outdoor residual spraying -...

OUTDOOR RESIDUAL SPRAYING (ORS) SEBAGAI PENCEGAHAN

DAN KAWALAN DENGGI

TOPEK BIN OMARPegawai Sains (Kaji Serangga)

Sektor Penyakit Bawaan VektorBahagian Kawalan Penyakit

Kementerian Kesihatan Malaysia

PERSIDANGAN KESIHATAN PERSEKITARAN 2015

Aedes aegypti Aedes albopictus

Important MOSQUITOES

Anopheles sp.

Culex sp.

Lain- lain genus:

1. Armigeres sp

2. Mansonia sp

MALE FEMALE

Hanya nyamuk BETINA sahaja yang menggigit dan menghisap darah!

Nyamuk BETINA bertanggungjawab menyebarkan PENYAKIT

Nyamuk JANTAN memerlukan madu, nektar dan jus buah

sebagai makanan dan sumber tenaga

MALARIA DENGUEFILARIASIS

JAPANESE ENCEPHALITIS CHIKUNGUNYA FEVER

Penyakit bawaan nyamuk di Malaysia

DENGUE

HISTORY OF DENGUE IN MALAYSIA

1902 DENGUE FIRST REPORTED BY SKAE IN

PENANG

1954 FIRST ISOLATION OF DENGUE VIRUS (IMR)

1962 -

1964

DENGUE HAEMORRHAGIC FEVER FIRST REPORTED

IN PENANG

1965 -

1980

JUNGLE CYCLE OF DENGUE DISCOVERED (UC-ICMR & IMR)

1973 -

1975

FIRST NATIOWIDE OUTBREAK

1995 FIRST REPORT OF TRANSOVARIAN TRANSMISSION

OF DENGUE VIRUS (IMR)

DENGUE VECTORS

Aedes aegypti

Aedes albopictus

(Rudnick [1986]. Dengue virus ecology in Malaysia. IMR

Bulletin No. 23, pp 51-153.)

Aedes breeds in Containers!

Outdoor breeding of Aedes

Indoor Breeding of Aedes

Integrated Vector Control

Environmental

Management

Indoor Residual

Spraying

Insecticide-treated

bednets

Larviciding

“OUTDOOR

RESIDUAL SPRAY”

UNTUK KAWALAN

DENGGI

Mesyuarat khas yang dipengerusikan

oleh YBMK pada 28 Januari 2015

Susulan daripada peningkatan ketara kes dan

kematian denggi di Malaysia, Menteri Kesihatan

Malaysia telah menyarankan supaya KKM

mengambil satu tindakan yang ‘out of box’

tetapi ‘workable’ dalam kawalan denggi.

Sehubungan dengan itu, YBhg. TKPK(KA) telah

mengarahkan supaya strategi baru iaitu Outdoor

Residual Spraying (ORS) dilaksanakan.

Rationale Pelaksanaan ORS

Kawalan konvensional (PTP, SRT, ULV)

dianggap tidak berjaya memutuskan

transmisi

Kekurangan tenaga kerja dan logistik

Kurangnya kerjasama penduduk

16

Notified and registered dengue cases by week,

Wk.1/2014–Wk. 33/2015, Malaysia.

2014 2015

1705

4314

12531

10501

0

2000

4000

6000

8000

10000

12000

14000

2012 2013 2014 2015

No. of episode of outbreak

2015 – Until EW34

20152014

0

200

400

600

800

1000

1200

1400

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51

Jum

lah

Minggu Epid

WABAK HOTSPOT

Controlled outbreak Uncontrolled Hotspot

2012 1657 43 5

2013 3748 284 282

2014 10048 1239 1244

2015 8334 1028 1139

0

2000

4000

6000

8000

10000

12000

No

. o

de

pis

od

es

Status of Dengue Outbreak 2012-2015

2015 – Until EW34

Outdoor Residual Spraying (ORS)

