outdoor residual spraying -...
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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