33491 - Using the Modified Haddon Matrix to Using the...

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Unformatted text preview: Using the Modified Haddon Matrix to Using the Modified Haddon Matrix to Deal with Infectious Disease Outbreaks Kai­Lit Phua, PhD FLMI Associate Professor Medicine & Health Sciences Monash University (Sunway Campus) Biographical details Biographical details Kai­Lit Phua received his BA (cum laude) in Public Health & Population Studies from the University of Rochester and his PhD in Sociology (medical sociology) from Johns Hopkins University. He also holds professional qualifications from the insurance industry. Prior to joining academia, he worked as a research statistician for the Maryland Department of Health and Mental Hygiene and as an Assistant Manager for the Managed Care Department of a leading insurance company in Singapore. He was awarded an Asian Public Intellectual Senior Fellowship by the Nippon Foundation in 2003. Lecture Objectives Lecture Objectives Brief overview of the Haddon Matrix The Haddon Matrix as a useful tool in the analysis and control of disease outbreaks Example of the use of the Haddon Matrix The Haddon Matrix The Haddon Matrix William H. Haddon, Jr., came up with a Matrix to systematically analyze car crashes The aim was to derive effective injury prevention and control strategies The original Matrix was a 3 X 3 table It was later expanded to a 3 X 4 table Haddon Matrix Haddon Matrix Agent Pre­event During the event Post­event Host Physical Social Environment Environment Using the Haddon Matrix (based Using the Haddon Matrix (based on Cassens 1992) Agent e.g. Before the event (crash) During the event After the event Host e.g. car Good brakes, car properly maintained Airbags, anti­lock brakes Physical Social Environment Environment driver Good vision, Well­ designed alert roads and highways Motorcycle Non­rigid helmet, roadside seatbelt poles, crash Burn­ Emergency resistant medical care fabrics in car barriers Effective emergency transport Penalize drunk driving heavily Mandate the use of safety glass in windows Support medical and rehabilitation Successful Use of the Successful Use of the Haddon Matrix in Injury Control The Haddon Matrix was successfully used in the control of car crash injuries. It was later used to control other injuries too. Can the Haddon Matrix Be Used Can the Haddon Matrix Be Used for Infectious Disease Control? The Haddon Matrix forces us to think systematically about the particular health problem we are dealing with Dan Burnett proposed that the Haddon Matrix be used against SARS Phua modified and expanded the Haddon Matrix and proposed its use against Nipah virus. (He also proposed its use against natural disasters such as tsunamis). Phua’s “Modified Haddon Matrix” to Study Infectious Disease Outbreaks & Natural Disasters Agent Factors leading to the event (before the event) Factors affecting severity, rate of spread, and extent of impact (during the event) Reactions to the event (during the event) Short-term and long-term effects (after the event) Intermediate host “Host” (I)Affected individual (II)Individual’s family (III)Affected community (IV)The larger society Environment Using the “Modified Haddon Matrix” to Analyze Avian Influenza : Action to be Taken Against Factors Identified Below Agent Intermediate host “Host” Environment (I)Affected individual (II) Family members (III)Affected community (IV) Larger society Factors leading to the event (before the event) Agent can Agent cause disease in humans Avian influenza virus present in wild, migratory birds migratory (I) Close contact with & (I) eating of sick birds eating (III) Raising chickens is (III) important economic activity activity Close proximity of Close people & birds e.g. rearing backyard chickens Factors affecting severity, rate of spread, and extent of impact (during the event) Agent does Agent not spread easily between humans humans Can spread from wild to Can domestic birds; wild bird migration patterns in Europe and Asia Europe (I) Mobility of infected (I) individual individual (II) Close contact (III) Community (III) dependent on raising chickens chickens (IV) Chicken exports to (IV) foreign countries foreign Sale and smuggling Sale of infected birds is not stopped quickly not (III) Fear (IV) Mass (III) culling; active monitoring by WHO & Ministry of Health Ministry Tourist arrivals Tourist affected affected (I) High mortality (I) (II) Deaths affect family members members (III) & (IV) Economic (III) losses losses Boon for drug Boon companies; fear of more virulent strains appearing strains Reactions to the event (during the event) Short-term and long-term effects (after the event) Evidence that H5N1 can Evidence also affect non-human animals animals References References Burnett DJ et al. The Application of the Haddon Matrix to Public Health Readiness and Response Training. Environ Health Perspect. 2005; 113(5): 561­66 Cassens BJ. Preventive Medicine and Public Health. 2 nd ed. 1992. Philadelphia: Harwal Publishing. Haddon W. On the Escape of Tigers: An Ecologic Note. Am J Pub Health. 1970; 60: 2229­34. Haddon W. Options for the Prevention of Motor Vehicle Crash Injury. Isr Med J. 1980; 16: 45­65. Phua KL, Lee LK. Meeting the Challenge of Epidemic Disease Outbreaks: An Agenda for Research. J of Pub Health Policy. 2005; 26(1): 122­32. Phua KL. A Model for Lessening the Impact of Natural Disasters and Infectious Disease Outbreaks. J of Emergency Management. 2006; 4(5): 69­74. Phua KL. Post­Disaster Victimization: How Survivors of Disasters Can Continue to Suffer After the Event is Over. New Solutions. 2008; 18(2): 221­31. Thank You Thank You ...
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