1. Guna pendekatan IRS dalam kawalan

Malaria

2. Melibatkan 4 daerah utama di Selangor iaitu

Gombak, Hulu Langat, Klang dan Petaling

3. Semburan ke atas ekosistem

4. ORS pertama : Perumahan Jalan Plumbum

7/103, seawal hari Sabtu (7hb Februari 2015)

- Tindakan PKD Petaling

5. ORS Johor bermula pada 27 Jun 2015

Outdoor Residual Spraying (ORS)

ORS sebagai aktiviti komplimentari dalam

kawalan denggi

Sebagai sebahagian dari pada kawalan

ekosistem

SEKSYEN 7 - Shah Alam

2013

2014

Perumahan Plumbum 101-103

Masjid

Flat

Rumah Teres

Sekolah

Kawasan 1 ekosistem. Terdapat 9 lokaliti

Pemilihan Lokaliti Keutamaan Denggi

• Lokaliti hotspot aktif perlu diberi keutamaan.

– Lokaliti hotspot yang berlarutan dengan kes terbanyak perlu disembur dahulu.

• Lokaliti yang mencatatkan kes tinggi sepanjang tahun.

• Lokaliti yang kerap berlaku hotspot atau wabak tidak terkawal.

KAWALAN EKOSISTEM :

Senarai Semak Aktiviti Yang Perlu Dilaksanakan Di Sesuatu

Ekosistem

BIL. AKTIVITI

5 Pemantauan indikator entomologi

o AI / BI / CI / OI / SOI

6 Penjagaan persekitaran

6a o Pengumpulan dan kutipan

sampah yang baik

6b o Sistem peparitan lancar

6c o Pembersihan kawasan lapang

(no man’s land) termasuk

tempat tumpuan awam

7 Pendidikan kesihatan

7a o Gotong-royong

7b o Hebahan awam

8 Penglibatan komuniti

8a o Pemeriksaan kendiri

8b o Semburan aerosol

BIL. AKTIVITI

1 Penghapusan Tempat Pembiakan

(PTP)

o Apabila terdapat kes baru

dalam ekosistem (jika perlu)

o Search and destroy

2 Semburan Ruang

o Apabila terdapat kes baru

dalam ekosistem (jika perlu)

3 Semburan Larviciding Temephos

EC/Bti

o Kekerapan setiap minggu

selama sebulan diikuti selang

2 minggu sehingga wabak

tamat bagi lokaliti hotspot

4 Semburan residual setiap 3 bulan

o Di lokaliti terpilih

o Di blok terpilih

Objektif ORS

Mengurangkan densiti nyamuk Aedes

Aedes mendarat dan berehat

Mengurangkan jangka hayat nyamuk Aedes

Kemandirian berkurangan

Mengurangkan transmisi denggi

Mengurangkan morbiditi dan mortaliti kes

denggi

Kesihatan awam terpelihara

Semburan ResiduSEMBURAN RESIDU – semburan yang menggunakan racun

serangga yang tahan lama seperti Deltamethrin ke atas

PERMUKAAN RATA seperti di dinding rumah (porch / backyard),

pagar konkrit, tiang, alang yang dipercayai menjadi tempat

persembunyian nyamuk.

Semburan PerifokalSemburan perifokal – juga disebut barrier spray. Racun serangga

disembur pada KAWASAN BERSEMPADANAN dengan kediaman

manusia seperti pagar, longkang, pokok-pokok renek yang berpotensi

menjadi tempat persembunyian/rehat nyamuk

Kawasan Semburan – Rumah Teres

During the spray….

During the spray….

Residual Study pada 1954

The first residual spraying for control of Aedes using

DDT was conducted in 1954 in Port Swettenham (Port

Klang).

The results were not published because it was

ineffective in controlling Ae. aegypti.

This study was mentioned by Cheong in IMR Bulletin

No 23 (Dengue fever studies in Malaysia, 1986)

Residual Study pada 1957

Later McDonald (1957) carried out control experiment in Jeram

and Kapar using DDT.

In Jeram, a total of 2 six-monthly perifocal sprays of DDT were carried out.

