.1%) in children less than five years-old, and 20.9 % for children older than five. The 2004 infant ARI rate of 223/1000, was more than double that of clinical malaria (41/1000), the next most commonly reported illness for this group. Nationally ARI rates have remained fairly constant since 1997, with intermittent periods of increase. Reduced rates in 2002-2003 may show true decreases in incidence or may also result from decreased service delivery and case reporting in Guadalcanal and Honiara. Severe incidences of ARI account for only a small proportion of notifications, 3% in children under five. The burden of diseases is greatest in infants in whom rates have not fallen below 2000/1000 since HIS data collection commenced. Rates in 2004-2006 were higher than previous years in all the provinces, possibly the result of an outbreak or outbreaks, an increase in the circulation of respiratory pathogens, or more complete HIS reporting data. The ILI distributions are higher in the younger age group, mainly in females. The second highest ILI distribution is among children under five years-old. There were four AH1N1 2009 confirmed cases in the Solomon Islands, but only two patients were admitted to the hospital. One patient was quarantined at a training ground and was treated by the health team; the other one was admitted to a private hospital, and there was one admitted to a hospital in the province. All the patients were treated and discharged after recovery. They were all experts; only one was an indigenous person from one of the sentinel sites in the provinces. Total clinic consults remained high in all centers from May to October 2009. The highest peak was in September, at 29%. May was at 18%, October at 18%, and June at 15%. Surprisingly, one of the four was an infant with no history of travel, no contact ,lived in the remote village had confirmed with H1N1 compared to 3 had met the case definitions.Discussion: The objective of this study is to identify issues or problems in the Solomon Islands National Influence Pandemic Preparedness and Response Plan for the AH1N1 2009, and their response to the outbreak. As a pandemic is in evitable and countries don't know when the next arrival of the second wave will come, plans need to be revised and made workable. Pandemic planning should be happening on all levels, including public and private sectors at the national, provincial, and community levels for effectively and efficiently responding to a pandemic crisis. Lessons learned during these outbreaks have been used when preparing for the pandemic response plans for H1N1 2009. Experiences with these outbreaks have shown that there is always room for improvement in pandemic preparedness. It is expected that whatever the pandemic preparedness plans of countries, they will need regular revision. In preparing for the next pandemic, governments face challenges that are beyond their means and over which they have little control. Influenza pandemic preparedness and response to Solomon's mean surveillance, communication and training, infection control and testing of the plans. It is very important to take the lessons learned from SARS, avian influenza and H1N1 2009 to improve the operational management plans of the country in all these areas. The Solomon Islands continue to experience an outbreak of an influenza-like illness. Total clinic consults have remained high in all centers since August 2009. This places pressure on human resources at the hospital and clinic levels with many clinics working overtime.
- 2011-10-00