TB & Leprosy Free Majuro...5 to 7 degrees north of the equator 29 coral atolls including 1,200...
Transcript of TB & Leprosy Free Majuro...5 to 7 degrees north of the equator 29 coral atolls including 1,200...
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TB & Leprosy Free Majuro
WMLN Annual Conference Presentation October 8, 2019
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Where?
About 26 hours and 10 minutes travel time from Madison and minus one day (International date line)
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The Republic of the Marshall Islands (RMI)
2,300 miles southwest of Hawaii
5 to 7 degrees north of the equator
29 coral atolls including 1,200 islands
Total land mass = 70 square miles
Population = 60,000
Background
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Majuro
Capitol city of RMI
About ½ of the population of RMI (27,000)
30 miles long = less than 10 square miles of land
Elevation is 6 feet above sea level
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Bikini Atoll -Baker test 1946
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Climate change and rising sea levels
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Mass TB screening (leprosy, diabetes)
Mass treatment of latent TB Infection
Increased support for TB program
8 Groups 10-15 per group 3 weeks per group (24 weeks)
Doctors, Nurses, Epidemiologists,
X-ray technicians
Many locals in support
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Why? TB in the Pacific
0 50 100 150 200 250 300 350 400 450
US
AmSam
US FB
Kosrae
US Homeless
Guam
US 1950
Yap
CNMI
Palau
Pohnpei
USAPI
Ebeye
Weno/Tol
Majuro
Source: Average TB Rate 2009 – 2015, EpiAnywhere
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Higher death rate
Greater risk of relapse
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COLLABORATION
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TB & LEPROSY-FREE MAJURO
Julia Greenleaf, Public Health Nurse | volunteer 5/30/18 – 6/22/18
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HISTORY TRAINING &
SET-UP
KICK-OFF &
GO!
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HISTORY
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HISTORY
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TB Stigma refers
to negative
beliefs, feelings, &
attitudes toward
people living with
TB, their families,
and people who
work with them. 45%
HISTORY
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45%
TRAINING & SET-UP
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45%
TRAINING & SET-UP
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KICK-OFF & GO!
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KICK-OFF & GO!
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KICK-OFF & GO!
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Over 2,000 people screened ∙ 14 people diagnosed with TB disease ∙
200+ people started on treatment for TB infection ∙ 4 people diagnosed with Hansen’s Disease ∙ Systems in place for ongoing screening,
diagnosis, and treatment moving forward LEGACY
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NEXT VOLUNTEER
ANN MISCH MD
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NEXT VOLUNTEER
PHILIP WEGNER
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OUTCOMES
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Outcomes : TB + Leprosy Free Majuro
RMI Report: November 26, 2018
Screening Process Total Percent
First screening at home 22,402
82% of population reached
Completed screening
19,136 85% completed second visit
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Outcomes : TB + Leprosy Free Majuro
RMI Report: November 26, 2018
Active TB
Total Percent
Started Treatment
307
1,604 active TB diagnoses per 100,000
people screened
Latent TB
(sleeping TB)
Latent TB Diagnosis 5,367 29% of people screened diagnosed
with Latent TB
Recommended for
Latent TB Treatment
4,897 9% with latent TB were not medically
eligible for latent TB treatment
Started Latent TB
Treatment 4,705 96% of eligible patients started latent
TB treatment
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Outcomes : TB + Leprosy Free Majuro
RMI Report: November 26, 2018
Leprosy Total Percent
Referred for evaluation 394 2.5% of people screened were
referred for leprosy evaluation
New cases of leprosy 54 14% of referred patients were diagnosed with leprosy
Diabetes
Identified with diabetes
(A2c ≥ 6.5)
929 24% of people screened for
diabetes have diabetes
New diagnosis of diabetes 409 11% of people screed for
diabetes were newly diagnosed
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Iakwe!