In Kapar, DDT pallets (DDT+ plaster of Paris) were also added into

container for 5 months.

Residual spraying with DDT in Jeram showed complete control of

Ae. aegypti for >1 year.

McDonald (1957) concluded that perifocal residual spraying was a simple and effective method for controlling Ae. aegypti.

However, this method was never used probably due to the safety

consideration of DDT toxicity.

Pada 2007…

Pn Mahani Yusoff (Entomologis) telah menjalankan

semburan yang sama di kawasan Wakaf Mek

Zainab.

Hasil kajian menunjukkan bahawa metod ini

berjaya mengurangkan nyamuk Aedes selama

setahun.

Walaubagaimanapun kajian ini tidak diterbitkan.

Pada 2005…

Rozilawati et al conducted the ORS study and had shown that

ORS WAS EFFECTIVE for controlling dengue vectors especially in

the area where the Aedes population was high and routine

preventive maintenance could not be implemented, e.g. in a

slum

25mg/m2 of deltamethrin was sprayed on concrete wall and it

was effective in controlling adult Ae. aegypti and Ae. albopictus for 6 weeks.

Pada tahun 2013…

Pendekatan ini digunakan semula di Daerah

Hulu Langat, Selangor.

4 Lokaliti digunakan dalam kajian ini dan 2

lokaliti sebagai kawalan iaitu

Apartment Seraya

Sebahagian daripada Seksyen 5 Bandar

Rinching.

Kajian selama setahun menunjukkan bahawa

terdapat penurunan dalam kes yang

dilaporkan dan populasi nyamuk sehingga 2

bulan.

WHO Guidelines

Prosedur penyemburan

mestilah mengikut garis

panduan yang diberikan

oleh WHO

(Indoor Residual

Spraying: An Operational

Manual For Indoor

Residual Spraying (IRS)

For Malaria Transmission

Control And Elimination,

2013)

AEDES RESTING ON THE WALLS !

IS IT ?

Mosquito resting on the walls: Others study

AEDES RESTING ON THE WALLS! IS IT?

THE EVALUATION OF THE

EFFECTIVENESS OF RESIDUAL

SPRAY IN RESIDENTIAL AREA

INDICATOR OF EFFECTIVENESS

Ovitrap Index

Epidemiology Data

Knockdown and mortality rate of adults

for WHO cone bioassay

Laboratory strain; Aedes aegypti and Aedes

albopictus

THE METHODS

PUBLIC ENGAGEMENT

BROCHURE

BANNER

POSTER

INTERVIEWS

ANNOUNCEMENT - THROUGH THE NEARBY MOSQUE, EVERY PRAYER TIME

AND FRIDAY PRAYER 3 DAYS BEFORE THE SPRAYING ACTIVITIES WERE

CONDUCTED

• Made of stainless steel

• Recommended and Approved

by WHO

Compression Sprayer Can

ACTIVITIES: OVITRAPPING

EVALUATION OF EFFECTIVENESS

Cone Bioassay

Analysis

Semburan Residual Kawalan

Denggi di Kg Tengku Hussein

Baharu, Perak

Pn Mahani Yusoff

Pegawai Sains (Kaji Serangga)

Unit Kawalan Penyakit Bawaan Vektor

Perak Darul Ridzuan.

&

Unit Entomologi dan Pest Negeri Perak

Study Details

Lokaliti:

Kg Tengku Hussein (no wabak 21324) – hotspot

Wabak bermula 21 Nov 2014 dan tamat 17 Feb 2015

Penempatan tradisional dan didiami oleh 100% kaum Melayu.

Semburan:

Semburan residu, “spot indoor residual spray”, perifocal spray.

Racun serangga: K-Othrine 250WG

Spray can: Hudson X-pert.

Bilangan staf: 4 PKA dan 7 Pembantu Awam

Results

Sejumlah 355 buah rumah telah disasarkan

76% telah dijalankan spot indoor residual spray and

residual spray

95% telah berjaya disembur di bahagian luar

Sebanyak 4.36kg racun telah digunakan.

