| How is an outbreak defined in general terms? | the occurrence of an illness in a community, clearly in excess of the expected numbers | Outbreak investigation, response and control An outbreak is defined as the occurrence of an illness in a community, clearly in excess of the expected numbers. Usually, an outbreak is limited to a small focal area. When an outbreak covers a larger geographic area and has more than one focal point, it is termed as an epidemic. Outbreaks are defined differently for different VPDs. For diphtheria, polio, neonatal tetanus or JE, even a single case is defined as an outbreak, whereas for measles and pertussis, a sudden increase in the number of cases is considered to be an outbreak. Steps in outbreak investigation Prompt and timely action during an outbreak is critical for minimizing the damage and maintaining public trust in health and immunization services. The emphasis should be on saving lives. | 71 | definition | 1.000 | https://www.nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Immunization_Handbook_for_Medical_Officers%202017.pdf | Outbreak investigation, response and control An outbreak is defined as the occurrence of an illness in a community, clearly in excess of the expected numbers. | 264 | page=264,block=0 | 0.700 | valid |
| How is the coverage for an antigen calculated? | Total Antigen administered X 100 Yearly target | Immunization handbook for Medical Officers 173 Unit 7 : Sources and use of data Calculating coverage for an antigen at any time = Total Antigen administered X 100 Yearly target Eg- Coverage for Penta 1 from Apr till July is: 104 / 360 X 100 = 28.8% rounded off = 29% Calculate the total number of dropouts and the Dropout Rate (%) as follows: = (Penta 1 cumulative total - Penta 3 cumulative total) x100 Penta 1 Cumulative total Using routine data for action As a first step to data analysis, you should: • Ensure that the vaccination coverage report is received from all ANMs through alternate vaccine delivery system after each session; • Check the data from the monthly progress reports (HMIS/MCTS) for timeliness and completeness. Steps in using routine data for action (refer data in table 7.1 on page 176) There are three major steps in using routine data. Step 1. | 130 | definition | 1.000 | https://www.nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Immunization_Handbook_for_Medical_Officers%202017.pdf | Immunization handbook for Medical Officers 173 Unit 7 : Sources and use of data Calculating coverage for an antigen at any time = Total Antigen administered X 100 Yearly target Eg- Coverage for Penta 1 from Apr till July is: 104 / 360 X 100 = 28.8% rounded off = 29% Calculate the total number of dropouts and the Dropout Rate (%) as follows: = (Penta 1 cumulative total - Penta 3 cumulative total) x100 Penta 1 Cumulative total Using routine data for action As a first step to data analysis, you should: • Ensure that the vaccination coverage report is received from all ANMs through alternate |
| How is the diagnosis of an outbreak confirmed according to clinical criteria? | According to the standard case definition using information obtained by history and examination | Do not wait for confirmation of a suspected outbreak, immediately provide logistic support to the field teams. Once the cause of the outbreak is confirmed, do not further waste laboratory support for diagnosing every case, since standard case management for epidemiologically-linked cases does not require laboratory confirmation. Step 1: Confirm the outbreak Confirmation of an outbreak is done through two related steps. Firstly, you have to visit the area concerned and confirm the diagnosis of as many reported cases as possible. Next, you should ascertain its geographical spread through a preliminary search. Confirm the diagnosis by: – Clinical criteria: According to the standard case definition using information obtained by history and examination. | 665 | definition | 1.000 | https://www.nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Immunization_Handbook_for_Medical_Officers%202017.pdf | Confirm the diagnosis by: – Clinical criteria: According to the standard case definition using information obtained by history and examination. | 264 |
| What are dropouts in the context of immunization? | those children who started vaccination but did not complete the schedule (thus remaining partially immunized) | Immunization handbook for Medical Officers 198 Unit 9 : Communication for behaviour change Left-outs and dropouts From a service delivery perspective: • left-outs are those children who have never been vaccinated or reached (thus remaining unimmunized); • dropouts are those children who started vaccination but did not complete the schedule (thus remaining partially immunized). The immunization-targeted community can be divided into three groups as shown in Fig. 9.1. The aim of the health system (including MOs, HWs and mobilizers) should be to expand the inner circle to cover the entire universe of eligible children in its catchment area. | 269 | definition | 1.000 | https://www.nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Immunization_Handbook_for_Medical_Officers%202017.pdf | Immunization handbook for Medical Officers 198 Unit 9 : Communication for behaviour change Left-outs and dropouts From a service delivery perspective: • left-outs are those children who have never been vaccinated or reached (thus remaining unimmunized); • dropouts are those children who started vaccination but did not complete the schedule (thus remaining partially immunized). |
| What are left-outs in the context of immunization? | those children who have never been vaccinated or reached (thus remaining unimmunized) | Immunization handbook for Medical Officers 198 Unit 9 : Communication for behaviour change Left-outs and dropouts From a service delivery perspective: • left-outs are those children who have never been vaccinated or reached (thus remaining unimmunized); • dropouts are those children who started vaccination but did not complete the schedule (thus remaining partially immunized). The immunization-targeted community can be divided into three groups as shown in Fig. 9.1. The aim of the health system (including MOs, HWs and mobilizers) should be to expand the inner circle to cover the entire universe of eligible children in its catchment area. | 167 | definition | 1.000 | https://www.nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Immunization_Handbook_for_Medical_Officers%202017.pdf | Immunization handbook for Medical Officers 198 Unit 9 : Communication for behaviour change Left-outs and dropouts From a service delivery perspective: • left-outs are those children who have never been vaccinated or reached (thus remaining unimmunized); • dropouts are those children who started vaccination but did not complete the schedule (thus remaining partially immunized). |
