Malaria Prevention Level 2

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Malaria Prevention - Level 2
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Prevention Level 2
This presentation is for Schlumberger
international employees working in medium and
high malaria risk countries. In particular for
those working in the company designated high
malaria risk countries below
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Kills
It can happen to you.remember?
June 2001 An employee working in Equatorial Guine
a, went on days off and a few days later, he died
of deadly malaria (falciparum)
He left a wife and 3 kids behind
Sept 2002 An employee working in Chad, went for d
ays off and 12 days later, he died of deadly
malaria (falciparum)
He left behind a big family
July 2006 An employee working offshore on a rig,
started feeling ill. No test for malaria was ever
made and he died of deadly falciparum malaria 4
hours after retuning to land He left behind a wif
e and 2 young children
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Kills.
Attending this training and following these reco
mmendations
could save your life
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Deaths Common Threads
There were 5 SLB-involved malaria deaths from
2000 - 2006

• Most happened away from high-risk area (days-off)

• Visitors / rotators / staff in transit / long
  term resident expats

• Time lost due to late diagnosis lack of
  medication

• None had curative medicine with them
• The Curative Malaria Kit was introduced
  in 2003

• Most cases from Sub-Saharan Africa

We have had MANY close calls
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Deaths Pattern due to.

• Days-off mentality

• Awareness levels fall when away from high risk
  location

• Incubation period of malaria delays symptoms

• Symptoms easily-confused (looks like the flu)

• Doctors ignorance of malaria in much of world

• Complacency it wont happen to me

OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Who is fit to go?

• In order to work in high malaria risk countries
  you must
  
• Be declared medically fit on your last company
  health assessment
  
• Have the required company-designated
  vaccinations
  
• Be aware of the dangers of malaria

• Special attention should be paid to
• Children under 3 years of age
• Mosquito nets should be used whenever possible
  and a doctors advice should be sought prior to
  administering any preventative or curative
  medicine

• Company designated high malaria risk countries
  are not recommended for
  
• Pregnant women

OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria The Key Facts

• It is a disease transmitted by mosquitoes

• The disease is passed by female Anopheles
  mosquitoes that bite at NIGHT

• The mosquito injects parasites into the blood
  which take less that 30 minutes to reach the liver

• Once in the liver parasites develop until ready
  to leave and enter the blood stream where they
  attack red blood cells

• One bite is enough to give you malaria

• It affects over 40 of the worlds population
  infecting between 300 500 million people per
  year resulting in over a million deaths worldwide
  (80 in Africa)

• From the time one gets bitten to the time the
  symptoms start to appear can take between 7 and
  60 days

• There is no vaccination

TREATMENT IS URGENT! THIS IS AN EMERGENCY
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria The Key Facts
The Anopheles Mosquito

• Only falciparum malaria kills

• Once correctly treated falciparum malaria can
  ONLY reoccur if the person is once again bitten
  by an infected mosquito

• There are 3 other forms of malaria vivax, ovale
  and malariae these are very rarely fatal.
  However, even if correctly treated, these 3 forms
  of malaria can reoccur for many years without any
  new mosquito bite

• The Schlumberger Curative Malaria Kit ONLY tests
  for the fatal form of falciparum malaria,
  however, the medication is effective on ALL 4
  types of malaria

OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Life Cycle of Malaria In nature, malaria parasit
es spread by infecting successively two types of
hosts humans and female Anopheles mosquitoes. In
humans, the parasites grow and multiply first in
the liver cells and then in the red cells of the
blood. In the blood, successive broods of
parasites grow inside the red cells and destroy
them, releasing daughter parasites that continue
the cycle by invading other red cells.
The blood stage parasites are those that cause
the symptoms of malaria. When certain forms of
blood stage parasites are picked up by a female
Anopheles mosquito during a blood meal, they
start another, different cycle of growth and
multiplication in the mosquito.
After 10-18 days, the parasites are found in the
mosquito's salivary glands. When the Anopheles
mosquito takes a blood meal on another human, the
parasites are injected with the mosquito's saliva
and start another human infection when they
parasitize the liver cells. Thus the mosquito car
ries the disease from one human to another
(acting as a "vector"). Differently from the
human host, the mosquito vector does not suffer
from the presence of the parasites.
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Malaria Symptoms
There are no specific symptoms for malaria. The
main symptoms of malaria are often mistaken for
those of flu (the common cold). They can include
any of the following