42

.80

37

.20

41

.10

7.1

0

52

.90

34

.80

37

.00

10

.70

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00

Pre -Week 1 Pre -Week 2 Spray Week Post - Week 1 Post - Week 2

Ovi

trap

Ind

eks

Tren Indeks Ovitrap Dari Minggu Pertama Aktiviti Dijalankan Sehingga Minggu Terakhir Aktiviti Dijalankan

Ovitrap Index Indoor Ovitrap Index Outdoor

Reduction of OI was observed after 2 weeks post

residual spray

DENGUE & MENTARI COURT

Topek Omar, Entomologist, Vector Borne Disease Sector, Disease Control Division , Ministry of Health, Putrajaya

• Mentari Court, located in Petaling

District.

• This area is one of the areas that has a

non-stop dengue cases since June

2013.

• Contains of 7 block, 17 stories, 25 unit

apartments in every floor.

• Most of the population in this area are

immigrant workers and also foreign

students

Residual Spray in Mentari Court

0

2

4

6

8

10

12

14

16

18

20

No

of

de

ng

ue

ca

ses

rep

ort

ed

Epid Weeks

1st spray

1st spray

(mopping) 2nd spray

DENGUE & APARTMEN SERI IMPIAN,

JOHOR BAHRU

Dr Roslinda Abdul Rahman, Kayrul Hidayah bt Mansor, Johor Bahru Health Office

Topek Omar, Entomologist, Vector Borne Disease Sector, Disease Control Division , Ministry of Health,

Putrajaya

• The first Residual Spray (RS) conducted in Johor Bahru was in

Apartment Seri Impian on 7th – 9th July 2015.

• Apartment Sri Impian contain 4 blocks, and 23 stories.

• The youngest patient recorded was 2 years old and the oldest was

55 years old.

• This area is located near to the construction sites (~100m) and

also near to the town house with the massive breeding area.

Dengue cases reported VS Epid Week

0

5

10

15

20

25

30

20 21 22 23 24 25 26 27 28 29 30

No

of

de

ng

ue

ca

ses

rep

ort

ed

Epid Weeks

Residual Spray 7th – 9th July

2015

Pre Spray Ovitrap

Index

1st Post RS Ovitrap

Index

2nd Post Spray Ovitrap

Index

7 July 2015 28 July 2015 4 August 2015

16.2 % 7.0% 2.8%

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT RS DAN LOKALITI

TIADA RS (PETALING)

5 MINGGU SEBELUM DAN SELEPAS ORS DIJALANKAN

69

TREN KES DI NEGERI SELANGOR

0

500

1000

1500

2000

2500

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53

JU

MLA

H K

ES

MINGGU EPID

Median 2010-2014 2014 2015

1st cycle of

ORS

2nd cycle of

ORS

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SEKSYEN 7 SHAH ALAM (7 LOKALITI)

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO SEKSYEN 7 SHAH ALAM (ORS) Linear (EKO SEKSYEN 7 SHAH ALAM (ORS))

ORS

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO SEKSYEN 7 SHAH ALAM (TIADA ORS) Linear (EKO SEKSYEN 7 SHAH ALAM (TIADA ORS))

AI

9.38%

CI

1.67%

AI

1.67%

CI

0.38%

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM PJS SEK. 14-18 (5 LOKALITI)

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO PJS SEK. 14-18 (ORS) Linear (EKO PJS SEK. 14-18 (ORS))

ORS

AI 7.53%

CI 0.86%

AI 3.8%

CI 0.73%

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO PJS SEK. 14-18 (TIADA ORS) Linear (EKO PJS SEK. 14-18 (TIADA ORS))

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM PJU 1A (4 LOKALITI)

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

PETALING EKO PJU 1A (ORS) Linear (PETALING EKO PJU 1A (ORS))

ORS

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO PJU 1A (TIADA ORS) Linear (EKO PJU 1A (TIADA ORS))

