Tuesday, January 6, 2009

HIV/AIDS Unit

Date: 05 Jan 2009
Group A
DHO: Kota Star

Today group A visited the HIV/AIDS unit in the DHO. There were two people working in this unit they were KKPK Hasrul. This unit comes under the main unit of communicable diseases (CDC). Following is the responsibilities of the unit and the procedure which medical staff has to follow when they detect a person with HIV.

Firstly, the HIV unit has to prepare reports regarding the screening test in the KK. These include the anonymous screening programme, Program Pengurusan HIV(PPHIV), surveillance programme, disease burden, HIV screening for to be married, screening in the prisons, antiretroviral therapy, health promotion activities, program saringan ibu mengandung (PMTCT).They also have to prepare a action plan. Under the Kota Star district there are two prisons which are the Alor Setar prison and the Pokok Sena prison. Each new prisoner is screened for HIV.

Next responsibility of the unit is to identify the cases of HIV or AIDS. This includes receiving notifications from various treatment centers and identifies the cases within and outside the district. The unit also has to shift all the cases outside the district to their various DHOs.

The DHO also has to register all HIV cases in the local register and in the e-notification system to inform the Ministry of Health.
For each diagnosed case of HIV the staff have investigate the case. This includes locating the address and filling in the National AIDS Registry form. A report has to be complied and sent to MOH.

Subsequently the unit also has to do contact tracing, where the contacts of the HIV cases are promptly referred to the nearest KK for screening. The unit also has to manage cases which have defaulted follow up and prepare reports regarding antiretroviral therapy – reports are sent each month for new cases.

The unit also gives information on how to manage the death of a person with HIV. This is done to avoid infection although the chances of transmission is low it is still done.

Next come training and proposal preparation. Training progarammes which are conducted by this unit are AIDS Update programme and Modified Syndromic Approach (MSA) for medical assistants (MA). MSA is a programme where MAs are educated to diagnose based on the patients syndrome so as not to miss any important diagnosis.
The unit also monitors and conducts National Strategic Planning (NSP) in Kota Star. Subdivisions of this duty include preparing a proposal, discussion with various agencies and preparing a report for the JKN.

Also, the unit conducts programmes for the Khidmat Negara project. It is done for each batch and a report is prepared after each session.

Furthermore, the unit conducts activities which are recommended by the UNICEF. This includes training staff for the People Living with HIV/AIDS (PLWHA) project. The unit also conducts various health promotion campaigns and executes the UNICEF action plan.

Each Monday there is an Epid meeting. In this meeting the weekly notifications are presented. Apart form the Epid meeting there is also the inspectorate meeting on Mondays where the weekly agenda is presented.

The unit will also visit pregnant women, postnatal women with HIV and their babies to monitor the HIV status of the baby. The mothers should not breastfeed their children as this increases the risk of vertical transmission.

There are also meetings conducted by the state and the district which have to be attended. Finally the unit also has to prepare for MS ISO monitoring.

HIV is detected and confirmed by ELISA. 2 test are needed to confirm the disease. The screening method used is a rapid antigen detection test. This screening method must be followed by 2 ELISA test to confirm the diagnosis. As a doctor, one should perform 3 task when he detects a case of HIV. They are filling in the form for Laporan Kes Jangkitan HIV and Borang Penyakit Berjangkit. These forms will be stored in the Records department. The final task is to key in the data in to Communicable Disease Control Information System (CDCIS).

No comments: