The application incident command system in public health emergencies model to control diphtheria outbreak in Loei Province 2012

Abstract

The objective of this study was to evaluate the efficacy of an incident command system in controlling public health emergencies, specifically applied to a Diphtheria outbreak in Loei Province in 2012. The study was completed in 2 steps; step 1 was a quantitative study. To complete this, all patients and exposed diph¬theria cases who lived in Loei Province in 2012 were given an investigation report form from the Bureau of Epidemiology. The results were then used for a data analysis. The result showed that this diphtheria outbreak occurred from June to November 2012. Twenty seven confirmed cases and two deaths were found with a morbidity rate of 4.35 per 100,000 pop, a mortality rate of 0.32 per 100,000 pop, and a case fatality rate of 7.41 percent. The patients were distributed in four districts, 19 cases were observed at Dan sai, 5 in Wangsaphung, 2 in Phakao, and 1 in Phulaung. In the thirteen sub-districts, the highest number of patients were in the Songkhram sub-district of Wangsaphung, followed by the Kok Sathon and Ipum sub-districts of Dan Sai. Step 2 was a qualitative study. Study subjects were selected using a purposive sampling technique taken from doctors, nurses, health officers, SRRT officers and Village Health Volunteers (VHV) that were present in the diphtheria outbreak area. A survey was used in evaluating the guidelines on treating patients with suspected diphtheria. Immunization status using was also evaluated a data collection form created by the researchers. Results were then used for a data analysis. Results showed that this out break control model in¬cludes four components: (1) Primary prevention & communication (2) Investigation, Lab diagnosis, and surveillance (3) Clinical care and mop up (4) and Back up, and used 6 main measures includeing: (1) Synchronization command (2) investigation and diphtheria surveillance (3) care of patients and close contact cases and carriers (4) immunization (5) pharmaceutical preparations (6) and risk assessment communications. This model was divided in respect to the command system at all levels R10way, region, province and district.