AI 0.38%

CI 0.83%AI 10.53%

CI 0.86%

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM BANDAR KINRARA (6 LOKALITI)

-10

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10 11 12

EKO BANDAR…Linear (EKO…

ORS

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

PETALING EKO BANDAR KINRARA (TIADA…

AI 12.37%

CI 2.14%AI 4.88%

CI 0.84%

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SEKSYEN 24-29 SHAH ALAM (7 LOKALITI)

-10

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO SEK. 24-29 SHAH ALAM (ORS) Linear (EKO SEK. 24-29 SHAH ALAM (ORS))

ORS

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO SEK. 24-29 SHAH ALAM (TIADA ORS) Linear (EKO SEK. 24-29 SHAH ALAM (TIADA ORS))

AI 11.86%

CI 2.5%AI 1.49%

CI 0.38%

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM USJ (8 LOKALITI)

-10

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10 11 12

EKO USJ (ORS) Linear (EKO USJ (ORS))

ORS

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10 11 12

EKO USJ (TIADA ORS)

EKO USJ (TIADA ORS) Linear (EKO USJ (TIADA ORS))

AI 6.06%

CI 0.63%

AI 2.09%

CI 0.58%

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SEKSYEN 20 SHAH ALAM (9 LOKALITI)

-10

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO SEKSYEN 20 SHAH ALAM (ORS) Linear (EKO SEKSYEN 20 SHAH ALAM (ORS))

AI 2.27%CI 0.5%

ORS

-10

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO SEKSYEN 20 SHAH ALAM…

AI 9.62%

CI 2.5%

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM PUCHONG (7 LOKALITI)

-10

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

PETALING EKO PUCHONG (ORS) Linear (PETALING EKO PUCHONG (ORS))

AI 2.73%

CI 2.5%

AI

14.29%

CI 0.71%

0

2

4

6

8

10

12

14

16

18

20

1 2 3 4 5 6 7 8 9 10

PETALING EKO PUCHONG (TIADA ORS) Linear (PETALING EKO PUCHONG (TIADA ORS))

ORS

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM PJU 6 KAYU ARA (3 LOKALITI)

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

PETALING EKO PJU6 KAYU ARA (ORS) Linear (PETALING EKO PJU6 KAYU ARA (ORS))

ORS

AI 25.0%

CI 5.0%

AI 4.26%

CI 1.67%

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

PETALING EKO PJU6 KAYU ARA (TIADA ORS) Linear (PETALING EKO PJU6 KAYU ARA (TIADA ORS))

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SEKSYEN U2-U6 (5 LOKALITI)

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO SEKSYEN U2-U6 (ORS)

ORS

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO SEKSYEN U2-U6 (TIADA ORS)

AI 14.31%

CI 6.35%

AI 3.33%

CI 2.5%

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SRI DAMANSARA (5 LOKALITI)

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO SRI DAMANSARA (ORS) Linear (EKO SRI DAMANSARA (ORS))

ORS

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO SRI DAMANSARA (TIADA ORS) Linear (EKO SRI DAMANSARA (TIADA ORS))

AI

8.0%

CI

1.1%

AI

3.33%

CI

1.1%

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SS 14-18 (7 LOKALITI)

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKO SS 14-17 (ORS) Linear (EKO SS 14-17 (ORS))

ORS

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10 11 12

EKO SS 14-17 (TIADA ORS) Linear (EKO SS 14-17 (TIADA ORS))

AI 6.25%

CI 1.1%AI 5.18%

CI 1.25%

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SG. BULOH (8 LOKALITI)

-10

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKOSISTEM SG. BULOH (ORS) Linear (EKOSISTEM SG. BULOH (ORS))

ORS

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

EKOSISTEM SG. BULOH (TIADA ORS) Linear (EKOSISTEM SG. BULOH (TIADA ORS))

AI 23.08%

CI 1.15% AI 12.5%

CI .0.25%

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM TAMAN LESTARI (4 LOKALITI)

