IMPACT OF CLIMATE CHANGE ON DENGUE FEVER PATTERN

Transcription

1 IMPACT OF CLIMATE CHANGE ON DENGUE FEVER PATTERN A CASE STUDY ON TREATING DENGUE FEVER AT MILITARY INSTITUTE OF TRADITIONAL MEDICINE- VIETNAM 2015 Major General, Prof. PhD. Nguyen Minh Ha; Colonel, PhD. Tran Cong Truong; Colonel, PhD. Tran Ngoc Lien; Captain, MD. Nguyen Tuan Luong; Lieutenant colonel, MD. Dinh Thanh Ha; Lieutenant, Dr. Nguyen Thi Tuyet Minh Military Institute of Traditional Medicine (MITM), Viet Nam

2 CONTENT Introduction Objectives Methods Results and Discussion Conclusion

3 INTRODUCTION

4 INTRODUCTION Climate change Impact on the ecosystem Changes of infectious disease patterns

5 DENGUE HEMORRHAGIC FEVER (DHF) Tropical areas Aedes aegypti Great affect on society and military activities

6 TVM THEORY Heat Heat clearance Qi Qi nourishment DHF Blood Blood nourishment Body fluid Body fluid reproduction

7 OBJECTIVES

8 OBJECTIVES Observe the impact of climate change on DHF pattern Evaluate the effectiveness of Sinh tan chi huyet remedy in treatment DHF in combination with the background regimen recommended by the Ministry of Health

9 METHODS

10 METHODS 1- Clinical trial to evaluate the therapeutic effect of the Sinh tan chi huyet remedy on DHF at MITM 2- Survey and statistic data of the climate pattern in 3 ending months of 2015 comparing to the mean climate pattern yearly at the same time in Hanoi, Vietnam

11 SELECTION CRITERIA IN CLINICAL STUDY Dengue hemorrhagic fever (DHF) sudden high fever continously from 2-7 days; bleeding under the skin headaches - pain fovea; muscle pain heamatocrit normal or elevated; platelet count normal or reduced ; WBC reduced Dengue NS1 test / IgM (+). DHF with warning signs Struggle, lethargy, vomiting Liver enlarge >2cm mucosal bleeding; urination decreased heamatocrit rising; Platelet count decreased rapidly Dengue NS1 test / IgM (+).

12 EXCLUSION CRITERIA DHF with severe condition Hypovolemia shock (DHF shock) happened when plasma draining severely or major bleeding or organ failure.

13 CLINICAL STUDY PROCEDURE Inpatients at MITM from 01/10/2015 to 31/12/ patients Selection criteria Exclusion criteria Dengue hemorrhagic fever DHF with warning signs DHF with severe condition

14 TREATMENT STRATEGY Combining traditional medicine with morden medicine The therapy combining the background regimen recommended by the Ministry of Health (2011) with Sinh tan chi huyet remedy

15 OBSERVING INDICES IN STUDY Treatment duration,cured rates Patients characteristics Tests indices

16 RESULTS AND DISCUSSION

17 EVALUATING THE EFFECTIVENESS OF TREATMENT DHF USING SINH TAN CHI HUYET REMEDY Epidemiological characteristics Number Percentage (%) 17 years old Age (n = 199) Average age 40,5 ± 20,6 Gender (n = 199) Patients (n = 199) Male Female Insuranced Not insuranced

18 EVALUATING THE EFFECTIVENESS OF TREATMENT DHF USING SINH TAN CHI HUYET REMEDY Clinical characteristics Number Percentage (%) Amission date (n = 199) Day 2 + day DHF Level (n = 199) DHF with warning signs Severe DHF 0 0

19 EVALUATING THE EFFECTIVENESS OF TREATMENT DHF USING SINH TAN CHI HUYET REMEDY 12 G/L Changes of WBC count Day

20 EVALUATING THE EFFECTIVENESS OF TREATMENT DHF USING SINH TAN CHI HUYET REMEDY 8 T/L CHANGES OF RBC COUNT Day

21 EVALUATING THE EFFECTIVENESS OF TREATMENT DHF USING SINH TAN CHI HUYET REMEDY 0.80 % Changes of hematocrit Day

22 EVALUATING THE EFFECTIVENESS OF TREATMENT DHF USING SINH TAN CHI HUYET REMEDY G/L Changes of platelet count Day

23 OVERALL TREATMENT OUTCOME 0.5% Cured, discharged Hospital transferred Dead 99.5%

24 OVERALL TREATMENT OUTCOME Treatment results Average treatment days DHF with warning signs (n = 31) 8.67 ± 2.38 In general (n = 199) 6.81 ± 1.89 Le Thi Luu (2011): 7,05 ± 0,6 days

25 ACCORDING TO TVM THEORY The remedy of Sinh tan chi huyet have many effects Clearing heat Nourishing Qi and blood Reproducing body fluid To treat DHF was suitable to TVM theory The results showed Shortened the duration of treatment Increased the ratio of recovery patients Reduced the number of patients with severe conditions

26 CLIMATE CHANGE PATTERN AND RESEARCH VECTORS OF DHF IN 7 MILITARY ZONES IN 2013 IN VIET NAM Temperature (ºC) Humidity (%) Rain fall (mm) The number of mosquitoes/mm³ Month

27 CLIMATE CHANGE PATTERN IN HANOI AND DHF PATTERN AT MITM IN 2015 Average rain fall in 3 months 2015 Average temp. in 3 months 2015 (mm) Oct Nov Dec rain fall Yearly average rain fall ( 0 C) 2015 temperature Yearly average temp. Oct Nov Dec During 3 months Annual in 2015, aver. temp. monthly in VN: 21 average 27 o C temperature and rail fall increased over the - normal 2014 temp. from o C 0 C and from %, respectively, making good temp. condition from for o C Culex species Aedes to develop.

28 CLIMATE CHANGE PATTERN IN HANOI AND DHF PATTERN AT MITM (IN 3 MONTHS OF 2015) Number of patients month

29 CONCLUSION

30 CONCLUSION There was expression of the climate change impact on the number of patients hospitalized with DHF Sinh tan chi huyet remedy combined with the background regimen has effect on DHF treatment

31 RECOMMENDATION Global solution is needed to cope with the impact of climate change on several infectious diseases

32 THANK YOU FOR YOUR ATTENTION!