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Civilization & Peptic Ulcer. Indiana Pacesetters. Also Known As: A Rooster, Three Hens & A Chick. Outline . What is a peptic ulcer? What are the characteristic symptoms of an ulcer in the stomach or duodenum (peptic ulcer)? What are the causes of ulcer in the stomach?

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Civilization peptic ulcer

Civilization & Peptic Ulcer

Indiana Pacesetters

Also Known As:

A Rooster, Three Hens & A Chick


Outline
Outline

  • What is a peptic ulcer?

  • What are the characteristic symptoms of an ulcer in the stomach or duodenum (peptic ulcer)?

  • What are the causes of ulcer in the stomach?

  • Are genetic factors involved in the cause of peptic ulcers (stomach ulcers)?


What is a peptic ulcer
What is a Peptic Ulcer

Definition

A peptic ulcer is a circumscribed erosion in or loss of the mucous membrane lining of the gastro-intestinal tract. Pepticulcers are chronic but may have acute exacerbations.


Please remain calm
Please Remain Calm….

EMERGENCY

EMERGENCY


Civilization peptic ulcer


Civilization peptic ulcer

SYPHILIS OUTBREAK IN BRAHMA COUNTY

  • Background

  • Determine Outbreak

  • Process

  • Communities Effected

  • Action Taken

  • Results

Brahma County



Background
Background

  • From 1996 to 1999, Brahma County went from 25th to 1st nationally.

  • Syphilis cases reported in

    Brahma County during 1999

    represented a 160%increase

    over cases reported in 1998.



Determining the outbreak
Determining The Outbreak actions to take

  • What were existing problems?

  • How can we rectify them?

    At the time, there was no official CDC criteria to eliminate syphilis .


Process
Process actions to take

  • Funding

  • Testing

  • Reporting & Notification

  • Surveillance


Funding
Funding actions to take

Redirected funds

  • reduced dollars for syphilis screening, testing, and treatment

  • lack of visits by Disease Intervention Specialists (DIS)

  • delays in partner notification


Testing
Testing actions to take

  • lack of early diagnosis and subsequent treatment


Reporting notification
Reporting & Notification actions to take

  • Reporting in a timely fashion

    Created delays in partner notification,

    education, and risk reduction of syphilis

    cases by DIS


Surveillance
Surveillance actions to take

  • BCHD staff was not conducting effective surveillance

  • Surveillance reports from physicians were not being reported.

  • CDC comes into play


Communities effected
Communities Effected actions to take

Syphilis Cases in Brahma County, 1999

  • African Americans made up a large percent

    87% of Syphilis Cases

15

Hispanic

362

Black

39

White

Total

416

0

50

100

150

200

250

300

350

400

450

Number of Cases Reported


Factors contributing to communities effected
Factors Contributing to Communities Effected actions to take

  • Poverty

  • Lack of access to quality health care

  • Recreational drug use

  • High-risk sexual behaviors

  • Jails


Action taken
Action Taken actions to take

An assessment of the MSDH syphilis program by CDC in 1999 was satisfactory, but CDC indicated it could be improved. Among the items suggested by CDC were to:

  • Increase surveillance;

  • Provide access to testing and treatment;

  • Implement a jail program to diagnosis and treat syphilis cases, and;

  • Identify areas as high morbidity areas to obtain financial support for staff/programs to combat syphilis.


Action taken cont
Action Taken Cont.... actions to take

  • Funding

  • Staffing

  • Testing,Reporting, and Notification

  • Community Involvement


Pluck out syphilis
Pluck Out Syphilis actions to take

  • The coalition was formed in late 1999 to address the epidemic of syphilis occurring in Brahma County

  • BCHD’s health officer was instrumental in bringing community groups together around the issue.


Pluck out syphilis cont
Pluck Out Syphilis Cont.…. actions to take

  • Community members and organizations were notified when the BCHD would be coming out to test, screen and educate residents about syphilis

  • Four committees: faith & outreach, communications, men having sex with men, and evaluation


Pluck out syphilis cont1
Pluck Out Syphilis Cont.... actions to take

Member organizations reached out to the

community, identifying risks for contracting

syphilis, and attempting to remediate the

problems that were occurring in this

community.

Billboards, bus placard,brochures,posters,community forums

and radio ads.


Results
Results actions to take

Contributory factors leading to a decline

  • increases in funding as well as staffing

  • better testing

  • reporting and partner notification

  • collaboration between the community organizations resulting in an increase in community awareness and knowledge.


Overall
Overall actions to take

  • This case study points out that with or without the existence of a disaster plan for epidemics, stumbling blocks such as funding, testing, reporting, notification, and surveillance can hinder even the best plans and policies.