0

5

10

15

20

25

30

35

40

45

50

1 2 3 4 5 6 7 8 9 10

PETALING EKO TAMAN LESTARI (ORS)

ORS

-10

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10

PETALING EKO TAMAN LESTARI (TIADA ORS) Linear (PETALING EKO TAMAN LESTARI (TIADA ORS))

AI 13.33%

CI 1.25%

AI 7.41%

CI 0.25%

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SS2 PETALING JAYA (6 LOKALITI)

-10

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10 11 12

EKO SS2 PETALING JAYA (ORS) Linear (EKO SS2 PETALING JAYA (ORS))

ORS

0

10

20

30

40

50

1 2 3 4 5 6 7 8 9 10 11 12

EKO SS2 PETALING JAYA (TIADA ORS) Linear (EKO SS2 PETALING JAYA (TIADA ORS))

AI 5.41%

CI 5.0%

AI 2.17%

CI 2.5%

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN

LOKALITI TIADA ORS

SEHINGGA ME30 BERDASARKAN TARIKH ONSET

y = -0.5059x + 14.308R² = 0.5419

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

EKOSISTEM LESTARI PUCHONG (7 Lokaliti ORS)

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM LESTARI PUCHONG (7 LOKALITI)

y = 0.0216x + 2.2989R² = 0.007

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM LESTARI PUCHONG (7 Lokaliti TIADA ORS)

BERKESAN

Du

rati

on

of

1st

Cyc

le O

RS

y = -0.3364x + 10.68R² = 0.4839

0

2

4

6

8

10

12

14

16

18

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

EKOSISTEM PJU 1A (6 Lokaliti ORS)

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM PJU 1A (6 LOKALITI)

Du

rati

on

of

1st

Cyc

le O

RS

y = 0.0151x + 4.2322R² = 0.001

0

2

4

6

8

10

12

14

16

18

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM PJU 1A (6 Lokaliti TIADA ORS)

BERKESAN

y = -0.1878x + 7.0437R² = 0.4621

0

1

2

3

4

5

6

7

8

9

10

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM SG. BULOH (8 Lokaliti ORS)

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SG. BULOH (8 LOKALITI)

y = -0.1206x + 4.869R² = 0.2971

0

1

2

3

4

5

6

7

8

9

10

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

EKOSISTEM SG. BULOH (8 Lokaliti TIADA ORS)

BERKESAN

Duration of

1st

Cycle ORS

y = -1.8303x + 46.536R² = 0.6326

0

5

10

15

20

25

30

35

40

45

50

55

60

65

1 2 3 4 5 6 7 8 9 1011121314151617181920212223242526272829303132

EKOSISTEM SEK. 7 (7 Lokaliti ORS)

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SEK. 7 (7 LOKALITI)

y = -0.2069x + 7.0069R² = 0.3962

0

5

10

15

20

25

30

35

40

45

50

55

60

65

1 2 3 4 5 6 7 8 9 1011121314151617181920212223242526272829303132

EKOSISTEM SEK. 7 (7 Lokaliti TIADA ORS)

BERKESAN

Duration of 1st

Cycle ORS

y = -0.4632x + 14.446R² = 0.5034

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM S24-29 (7 Lokaliti ORS)

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SEKSYEN 24-29 SHAH ALAM (7

LOKALITI)

y = -0.1453x + 6.8184R² = 0.2223

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM S24-29 (7 Lokaliti TIADA ORS)

BERKESAN

Du

rati

on

of

1st

Cyc

le O

RS

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM BANDAR KINRARA (10 LOKALITI)

y = -0.3695x + 12.714R² = 0.3994

0

2

4

6

8

10

12

14

16

18

20

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

EKOSISTEM KINRARA (10 Lokaliti ORS)

y = -0.0836x + 5.6966R² = 0.0806

0

2

4

6

8

10

12

14

16

18

20

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM KINRARA (10 Lokaliti TIADA ORS)

