DEATH AUDIT_Rotavirus Outbreak Alison Ripiapu SIO Cynthia A Joshua Freda Pitakaka MHMS-Public Health Emergency and Surveillance Unit. Ministry of Health and Medical Services

Ministry of Health and Medical Services AIM To enable MHMS to review all deaths that have occurred during the course of this outbreak in order to understand patterns and factors contributing to the deaths and ultimately to take steps to prevent future diarrhoeal related deaths. Ministry of Health and Medical Services

Objectives To determine the socio-demographic characteristics of the diarrhea related death cases To examine the health service factors utilized by care-givers and the death cases To ascertain the health care seeking behavior of care-givers prior to experiencing death To identify vulnerable populations in Solomon Islands and understand factors pertaining to deaths among the reported cases.

Method Audit forms were sent to all Health facilities where deaths occurred- Health facility review and detailed collection of information's from outpatient registration . Verbal communications with surveillance nurses where death occurred through Phone calls.  

Epidemiological summary From Nov 2015 – March 2016 ,approx. 6900 of acute diarrhea attributed to rotavirus outbreak outbreak Age group 0-1 years 2-4 years 5+ years Total Total cases 16 8 10 34

Clinical presentation Ministry of Health and Medical Services

Treatment administered at home & health facility 90% of diarrhea death cases had vomiting & 70% with dehydration. Small proportions with fever, abdominal pain & bloody stool. Majority of the cases at least took traditional medications during illness.

Ministry of Health and Medical Services Place of death 50 Half of all 10 deaths occurred in the clinics – 2/3 deaths with recorded time series died upon reaching the clinic while 1 case stayed for 7 days before died. Ministry of Health and Medical Services

Factors contributed-death . Severe dehydration Late presentations –Health facilities Used of custom medicine Underlying cause-Malnutrition Locations-transports Unavailability of Zinc Oxide and ORS.

Recommendations Strengthen the capacity (resources) of the Health Promotion Unit for continuous administering of key activities to sensitize rural communities and the populations. Death audit – for decision-making – should do for other programs/outbreaks Review/check primary health care package for health workers – establish a system to enhance PHC activities. Implement target programs as priority – e.g. hand washing Change perception of the populations – diarrhea.

Ministry of Health and Medical Services Limitations Discrepancy of death audit forms Incomplete information Only 10 forms received with completed information. Acknowledged all Nurses contributed to this Rotavirus death Audit. TAGIO TUMAS Ministry of Health and Medical Services