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WHO Centre Imperial College London - Imperial College Faculty of ...

WHO Centre Imperial College London - Imperial College Faculty of ...

DiagnosisBecause

DiagnosisBecause detection of Giardia can be difficult, patients may be asked to submit several stoolsamples over several days. Most often, stool specimens are examined microscopically byusing different techniques (e.g., wet mount with iodine, trichrome, or immunofluorescentantibody staining, and/or enzyme immunoassays for detection of Giardia sp. antigens).TreatmentDiarrhoea should be managed with adequate fluid replacement to prevent dehydration.Several antimicrobial drugs (i.e., tinidazole, metronidazole, nitazoxanide, paromomycin,furazolidone, quinacrine) are available by prescription.Key features of neglected tropical diseases:Neglected tropical diseases affect an estimated one billion people, primarily poorpopulations living in tropical and subtropical climates. They frequently clustergeographically and overlap; individuals are often afflicted with more than one parasiteor infection.100 % of low-income countries are affected by at least five neglected tropicaldiseases simultaneously.More than 70 % of countries and territories that report the presence of neglectedtropical disease are low-income and lower middle-income economies.Infections are attributable to unsafe water, poor housing conditions and poorsanitation.Children are most vulnerable to infections of most neglected tropical diseases.Many can be prevented, eliminated or even eradicated with improved access toexisting safe and cost-effective tools.46

11.4 Appendix DOur Findings – FlowchartSummary Charts: Incident timeline, actions taken, WHO Team AssessmentOur Assessment Incident Timeline Actions TakenPHD; PUCWe strongly believe thatplanning permission should notbe granted. Vital water sourcesshould be protected. Nobuilding should be allowedabove 250 metersConstruction near the oldUS Satellite started withundefined # of workers(??date)? PlanningPermissionRegulations and Enforcementare in questionExtra workers draftedOur patient data andepidemiological curve indicatethat the contamination musthave happened earlier in 2009(possibly October). We believethat both PHD and PUC wereaware, warned the constructioncompany but did not enforceregulation14th FebruaryWater ContaminationBoth PHD and PUCconformed with variousactions/measuresWe believe information of the leakreached PUC on 13 th Feb when thewater supply was disconnected at7:30 pmMeetings and site visitsBoth PUC & PHDconfirmed that site still ina desperateunsatisfactory conditionDelay due to (?): politicalapproval, lack ofemergency/business continuityplan, poor logisticsWater supply disconnectedat 7:30pm&:30 PmPHD was not informedPublic announcement should havebeen made earlier with fullinformation. Better use of mediaMinister announcement at 8pmThis was made underpressure from PUC47

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