• fever
• chills
• headache
• fatigue
• weakness
• aches and pains
• abdominal pain
• diarrhoea
• vomiting

If you have any of these symptoms and you live in
a malaria country or have visited a malaria
country within the last 8 weeks

• See a doctor

• Get a blood test for malaria

• Do not lose time

Until you have proven otherwise, assume any of
these symptoms are symptoms of malaria
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Prevention is based on
If you are a visitor to or an employee in a high
risk country, your safety is based on two lines
of defense
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria - Mosquito control 6 Building Blocks
Source Reduction Deny breeding grounds
Personal Protection Deny the blood meal
Larvicides Chemical/Biological
Actions Prevent water logging, destroy unwanted w
ater collections, keep water containers closed
Actions Close windows and doors to prevent entry
Protect humans against mosquito bites by using
bednets (insecticide treated) and repellants
Actions Kill the larvae with larvicidal agents
Prevent Entry
Insecticides
Bite Prevention Adult female mosquitoes bite huma
n beings at night, maximum at 10pm-4am
Actions Close the doors and windows at that time
clear hiding places if possible
Actions Kill the adults with space sprays (for in
stant kill) and residual sprays (for lasting
effect)
Actions Personal protection by covering the body
with clothes use of mosquito nets and repellents
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Insect bite prevention 6 Top Tips
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Insect bite prevention

• INDOORS CHECKLIST
• Windows and doors are kept closed
• Doors and windows are fitted with screens and
  regularly checked for holes
  
• Where available air conditioning is working and
  on cold (preferably 20ºC)
  
• At night electric diffusers are plugged in and
  working, particularly in bedrooms
  
• On verandas coils are burned
• Accommodation is regularly sprayed with
  insecticide
  
• Chemically treated bed net is provided and
  regularly checked for holes and used correctly
  (tucked under the mattress all around the bed)
  

• OUTDOORS - CHECKLIST
• Long sleeve shirts are worn
• Long trousers are worn at all times
• Always wear socks outside at night
• Before going outdoors apply repellent to
  uncovered parts of the body
  
• Stay indoors at night whenever possible

OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Preventative medication
In company designated high malaria risk
countries, use of preventative medication is
highly recommended especially for visitors who
are particularly susceptible. Preventative
medicine works by preventing the malaria parasite
from growing in the liver.
Take as preventative medication one of the
following medicines

• 1 tablet/day of Malarone
• 1 tablet/WEEK of Lariam (Mefloquine) 250 mg
• 1 tablet/day of Doxycycline 100mg
• 1 tablet/day of Savarine (Note cannot be used
  on ExxonMobil projects e.g.Chad or Equatorial
  Guinea)

All medication needs to be taken REGULARLY during
the entire stay in a malaria country and for 4
weeks after leaving a malaria country except for
Malarone which needs to be taken for only 7 days
after leaving a malaria country.
The risk of side effects exists with all medicat
ions but is small and reversible when medication
is stopped. The risk of side effects is always
smaller than the risk of malaria which is..
DEATH !
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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WARNING.
Therefore, even if you are taking a preventative
treatment and come down with any of the symptoms
of malaria
see a Doctor URGENTLY!!
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Once you leave the work location
Once you leave a malaria country your malaria
risk increases dramatically because you may not
think malaria first. Once away from the
location

• You are in a days off mentality

• Those around you might not suspect malaria

• Your doctor will very likely not suspect malaria
  and may not have much experience of malaria or
  curative medicine

• The incubation period of malaria can cause the
  onset of symptoms to occur weeks after leaving
  work (up to 8 weeks!)

You must be aware that this is where the risk of
your contracting malaria is by far the highest!
Nearly all our malaria deaths have occurred after
leaving a high risk country!!!
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria When you travel to a remote location
When you travel to a remote location/rig your
malaria risk also increases significantly because
medical support and treatment could be many hours
way

• The location is remote and maybe hard to reach in
  an emergency

• You may not have access to high quality medical
  care

• You may not have reliable communications with the
  outside world

• Medivac takes time to arrange

You must always take a Curative Malaria Kit with
you when you visit a remote location or oil rig.
If you fail to do this you are putting your life
at risk
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria With a little help from my friends
When you have malaria you might not be able to
think correctly, having a high temperature may
impair your judgment. Make sure your family,
friends and co-workers

• know what the symptoms of malaria are so they
  know what to look out for

• understand that Plasmodium falciparum malaria can
  attack fast and that if not treated soon you may
  lose the ability to help yourself