| What are the conditions required to diagnose encephalopathy? | Acute onset of major illness characterized by any two of the following three conditions | Immunization handbook for Medical Officers 166 Unit 6 : Adverse events following immunization Encephalopathy • Acute onset of major illness characterized by any two of the following three conditions: • Seizures • Severe alteration in level of consciousness lasting for one day or more • Distinct change in behaviour lasting 1 day or more • Needs to occur within 48 hours of DTP vaccine or from 7 to 12 days after measles or MMR vaccine to be related to immunization No specific treatment available; supportive care Measles, pertussis Fever • The fever can be classified (based on rectal temperature) | 111 | definition | 1.000 | https://www.nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Immunization_Handbook_for_Medical_Officers%202017.pdf | Immunization handbook for Medical Officers 166 Unit 6 : Adverse events following immunization Encephalopathy • Acute onset of major illness characterized by any two of the following three conditions: • Seizures • Severe alteration in level of consciousness lasting for one day or more • Distinct change in behaviour lasting 1 day or more • Needs to occur within 48 hours of DTP vaccine or from 7 to 12 days after measles or MMR vaccine to be related to immunization No specific treatment available; supportive care Measles, pertussis Fever • The fever can be classified (based on rectal temperature) |
| What are working maps used for in microplanning for immunization services? | an overview of the areas with clear lines of demarcations | Unit 3 : Microplanning for immunization services Immunization handbook for Medical Officers 44 Creating working maps for each area: Working maps are simple maps (Figs 3.6/3.7/3.8) which need not be to scale, but provide an overview of the areas with clear lines of demarcations if there are more than one HW. These maps should be developed before going out into the area. Finer details may be added to this map during or in the next part of the process. Refer section on “Making maps” in this unit and also Unit 12. Walk through of areas to ensure clear area demarcation/HRA identification: Once the training is completed the MO/ANM along with the ICDS LS should visit some areas. Priority should be given to those areas where confusion of demarcation exists and HRA areas. A walk through will bring an agreement on the lines of demarcation and will verify all HRAs are included in the list of areas. | 220 | definition | 1.000 | https://www.nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Immunization_Handbook_for_Medical_Officers%202017.pdf | Unit 3 : Microplanning for immunization services Immunization handbook for Medical Officers 44 Creating working maps for each area: Working maps are simple maps (Figs 3.6/3.7/3.8) which need not be to scale, but provide an overview of the areas with clear lines of demarcations if there are more than one HW. |
| What does RI Form 2 provide space for? | drawing a map of the SC area | Unit 3 : Microplanning for immunization services Immunization handbook for Medical Officers 39 RI Form 2– Sub-centre map This form provides space for drawing a map of the SC area. A sample map is also given and health workers are encouraged to put forward simple drawings (see Figs 3.6, 3.7 and 3.8). The maps should be able to show at least the following: • All the villages in the SC area, with names • Shading of parts of a village to demonstrate the ASHA demarcation areas • Location of the SC • Location of all RI session sites • Major roads • Rivers streams. • AEFI management centres Each SC should have a map which helps to clearly demarcate the villages and areas to ensure that the frontline workers have clarity in operations, and avoid overlap or loss of services to the beneficiaries. | 150 | definition | 1.000 | https://www.nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Immunization_Handbook_for_Medical_Officers%202017.pdf | Unit 3 : Microplanning for immunization services Immunization handbook for Medical Officers 39 RI Form 2– Sub-centre map This form provides space for drawing a map of the SC area. | 63 | page=63,block=0 |
| What does a VVM attached to vaccine vials monitor? | cumulative heat exposure over time. | A VVM attached to vaccine vials is also a temperature monitoring device which records cumulative heat exposure over time. Electronic data logger (30DTR – 30 days temperature recorder) Electronic data loggers are being introduced to monitor the temperature of ILR. An electronic logger is an electronic device placed with the vaccines; it records the vaccine temperature for 30 days. It has an alarm that alerts the handlers as soon as the temperature of the equipment storing the vaccines crosses the safe range. Fridge indicator The fridge indicator (Fig. | 86 | definition | 1.000 | https://www.nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Immunization_Handbook_for_Medical_Officers%202017.pdf | A VVM attached to vaccine vials is also a temperature monitoring device which records cumulative heat exposure over time. Electronic data logger (30DTR – 30 days temperature recorder) Electronic data loggers are being introduced to monitor the temperature of ILR. | 127 | page=127,block=7 | 0.700 | valid |
| What does bundling ensure in the vaccine supply chain? | vaccines are always supplied with diluents, droppers, AD syringes and reconstitution syringes, in corresponding quantities | These should also not appear in the available stock balance. Since provision of immunization services depends on the simultaneous availability of a number of related supplies, shortage or stock-out of any of these negatively impact the programme. “Bundling” ensures that vaccines are always supplied with diluents, droppers, AD syringes and reconstitution syringes, in corresponding quantities, at each level of the supply chain. Other related items such as tablet IFA and ORS required for the conduct of Village Health and Nutrition Day also need to be supplied simultaneously. | 271 | definition | 1.000 | https://www.nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Immunization_Handbook_for_Medical_Officers%202017.pdf | “Bundling” ensures that vaccines are always supplied with diluents, droppers, AD syringes and reconstitution syringes, in corresponding quantities, at each level of the supply chain. | 144 | page=144,block=4 | 0.700 | valid |