MANAGEMENT OF COMMUNICABLE DISEASES

SERVICE DESCRIPTION

This chapter deals with the management of communicable diseases in general with the emphasis on prevention, early diagnosis and initiation of measures to prevent transmission and serious morbidity, disability and death. Separate chapters deal with Tuberculosis, HIV infection and AIDS, sexually transmitted diseases, cholera, rabies, leprosy, shigella dysentery and malaria. These are the diseases, which are either priority national public health diseases or are ones associated with the possibility of causing outbreaks. The communicable diseases, which are included in the South African Expanded Programme of Immunisation, and scabies, are dealt with separately under childhood diseases. Rheumatic fever and helminths are also dealt with separately.

NORMS
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  1. All clinics are supervised every three months by the District Communicable Disease Control Co-ordinator.

  2. All clinics send to the local authority or district health office an immediate telephonic report of acute flaccid paralysis or cholera.

  3. Cases referred as notifiable diseases to hospital are notified by the hospitals on a weekly basis on Form GW 17/3.

  4. All clinics send an individual notification on Form GW 17/5 to the local authority or district health office as soon as possible.

  5. Monthly report on deaths from a notifiable disease are notified on Form GW 17/4.
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STANDARDS
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  1. References, Prints and Educational Materials

1.1 Each clinic has the National and Provincial protocols and policy documents on communicable
Diseases and every 6 months reviews them with the Environmental Health Officer of the area.

  1. Equipment

2.1 See clinic generic equipment

  1. Medicines and Supplies

3.1 As per EDL

  1. Competence of Health Staff

4.1 All clinics have a book of notifiable disease forms GW17/5 and complete a form for every notifiable disease. Cases confirmed in hospital send a copy back to the clinic with the lower part of the form completed.
4.2 When the district office receives a notification the communicable disease control co-ordinator initiates a response, together with the District Environmental Health Officer and the local clinic staff. The Infection Control Nurse of the Hospital and in the case of an outbreak, the outbreak teams and the laboratory are also involved.
4.3 The clinic staffs are able to commence action by taking more complete patient and family histories and by visiting the home and environment to identify other cases and causes which can be prevented. Clinic staff are responsible for stabilising cases before hospitalisation and for taking initial specimens for the laboratory.
4.4 Clinic staff can interact with community health committees to maintain surveillance for cases and to ensure control measures after suitable education.
4.5 The emphasis is always on prevention, early diagnosis and initiation of measures to prevent transmission and serious morbidity, disability and death.
4.6 In endemic areas for Malaria, Schistosomiasis, Cysticercosis and Trachoma clinics receive extra protocols on management from the District Health Offices.

  1. Referrals

5.1

  1. Patient Education

6.1 All patients attending the service receive health education.

  1. Records

7.1 Clinic records of communicable diseases are kept up to date.

  1. Community Based Services

8.1

  1. Collaboration

9.1 Staff collaborate with other departments like Environmental health, Education and other sections within health like MCHW and Health Promotion.

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