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Analytical summary - Epidemic and pandemic-prone diseases

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Part III (special provisions regarding diseases) of the Public Health Act of Botswana (Chap 63.01) incorporates provisions for international health regulation with specific application to smallpox (including alastrione or variola minor), plague (all forms), cholera (including that due to EI Tor vibrio) and yellow fever. In addition, since 2006, the Ministry of Health has developed the Hepatitis B vaccination guidelines for health care workers in Botswana.[1]

The development of the guidelines was a fulfilment of the World Health Assembly resolution on viral hepatitis. They are aimed at ensuring that health care workers at risk of acquiring hepatitis are immunized to protect both the health worker and other patients whom he or she may infect. The Ministry of Health has developed guidelines to deal with infectious disease that cover equipment needed, possible symptoms that may give rise to suspicion, training of staff (lay personnel) on handling the suspicious case, and action to be taken before arrival at the nearest port of entry.

The Botswana Clinical Waste Management Code of Practice provides guidelines for safe handling, storage, transportation and disposal of clinical waste as a way to protect both the population and the environment from any infectious or toxic substances. The Code of Practice has particularly been important in protecting those who handle potentially HIV-infected blood and other body fluids but it also works for diseases such as hepatitis B.

Operational guidelines, service norms and standards for injection safety in Botswana[2] aims at reducing the chances of transmitting bloodborne diseases such as HIV and hepatitis B through infected needles and syringes. The guidelines address equipment management, health worker behaviour, health care waste management and occupational health issues in injection safety.

The Government of Botswana has developed Integrated Disease Surveillance and Response guidelines adapted from the WHO Integrated Disease Surveillance and Response guidelines to facilitate early detection and prompt reporting of priority and notifiable diseases. The guidelines use standard case definitions or define criteria for priority diseases, which may be based on the clinical manifestations or laboratory tests.

The report must indicate if the case has only a few of the typical clinical features (suspect), typical clinical features without laboratory confirmation (probable) or if the case has been confirmed by laboratory test (confirmed). Once a case is detected, appropriate history is collected to determine the source of the infection and the likelihood of immediate contacts also having the disease. Appropriate forms are completed and the report is sent to the district health management team within 48 hours.

If the disease or suspected disease has a significant risk of international spread or international travel or trade, the reports must reach the WHO Country Office. Prompt treatment is instituted following an established protocol for managing and containing a given disease. Priority disease outbreaks are published in the National Disease Control and Epidemiology Unit Bulletin.

References

  1. Hepatitis B vaccination guidelines for health care workers in Botswana. Gaborone, Government of Botswana, Ministry of Health, 2010
  2. Operational guidelines, service norms and standards for injection safety in Botswana. Gaborone, Government of Botswana, Ministry of Health