BERKESAN

Du

rati

on

of

1st

Cyc

le O

RS

y = -0.592x + 19.009R² = 0.6231

0

2

4

6

8

10

12

14

16

18

20

22

24

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

EKOSISTEM SEKSYEN 20 (9 Lokaliti ORS)

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SEKSYEN 20 SHAH ALAM (9

LOKALITI)

y = -0.1882x + 5.3839R² = 0.4247

0

2

4

6

8

10

12

14

16

18

20

22

24

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM SEKSYEN 20 (9 Lokaliti TIADA ORS)

BERKESAN

Duration of 1st

Cycle ORS

y = -0.4647x + 16.17R² = 0.4654

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

EKOSISTEM PUCHONG (12 Lokaliti ORS)

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM PUCHONG (12 LOKALITI)

y = -0.0926x + 7.0443R² = 0.0358

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9 1011121314151617181920212223242526272829

EKOSISTEM PUCHONG (12 Lokaliti TIADA ORS)

BERKESAN

Duration of 1st

Cycle ORS

y = -0.1938x + 7.3034R² = 0.3293

0

2

4

6

8

10

12

14

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM PJU 6 (6 Lokaliti ORS)

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM PJU 6 KAYU ARA (6 LOKALITI)

y = -0.0756x + 4.9724R² = 0.0414

0

2

4

6

8

10

12

14

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

EKOSISTEM PJU 6 (6 Lokaliti TIADA ORS)

BERKESAN

Du

rati

on

of

1st

Cyc

le O

RS

y = -0.8005x + 21.732R² = 0.4063

0

5

10

15

20

25

30

35

40

1 2 3 4 5 6 7 8 9 1011121314151617181920212223242526272829

EKOSISTEM PJS 14-18 (5 Lokaliti ORS)

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM PJS 14-18 (5 LOKALITI)

y = -0.1475x + 8.0529R² = 0.2170

5

10

15

20

25

30

35

40

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM PJS 14-18 (5 Lokaliti TIADA ORS)

BERKESAN

Du

rati

on

of

1st

Cyc

le O

RS

y = -0.2228x + 10.305R² = 0.2054

0

2

4

6

8

10

12

14

16

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27

EKOSISTEM SD DAMANSARA (10 Lokaliti ORS)

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SRI DAMANSARA (10 LOKALITI)

y = 0.0903x + 5.2R² = 0.0471

0

2

4

6

8

10

12

14

16

1 2 3 4 5 6 7 8 9 10 11 12 1314 15 16 1718 19 20 2122 23 24 2526 27 28 2930

EKOSISTEM SD DAMANSARA (10 Lokaliti TIADA ORS)

BERKESAN

Du

rati

on

of

1st

Cyc

le O

RS

y = -0.5726x + 16.143R² = 0.5687

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM SS U2 (7 Lokaliti ORS)

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SS U2 (7 LOKALITI)

y = -0.4227x + 12.085R² = 0.549

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM SS U2 (7 Lokaliti TIADA ORS)

KURANG BERKESAN : Both R-squared for ORS and

non-ORS are almost identicalValues of R-squared close to 1 indicates excellent

linear reliability

Du

rati

on

of

1st

Cyc

le O

RS

y = -0.0365x + 10.34R² = 0.0045

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9 1011121314151617181920212223242526272829

EKOSISTEM SS 2 (11 Lokaliti ORS)

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SS2 PETALING JAYA (11 LOKALITI)

y = -0.0836x + 6.3632R² = 0.0937

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM SS 2 (11 Lokaliti TIADA ORS)

KURANG BERKESAN : Both R-squared for ORS and

non-ORS are almost identical

Duration of

1st

Cycle ORS

y = -0.5101x + 15.274R² = 0.5962

0

2

4

6

8

10

12

14

16

18

20

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM SS 14-18 (7 Lokaliti ORS)

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM SS 14-18 (7 LOKALITI)

y = -0.3066x + 8.9517R² = 0.6796

0

2

4

6

8

10

12

14

16

18

20

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

EKOSISTEM SS 14-18 (7 Lokaliti TIADA ORS)

