93392821 Fisiologi Bayi Baru Lahir

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  Ministry of HealthSTANDARD OPERATING PROCEDUREDetection, Confirmation and ManagementofMeningitisOutbreak RBC/IHDPC/ EID DivisionNovember2011  2 |  P a g e 1Table of Contents 2. Introduction .........................................................................................................................................4 3Objectives  .............................................................................................................................................4 3.1General Objective  .........................................................................................................................4 3.2Specific Objective .........................................................................................................................4 4Definitions .............................................................................................................................................5 4.1Case definition ..............................................................................................................................5 4.1.1Suspected meningitis case .....................................................................................................5 4.1.2Probable meningococcal meningitis case ..............................................................................5 5Epidemiological thresholds ...................................................................................................................5 5.1Alertthreshold  ..............................................................................................................................5 5.2Epidemic threshold  .......................................................................................................................5 Enhancing Meningitis Surveillance ..........................................................................................................6 5.2.1Pre-epidemic phase ...............................................................................................................6 5.2.2Epidemic phase .....................................................................................................................7 5.2.3 Post-epidemic phase .....................................................................................................................8 5.3Data management ..........................................................................................................................9 5.3.1Data collection and transmission  ..........................................................................................9 5.3.2Data entry ..............................................................................................................................9 5.3.3Data analysis .......................................................................................................................10 5.4 Specimen collection, storage, transportation and processing (Ref.NRL SOP’s) ........................10 5.4.1Sample collection ................................................................................................................11 5.4.2Utilisation of TI bottles .......................................................................................................11 5.4.3Transportation of CSF specimen .........................................................................................12 5.4.4Specimen processing ...........................................................................................................12 5.4.5Turn-around time of laboratory results ...............................................................................13 6Criteria for vaccine choice ..................................................................................................................13 7Case management (Ref. IDSR TG, find updated sensitivity data at NRL) .........................................14 8  ..................................................................................................................................................................14 9Communication ...................................................................................................................................14 10Monitoring and Supervision ............................................................................................................14  3 |  P a g e 10.1District level ................................................................................................................................14 10.2National Surveillance Unit ..........................................................................................................15 10.3National Reference Laboratory ...................................................................................................15 10.4Feed Back  ....................................................................................................................................16  4 |  P a g e 2.Introduction Meningococcal meningitis is a bacterial infection of the meninges, the thin lining that surroundsthe brain and spinal cord, whose common symptoms are sudden onset of headache, high fever,stiff neck and sensitivity to light. The causative agent,  Neisseria meningitidis (  Nm ), istransmitted from person to person through infected respiratory droplets, often fromasymptomatic carriers.  Nm is carried in the nasopharyngeal mucosa of at least 10% of the generalpopulationinendemic areas at any given time. It causes disease only when particularenvironmental and physical conditions overwhelm the body.If left untreated, the disease canlead to fatality rates greater than 50% and despite treatment, at least 10% of patients die within48 hours of onset of symptoms, while 10  –  20% of survivors develop severe neurologicalsequelae(WHO Meningitis SOP).The aim of the standard operating procedures is to guide healthcare providers and public healthexpertsfrom various levels of the health system in the implementation of enhanced surveillanceofmeningococcalmeningitis. 3Objectives3.1General Objective To promptlydetect, confirm, andrespondappropriately tomeningococcalmeningitis epidemics. 3.2Specific Objective ã To systematically collect and analyze epidemiological and laboratory data ofsuspectedcases ã To conduct rapid laboratory confirmation of causativeagent ã To respond appropriately to meningococcal meningitis.
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