DYSENTERY

SERVICE DESCRIPTION

For surveillance and reporting purposes the case definition of dysentery is diarrhea with visible blood in the stool and an outbreak is when there is an unusual increase in the weekly number of patients with or deaths from bloody diarrhoea.

NORMS

Reduce the number of cases of Shigella dysenteriae type 1 (sd1) in communities from which it was previously notified.

STANDARDS
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  1. References, prints and educational materials

1.1 Copy of Steps in management of a dysentery outbreak.
1.2 Pamphlets in local languages.
1.3 Protocols on management of dysentery.

  1. Equipment

2.1

  1. Medicines and Supplies

3.1 List of drugs in accordance with the Essential Drugs List.
3.2 Oral and intravenous rehydration solutions.

  1. Competence of Health Staff

4.1 Clinic staff are able to identify and manage patients with dysentery using the triad of fever, convulsions and bloody diarrhoea.
4.2 Staff increase infection control measures in its premises especially in toilets at times of outbreaks.
4.3 Staff initiate, with the help of the environmental health officer, the collection of stool samples from the clinic patients and from cases in their neighbourhood. Rectal swabs or swabs of fresh stool are collected on Cary-Blair transport media, packed with ice in a box and sent to laboratory, which is warned of their arrival by phone.
4.4 A stool specimen form for all cases is completed and antibiotic sensitivity requested and sent with the specimen.

  1. Referrals

5.1 Criteria for referral are (1) a severely malnourished or very ill child under 5, (2) a child with measles in the last 6 weeks and (3) patients 50 years or older, dehydrated or having a convulsion.

  1. Patient Education

6.1 Clinic staff will intensify preventive measure such as health education on hand washing with soap, breast feeding, food and water safety, home storage, treatment of water and use of latrines at times of outbreaks.

  1. Records

7.1 Records are kept up to date.

  1. Community Based Services

8.1 The district notifies clinics of any outbreak of dysentery so that clinics are prepared with pamphlets and supplies of drugs to which the organism is sensitive

  1. Collaboration

9.1 Staff collaborate with other departments like environmental heath officer, water affairs and other community based organisations.

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