KURANG BERKESAN : Both R-squared for ORS and

non-ORS are almost identical

Du

rati

on

of

1st

Cyc

le O

RS

PERBANDINGAN KES DENGGI DI LOKALITI DIBUAT ORS DAN LOKALITI TIADA ORS (PETALING) - EKOSISTEM USJ (10 LOKALITI)

KURANG BERKESAN

y = -0.1566x + 8.2276R² = 0.1627

0

2

4

6

8

10

12

14

16

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930

EKOSISTEM USJ (10 Lokaliti ORS)

y = -0.2558x + 8.8989R² = 0.446

0

2

4

6

8

10

12

14

16

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

EKOSISTEM USJ (10 Lokaliti TIADA ORS)

Duration of 1st

Cycle ORS

Conclusion

• RS has reduced Ovitrap Index, Larval Number in the first month post spraying

• It interrupted dengue transmission in the treated area.

• Under Malaysian conditions, ORS is effective for about 3 months by using Deltamethrin

• ORS effectiveness appears to be dependent on the wall surface characteristics, geographical area, rainfall, relative humidity and temperature.

RINGKASAN

• Daripada 106 lokaliti yang menjalankan ORS sehingga 1.5.2015,sebanyak 87 (82%) lokaliti menunjukkan penurunan kes selepas 5minggu dilaksanakan.

• Sehingga 22.8.2015 (ME33), semburan ORS menunjukkan kesan positifke atas tren kes di 11 daripada 15 ekosistem di daerah Petaling.

• Antara faktor yang menyumbang kepada ketidakberkesanan ORS dibeberapa ekosistem adalah kerana masalah pembiakan lebih tertumpudi kawasan bukan kediaman seperti di SS2 Petaling Jaya

• Semburan ORS menggunakan K-Othrine WG hanya mampu bertahantidak lebih dari 2 bulan walaupun pada jangkaan awal adalah 3 bulan.

• Semburan pusingan seterusnya sebaiknya dilaksanakan setiap 2 bulan.

Residual Spray: Is it effective in

controlling dengue?

Yes, but it is only a method

It should combine with other methods, fogging, spot indoor residual spraying, treated ovitraps.

It is a complementary control method to the existing method that we have.

RS need

A good plan

Machine (compression sprayer)

Trained operators

Prioritize area

Acknowledgements

Deputy Director General of Health (PH)

Vector Borne Disease Sector, Disease Control Division – Dr. Rose Nani Mudin

Medical Entomology Unit, IMR - Dr Nurulhusna

DELTAMETHRIN: SAFETY PROFILES

Deltamethrin was first synthesized in 1974

Widelu used in agriculture & public health

WHO classified deltamethrin in the most favorable category

(products unlikely to induce risks of acute intoxication)

It has low vapour pressure (unable to vaporise easily)

Deltamethrin is used in malaria control since 1980’s

In Malaysia deltamethrin was first used for IRS for malaria control

To date, no report of human poisoning in irs n imprenated bednet

Health Impact to human and pets ?

Health Impact to human and pets ?

RESIDUAL SPRAY FOR DENGUE CONTROL

Topek O1, Nurulhusna AH2, Rose Nani M1

1 Vector Borne Disease Sector, Disease Control Division, Ministry of health Malaysia, Level 4, Block E10, Parcel E, Federal Government Administration Complex, 62590, Putrajaya, Malaysia.

2 Medical Entomology Unit, Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia

K-ORTHRINE POLYZONE & DOSE

PREPARATION

K-OTHRINE POLYZONE features a proprietary

polymer layer that protects the active

ingredient from weather, irrigation and

mechanical abrasion.

The a.i. consists of deltamethrin (4.65%)

This polymer enhanced formulation, which

resists erosion remains efficacious for up to

90 days on aggressive substrates, including

high alkaline surfaces such as cement (US

condition)

1 bottle formulation contain 62.5 g

deltamethrin and should be diluted with 7.5

L water and sprayed to obtain 30mg/m2