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Inside This Issue
- Pregnant Women Iodine Level in Syria

- Towards "Tuberculosis Free Country"

- Safe injection practices among health workers in public health centers in Syria

 - Directorate of Communicable Diseases/ 2010 annual report
 
Quarterly bulletin
published by MOH in Syria
Volume 5, No1, 2011
 

 

Editorial Director
Dr. Ousama Sammak
Deputy Minister

Executive Editor
Dr. Ahamad AL aboud
Health Care Director

Editor in chief
Dr. Nidal Aboursheed
Health Care Directorate

Editorial Board
Dr. Rustom Jafari
Association of Public Health Doctors.

Dr. Isam Anjak
Professor, Damascus Univ.
Syrian pediatrics Association

Dr. Maysaa Naji
Education Development Center

Dr. Hala Alkhair
Communicable & chronic Diseases Directorate

Dr. Hani Lahham
Communicable and Chronic Diseases Directorate

Dr.Hyam Bashour
Professor, Damascus Univ.

 

 

 

 

Design: Education Development Center.MOH

 

 

 

  
عــربــي

Pregnant Women Iodine Level in Syria:

field survey

 

 

The level of Iodine excretion in urine indicates its level in the body. Since pregnant women are amongst most sensitive population groups to Iodine deficiency, the directorate of health care in the ministry of health in cooperation with WHO conducted a survey in 2009 to study the levels of Iodine excretion in the urine of those women. The Central Bureau of Statistics determined the clusters needed for the study sample which included all Syrian governorates.
Laboratory tests were done in a WHO certified lab in Iran. Three thousands pregnant women participated in this survey. While, the mean of Iodine concentration in the urine was 109.73 mcg/ l, the median was 77.7 mcg/ l. Both of them were lower than normal. Therefore, it is recommended to increase Iodine intake in this group which could be implemented through raising the increment of Iodine additive to salt.

Dr. Abear ahamad
Archive For more information contact NTP, Tel 011 -2758162

           
Towards "Tuberculosis Free Country"
 
Tuberculosis (TB) is a bacterial communicable disease caused by acid and alcohol fast mycobacterium tuberculi. It affects mostly the lungs. It has 2 main sources for infection: open TB cases, and unpasteurized milk of infected cows.
The national program to prevent TB (NTP) is the technical and administrative structure responsible for planning, implementing, and evaluating TB prevention activities in Syria. It does that through specified goals, activities, and resources, which together constitute a tight network of TB preventing methods. The framework is an organized, scientifically and practically accepted, and economically feasible program. Centrally, the program is represented by: the department of TB and respiratory diseases prevention (affiliated with the directorate of communicable diseases), the national committee to prevent resistant TB, and the reference laboratory. Peripherally, TB specialized centers are located in all Syrian governorates, in addition to specified units in "health districts".
The NTP strategy to halt TB in Syria is adopted from the WHO strategy under the slogan "TB Free Country". Its components include: case detection rate of at least 80%, and cure rate of at least 90% in 2010. By 2015, mortality and morbidity rates will be cut by 50% comparing with 2000 leading to the elimination of TB as a public health problem by 2025. The following objectives are enlisted as sub targets: enabling all the patients to get benefits of the diagnostic and treatment high quality services, lowering human suffering, reducing TB related social and economic burden, protecting highly vulnerable groups against TB related illnesses (TB, drug resistant TB, and AIDS associated TB), creating wide partnership to improve population access to health services, and social promoting and communication and mobilization.
The NTP achievements during 2010 included: connecting peripheral TB centers with the central administration through the NTP web site, implementing training courses on electronic nominal reporting, activating other sectors' role in detecting TB, publishing guidelines for private and public partnership, conducting training courses for health workers in drug resistant TB section, conducting training courses for physicians on
 
PAL (Practical Approach to Lung Diseases), implementing GIS (geographical information system), continuous supervision and training on governorate level, and social promoting and communication and mobilization.
Epidemiologically, since the Syrian population in 2010 was estimated as 20.616.500 inhabitants, the TB (all types) prevalence that year was 18.5 per 100.000 (pulmonary TB/ extra pulmonary TB= 88%), TB incidence rate (sputum positive) was 5 per 100.000, the rate of TB positive cases to new cases was 34%, the total rate of successful treatment (DOTS) was 85%, and the number of TB drug resistant cases was 18.
Graph 1 shows decline of the number of TB detected cases' during 1997- 2010.

Regarding TB prevalence rate in 2010, Rural Damascus governorate held the highest record (29.1/100.000) followed by Aleppo governorate (22.9/100.000) among Syrian governorates (graph 2).

More efforts are to be dedicated towards the elimination of TB especially in Rural Damascus and Aleppo. More involvement of NTP partners is needed as well, especially the civil society organization such as the Syrian Society against Tuberculosis.

