TMID 516 GROUP III FIELD WORK FOR PARASITE AND VECTOR SURVEY IN THE COMMUNITY

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1 TMID 516 GROUP III FIELD WORK FOR PARASITE AND VECTOR SURVEY IN THE COMMUNITY

2 Objectives of field study To identify pathogens (Helminthes egg & Protozoa) Stool Examination Vector Survey: Breeding places of Mosquitoes Identification of Malarial Parasite Mosquito trapping REFUGEE CAMP & SCHOOL VISIT Rodent trapping- for identification of Vectors

3 *Stool Examination *50 Samples *Simple Smear (Iodine & Saline prep) *Kato Thick Smear

4 Results of Stool Examination 系列 1 系列 2 Incidence of Protoza in stool E.Coli E.nana B.Hominis G.lamblia

6 2. Health Centre Visit: Bamboo school : 18 Cases, Age 1-57yo 4/18 cases(~ 22,22%): Malaria 14/18 cases, including: + Measles + Bronchitis +Epigastritis + Shoulder pain + HTN + Otitis media + Siatica +Sorethroat.. Blood smear: taking 10 samples + 4/10 samples: positive,both thin and thick smear were prepared at the bedside, giemsa stain were done at field laboratory station.

7 * CASE (1) CC: headache for 4 days, vomiting(+), watery diarrhea. Ph.exam: BT37.3, PR102bpm, not anemic, not icteric, lymphadenopathy(-), aptha(-), hepato-splenomegary(-), no rash, dehydration(-), stiffneck(-) DDx: 1-Measles 2-Gastroentritis 3-Malaria, CSF infection Dx: Malaria (P.f) parasitemia 0.5%

9 * CASE (2) CC: Fever, shiver for 2 days, pain in the knee joints for 2 days Ph.exam: BT37.1, conj slight anemic, not icteric, lymphadenopathy(-), no rash, consciousness is normal DDx: 1-Malaraia. 2-influenza. 3-vitamin B12 deficiency. Dx: Malaria (P.f.) parasitemia 0.4%

11 * CASE (3) CC: fever, nausea, headache for 3 days, fever worsen the day before clinic visit. Ph.exam: BW27Kg,BT38.5, PR120bpm, conj anemic/icteric, lymphadenopathy(-), hepato-splenomegary(+), no rash, tiredness, dry lips. DDx: 1-Malaria. 2-TB. 3-Scrub Thyphus. 4-Enteric fever. 5-Septicemia. Dx: Malaria(P.f.) parasitemia 2.2%

12 * CASE (4) CC: High fever and chills for 1 day. Diagnosed and treated for malaria(p.f) few weeks ago in BKK with Artesunate and Mefloquine. Last day of treatment 7 th of June. Ph.exam: BT38, conj anemic,lymphadenopathy(-),hepato-splenomegary(-), no rash. DDx: 1-Recrudescent malaria. 2-New infection. 3-Drugs resistance. Dx: Malaria (Pf) with low parasitemia.

13 *

14 Health Centre visit~general discussion/ Conclusion 18 Cases from (1 to 57years old). 10 cases were clinically suspected as Malaria Blood samples were taken from 10 patients for microscopic (thick and thin) examination. 4 positive for Malaria (P.f ).

15 3. Vector survey ~ Mosquito survey (house visits) methods Breeding places of mosquitoes were surveyed in the community.

16 3. Vector survey ~ Mosquito Survey (House Visits) House drinking water water storage bathroom water vase ant guard animal fed water tyre bowl/bucket Discard coconut shell/leaves plant pot and dish other natural material No. surveyed No. positive

17 3. Vector survey ~ Mosquito survey (house visits) Result 2 No. surveyed No. positive drinking warter 11 1 water storage 15 2 bathroom water 7 4 vase 10 4 ant guard 1 0 animal fed water 5 1 tyre 10 5 House Index,=100 Container Index= Breteau Index =700 bowl/bucket 6 5 Discard 5 1 coconut shell/leaves 0 0 plant pot and dish other natural material 0 0 TOTAL

18 3. Vector survey ~ Insect trapping Mosquitoes were collected for over nights and day by advanced trapping methods and examined under microscope. Pi ct ur es Picture s

19 3. Vector survey ~ Insect trapping Results Traps time Ades Culex Anopheles Others Total Total (mosquito) BG-Trap day 8:00-18: BG-Trap night 18:00-8: CDC Light Trap night 18:00-8: * 7 6 * sand fly

20 Pi ct ur es

22 3. Vector survey ~ Rodent trapping For identification of ectoparasites rodents were trapped by well known methods of rodent trapping. Rodents (Rattus rattus) were anethetised by ether. Ectoparasites were removed from their body by brush into the water. Then they were examined under microscope after mounting.

23 *

25 3. Vector survey ~ Rodent trapping Rodent Rattus rattus Ectoparasites Ticks 0 Rat Fleas 6 Mites 0 Chigger mites 0 Lice 0

27 High incidence of malaria (40%) in that area. Alarmingly we found Opisthorcis egg and larva of strogyloides, even though they are a few (n=1, 2%) pathological consequences might be grave. Incidence of pathogenic protozoa is not significant, however, large scale study may reveal the truth. *Discussion Findings of Ades larvae in the community may explain the nature of the habitat of this group of mosquitoes and their impact on health should be noticeable.

28 Parasitic and vector transmitted (notably- malaria) disease is high and clearly malaria is endemic in that particular zone. Acknowledgement: We are grateful to the faculty of Tropical Medicine of Mahidol University to arrange such kind of excellent field study. Thanks to all distinguished faculty members and staff for their support, encouragement and their extraordinary teaching settings. *Conclusion

29 * *THNK YOU

30 Stool examination Results(provisional): Simple slides No. examined 43 Positive(detected) 19 Not detected 24 pathogen / Sample no detecte d E.coli E.nana Blastocyctis Giardia Strondyloides 1 1 minute 1 1 Hookworm Trichuris 1 1 Opisthochis 1 1 1, detected Pathogen positive samples and total numbers of positive samples Kato slides No. examined 39 Positive(detected) 8 Not detected 31 Positive samples and numbers of pathogens pathogen / Sample no Ascaris 117 Hookworm minute 4 47 Giardia 1

31 percent (%) positive Stool examination findings Kato thick vs simple smear Kato HW MINUTE TT OV SS Incidence of Protoza in stool Stool examination: Kato thick smear positive (helminthes egg) samples were 5 out of 50 (10%), among which n=4 (8%) is hookworm egg and 1 (2%) is minute intestinal flukes. On the other hand, simple smear positive samples were 6 out of 50 (12%), among which hook worm was 2 (4%), minute intestinal flukes 1 (2%), Trichuris trichura 1 (2%), opisthorcis 1(2%) and one (2%) rhabdatiform larva of strogyloides was identified ( Figure 1) E.Coli E.nana B.Hominis G.lamblia Simple: Protozoa were mainly examined in the simple smear. 17 out 50 (34%) were positive for protozoa, among them E.coli is 14% (n=7), E.nana 4% (n=2), B.hominis 10% (n=5) and Giardia lamblia 6% (n=3) [Figure 2].

FIELD STUDY REPORT GROUP 1

FIELD STUDY REPORT GROUP 1 Johanna List Sinaro Bun Tianshi Yu Ajib Diptyanusa Hay Mar Su Lwin Abdulrahman Ahmed M. Chantasari Charoenkongsakul Supervisors: Assoc. Prof. Dorn Watthanakulpanich, Asst. Prof.