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T indakan aspek manajemen kesehatan 15/2014

T indakan aspek manajemen kesehatan 15/2014. DISIAPKAN OLEH PROF. DR.DRH.PRATIWI, TS. MS DRH.ROSITAWATI, I. MP. Types of Vaccination Strategies. There are two types of vaccination policies:

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T indakan aspek manajemen kesehatan 15/2014

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  1. Tindakan aspek manajemen kesehatan15/2014 DISIAPKAN OLEH PROF. DR.DRH.PRATIWI, TS. MS DRH.ROSITAWATI, I. MP PTS-RST-PKH-15-2014

  2. Types of Vaccination Strategies • There are two types of vaccination policies: • Universal Vaccination – every person is vaccinated in the hope of eliminating/eradicating the disease from the community • Selective Vaccination – only individuals in particular risk groups are vaccinated. • Both policies are in use for rubella. • The US started off with universal vaccination. • The UK and HK started off with selective vaccination of primary school girls but decided to switch to universal vaccination because the uptake rate was not good enough. PTS-RST-PKH-15-2014

  3. Characteristics of vaccines The characteristics of the vaccine used is a major determinant on the outcome of the vaccination strategy. Factors to consider include • Response rate • Type of protection • Duration of protection • Local immunity • Side effects • Route of administration • Stability • Cost PTS-RST-PKH-15-2014

  4. Developing a vaccination policy The following questions should be asked when a vaccination policy against a particular virus is being developed. • What proportion of the population should be immunized to achieve eradication. • What is the best age to immunize? • How is this affected by birth rates and other factors • How does immunization affect the age distribution of susceptible individuals, particularly those in age-classes most at risk of serious disease? • How significant are genetic, social, or spatial heterogeneities in susceptibility to infection? • How does this affect herd immunity? PTS-RST-PKH-15-2014

  5. Coverage Required for eradication • Basic concept is that of the basic rate of the infection R0. • For most viral infections, R0 is the average number of secondary cases produced by a primary case in a wholly susceptible population. Clearly, an infection cannot maintain itself or spread if R0 is less than 1. • R0 can be estimated from as B/(A-D);B = life expectancy, A = average age at which infection is acquired, D = the characteristic duration of maternal antibodies. • The larger the value of R0, the harder it is to eradicate the infection from the community in question. • A rough estimate of the level of immunization coverage required can be estimated in the following manner: eradication will be achieved if the proportion immunized exceeds a critical value pinc = 1-1/R0. • Thus the larger the R0, the higher the coverage is required to eliminate the infection. • Thus the global eradication of measles, with its R0 of 10 to 20 or more, is almost sure to be more difficult to eradicate than smallpox, with its estimated R0 of 2 to 4. PTS-RST-PKH-15-2014

  6. Kapandilakukanvaksinasi • Sebagaiupayapencegahan penyakitsecara in vivo • Syaratutamaindividuharus sehat • Daerah endemis • Perlu legal formal PTS-RST-PKH-15-2014

  7. IMMUNISASI/VAKSINASI • Merangsang organ limpoidmembentukantibodi • Harussudahcukupumurdansehat • Dilakukandenganpengulangan yang benar agar titer propilaksitercapai • Pemilihanjenisvaksinharusbenar • Sisihkansisavaksinasidenganlegeartis PTS-RST-PKH-15-2014

  8. Vaksinasi VAKSINASI YANG TIDAK TEPAT JUSTRU MENJADI SUMBER PENYAKIT PTS-RST-PKH-15-2014

  9. Imunisasi • VAKSIN • Live virus • Dead virus • Attenuated virus • Rekombinan PTS-RST-PKH-15-2014

  10. Respon imun • ALAMI • maternal antibodi • genetis • sembuhdaripenyakit • EKSTERNAL • vaksinasi • paparan PTS-RST-PKH-15-2014

  11. Dynamics of infectiousness Latent period Infectious period Non-infectious Susceptible Time Infection Infection Dynamics of disease Incubation period Symptomatic period Non-diseased Susceptible Time Timeline for Infection PTS-RST-PKH-15-2014 (www)

  12. Apa yang seharusnya kita lakukan ??? • KONSEP LEGE ARTIS • Bioetika • Tidakbolehmencemari • Musnahkandenganbakaratau timbun • Lakukandengan booster yang disyaratkan PTS-RST-PKH-15-2014

  13. Perbaikan manajemen • Pemilihan sistem penggembalaan - unmixed aged group - alternatif grazing : rotational, zero - hindarkan overgrazing - removal of faecal PTS-RST-PKH-15-2014

  14. Perbaikan manajemen - Pemilihan sistem penggembalaan - unmixed aged group - alternatif grazing : rotational, zero - hindarkan overgrazing - removal of faecal PTS-RST-PKH-15-2014

  15. Future Control Measures • Better drugs should be available • Anti-viral prophylaxis • Vaccines • More sensitive diagnostic tests would enable the early detection of cases. • Better surveillance system • Better contingency procedures • Better education and facilities. PTS-RST-PKH-15-2014

  16. Apa yang seharusnya kita lakukan ??? • KONSEP LEGE ARTIS • Bioetika • Tidakbolehmencemari • Musnahkandenganbakaratautimbun • Lakukandengan booster yang disyaratkan PTS-RST-PKH-15-2014

  17. PTS-RST-PKH-15-2014

  18. Approach to Managing Dairy Herd Health • Main health elements • Reproduction • Lameness • Mastitis • Metabolic conditions • Infectious & parasitic disease • Injury • Nutrition • Culling reasons • Young stock • Biosecurity PTS-RST-PKH-15-2014

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