 

Dr. Kenaz Elsheik
Dr. Rustom Jafari

           
Safe injection practices among health workers in public health centers in Syria
 

Background

 

 
Safe injection practices constitute a vital part of safe injection program which aims to eliminate or reduce unwanted effects of injection. UNICEF reported 1.3 million deaths globally due to unsafe injection practices. Since it is very important to determine the prevalence of safe injection practices among health workers, especially those working in the EPI (Expanded Programme of Immunization), the Ministry of Health has conducted a two-stage field survey in 2001 and 2004 to assess this prevalence. The purpose of this survey is to clarify the development achieved in this field in Syria.

Materials
and
Methods
The study is of the cross sectional type. It included primary health care centers that provide vaccination services at the national level and lasted from 1/5/2010 to 30/8/2010. The sample was selected randomly to represent the whole population. The field research teams visited selected health centers during vaccination session, and watched this session for at least two hours. Then, they moved to other rooms (in case they exist) where giving injections might take place (such as general clinic, emergency room, dental clinic, and laboratory).

The study objective

 

 
The study objective was to assess the prevalence of safe injection practices among health workers, especially those working in the EPI, and making recommendation to increase the safety of injecting vaccines.
The study tool included a questionnaire that was designed especially to serve the study objectives. The field team explained the study objectives to the health workers, and filled the questionnaire through observation and personal interviews with them. CsPro was used to enter data to computer. SPSS package was used to analyze data.

Results





 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 
A total of 243 health centers were included in the survey (75 district health centers, and 168 local health centers). Regarding Vaccination rooms, they were clean in 91.4% of cases, and suitable in size and location in 88.5% of cases.
Table 1: Positive answer percentage to questions related to vaccine refrigerator

Regarding vaccine refrigerator, table 1 shows that availability of temperature chart on refrigerator door scored the highest percentage (97.5%) of positive answers.
* missing data
 
 
Table 2: Percentages of the potential of receiving needle sting according to the work station
When it comes to the potential of accidental needle sting during the last 6 months, the vaccination room scored the highest percentage (24.1%) followed by the laboratory then the dental clinic as it is shown in table 2.
* Some services are not available in some centers
 
 
Table 3: Percentages of health workers who have completed their hepatitis B vaccine schedule according to work station
Table 3 shows that the smallest percentage of health workers who have received 3 doses of hepatitis B vaccine was in the general clinic (65.9%) comparing to 80.8% in the dental clinic.
* Some services are not available in some centers
 
 
Table 4: Percentages of answers related to safety boxes
Regarding safety boxes (used to discard wasted syringes), percentages of acceptable practices were generally over 90%, table 4.
* Some services are not available in some centers
 
 
Table 5: Good practices' percentages in the vaccination room
Apart from recapping the needle, good practices percentages were above 90% in the vaccination room, table 5.
* Some services are not available in some centers
 

Recomm-endations



1. The need to confirm recording the vaccine refrigerator temperature morning and evening on daily basis, and taking the suitable necessary actions when the temperature slides out of the range 2-8 °C.
2. Assuring the suitable location and size for vaccination rooms when planning new health centers and replacing existing unsuitable ones with better choices.
3. Assuring commitment to best practices in every room where injection might take place.

Dr. Kenan Fanoos
Health Care Directorate

           
Directorate of Communicable Diseases/ 2010 annual report
 

The directorate of communicable diseases is a major pillar of providing treatment and preventive services in the Ministry of Health.

Vision:

healthy Syrian citizens in a country where the environment promote their health; and its borders are preserved against epidemics.

Mission:

prevention and control of all communicable and emerging diseases and epidemics, their risk factors, and their pathogens. It does that by using all available means that are scientifically sound and practically feasible in order to have Syrian community with the best possible health status.

Policies:

enhancing active surveillance of diseases, pathogens, risk factors, and health related events- developing integrated health programs and implementing them with full partnership of community- participating in developing health legislation- conducting scientific researches and using their results to create health policies- coordination with national governmental and non-governmental organizations- collaborate with relevant international organizations.

Objectives:

reducing communicable diseases morbidity and mortality-reducing prevalence rate of communicable diseases risk factors-increasing rates of early disease detection- blocking the incidence of epidemics and emerging diseases.
The directorate of communicable diseases has published the annual report of 2010 that described implemented activities. It could be found on the MOH web page by clicking this link:
http://moh.gov.sy/ar/HomePage/tabid/510/Default.aspx

           
 
Communicable Diseases Quarterly Report
Second Quarter (April to June 2011)
 
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Communicable Disease Quaterly Report by Governorates
Second Quarter (April to June 2011)
 
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Age Distribution of Communicable Diseases
Second Quarter (April to June 2011)
 
Print Table