• know that an extra pair of eyes watching you may
  see symptoms you yourself dont recognise

• know that they should inform Schlumberger if you
  become ill with flu like symptoms

• know about the Malaria Hotline and how to use it

• know how to use the Curative Malaria Kit

OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria What do I do if I suspect malaria?
Every member of staff has the responsibility to
locate the nearest doctor/hospital to their place
of residence that has experience in treating
tropical disease. Ensure that you

• See a doctor rapidly and take your Curative
  Malaria Kit

• If you catch malaria you may rapidly lose the
  ability to think straight

DO NOT LOSE TIME! THIS IS AN EMERGENCY
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Curative Kit

• Place the end of the pipette containing blood in
  window A (see next slide). Blood will be absorbed
  by the membrane

• Wait for up to 15 minutes to see the result of
  the test

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Malaria Curative Kit How to read the results
NOTE A negative test means you have a negative
test. It does NOT mean you do not have malaria
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Ignorance KILLS!
Maybe..
If symptoms persist you must make a re-test after
12 hours
THINK MALARIA FIRST
Your life is on the line
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Curative Kit If your first test is
negative

• The first malaria test could be negative

IF THE FIRST TEST IS NEGATIVE REPEAT THE TEST
AFTER 12Hrs
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Curative Kit How to use the lancet
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Malaria Curative Treatment
Company designated curative anti-malarial
treatment is based on

• 4 tablets morning and evening for 3 days. Total
  of 24 tablets
  
• Once started, Coartem should be continued for the
  full 3 days, even if the 3 tests remain negative
  
• Curative medicine kills the blood stage of the
  parasite
  
• (Tablets should be taken with a little food
  containing fat or with a glass of milk)

OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Schlumberger Malaria Hotline
The Malaria Hotline provides

• A phone service giving advice and emergency help
  on malaria 24/7

• Access to a team of doctors specialized in
  tropical medicine

• Staff with up-to-date knowledge on preventive and
  curative malaria medication

• Direct access to the Schlumberger organization

• A multi-lingual service

• Assistance with hospitalisation or evacuation
  when necessary

• A call back facility if you call the Hotline
  you must leave a contact number and the doctor
  will call you back to check on your health

Toll-free number 00 800 MALARIA 0 (00 800
6252 7420)
(In the USA dial 011 800 6252 7420)
In countries where the toll free number does not
directly connect, place a collect call (free) to
the following number 00 33 1 55 92 12 74 (In
the USA dial 011 33 1 55 92 12 74)
OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
DO NOT HESITATE TO CALL!
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Malaria When working a high risk country
An employee is responsible for ensuring that

• The date of the Curative Malaria Kit is valid and
  the expiry date has been logged in Quest

• The contents of the kit is complete with no
  missing items

• The kit is carried in hand luggage on departure
  for a remote location/rig or when departing from
  the high risk country on business or vacation

• They know how to use all items in the Curative
  Malaria Kit

• They have located the nearest medical facility to
  their residence that can diagnose and treat
  Plasmodium falciparum malaria

• Next of kin as well as relevant family members
  have been informed about the risk and symptoms of
  malaria (they could save your life)

• They see a doctor very rapidly if they become ill
  within 8 weeks after having left a high malaria
  risk country

• In the event of a positive malaria test the
  employee should contact the Malaria Hotline
  their manager as soon as possible. Schlumberger
  provides support

• If they need any advice or have any questions
  about malaria they should call the Malaria Hotline

OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006
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Malaria Conclusion

• The risk is highest after leaving a high risk
  country or when working in a remote location/rig

• Falciparum Malaria is fatal if not treated
  rapidly!!!
  
• THIS IS AN EMERGENCY!

• Take preventive medication regularly

• If you suspect malaria take Coartem / Riamet
  for 3 days and use your Curative Kit to perform
  a malaria test for confirmation of the diagnosis.
  Even if the 3 tests remains negative continue
  the Coartem or Riamet treatment for 3 days (4
  tablets morning and evening)

• Do not hesitate to call the Schlumberger Malaria
  HOTLINE for advice

• Malaria can be prevented and treated

• For more info read the Schlumberger Guide to
  Malaria on the Schlumberger Health Hub at
  http//www.hub.slb.com/display/index.do?idid28230

OFS-QHSE-MALARIA-Level 2-2 Rev. Date 10 Jul 2006