Category Archives: Disease Control

DHEC Division One of Four Selected for Nationwide CDC Pilot for Cancer Survivorship

The Division of Cancer Prevention, located in the Bureau of Chronic Disease and Injury Prevention, was one of four awardees nationwide selected by the Centers for Disease Control and Prevention (CDC) to conduct a pilot project to address rural and urban disparities in cancer survivorship.

The pilot project, titled “Improving the Health and Wellness of Cancer Survivors in Rural Communities,” focused specifically on tele-mentoring strategies using Project ECHO (Extension for Community Healthcare Outcomes) to increase coordination and movement of knowledge between specialists and primary care providers. The internationally recognized Project ECHO offers a unique knowledge-sharing approach to create an online community that shares best-practices and case-based learning resources. This online model leverages technology to expand the reach and connectivity of providers in rural areas to subject-specific knowledge and specialists.

SC CCCP held monthly; one-hour Zoom sessions from October 2020 to February 2021. Topics included cancer pain management, sexuality and intimacy, and nutrition for cancer survivor patients. Each session was able to provide expert-delivered content that highlighted best-care practices and created a community of practice among oncologists, primary care providers, nurses, social workers, researchers, administrators, and other caregivers.

Over this ECHO series, the project reached 102 unique participants, with an average of 37 participants per session. Data from this pilot project was able to link providers in four rural counties with specialists in seven urban SC counties and four out-of-state sites. Providers who participated in the ECHO intervention reported up to 60% of their patient population reside in rural areas, which speaks to the intervention’s achievement in targeting rural patients for improved cancer care and outcomes.

“Residents in our rural counties often have less health care access including fewer health care workers, specialists such as cancer doctors, and transportation options,” said Sonya Younger, Comprehensive Cancer Control Program Director. “Rural residents are also more likely to be uninsured and to live farther away from health services. Through innovative telementoring, Project ECHO helped the Division of Cancer Prevention and Control increase rural provider workforce knowledge to provide best-practice, cancer specialty extended care.”

Visit the SC Cancer Alliance’s website to listen to the Cancer Survivorship Project ECHO recorded presentations at https://www.sccancer.org/events/cancer-survivorship-project-echo-recorded-presentations/ 

VIDEO INFORMATION 

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By utilizing the ECHO model to share knowledge and foster a clinical community, reaching widespread providers and other clinical professionals that service rural communities, the Division of Cancer Prevention and Control shows the core value of Inspiring Innovation and is an example of the agency strategies of Service and Accessibility and Education and Engagement.

Success was possible through the connectedness of the SC Cancer Division including Best Chance Network, Comprehensive Cancer Control, and Research and Planning program staff and its partners and providers, as well as virtual sessions and electronic communication, demonstrating DHEC’s core value of Promoting Teamwork

DHEC “Shines the Light” on Sickle Cell

June 19th is World Sickle Cell Day across the globe! Every year, the international health community recognizes Sickle Cell Disease (SCD) as a debilitating genetic disease that impacts families across the globe. Keeping individuals and communities informed about the struggles that come with daily management of SCD, can help raise awareness as well as debunk stereotypes and stigmas associated with persons who have SCD.  

DHEC joins the Sickle Cell Disease Association of America (SCDAA) to “Shine the Light on Sickle Cell” for World Sickle Cell Day.  Through awareness, education, and research for a cure, we heighten awareness and keep our communities informed of the impact this disease has on over 100,000 Americans.

How Is Sickle Cell Disease Identified?

At birth, every child has a newborn screening test performed to screen for different genetic disorders.  Newborn screening consists of testing newborns for certain harmful or potentially fatal disorders that aren’t otherwise apparent at birth.  In 1987, sickle cell disease was added to this testing panel to screen newborns for sickle cell disease and sickle cell trait for South Carolina.  It is very important to know if your newborn has trait, because you, your partner, and family can determine if additional screening is necessary and what additional steps you should take.

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All About Bats: What you need to know about bats in SC

A big brown bat roosting on a vine near a cave.

Did you know SC is home to 14 different types of bats? Have you ever wondered what to do if you encounter one? DHEC is here to help. Check out the DHEC Bat Webpage for detailed information.

Bats are great for our ecosystems. They eat pesky bugs like disease carrying mosquitoes, which here in SC is very much appreciated.  Sometimes bats, people, and pets collide. When that happens, you can rest assured your DHEC EA team will be there.

Some species of bats enjoy making their homes in crevices, gaps, and holes of existing structures—like in your attic! The CDC has some helpful tips on how to bat proof your home.

Summer has arrived and the spirit of adventure is calling! If you happen to encounter a bat while camping, hiking, or cleaning out the garage, attic, etc., give them space. If you have direct contact with a bat or wake to one in a room or tent, reach out to your local DHEC Environmental Affairs rabies program for guidance.

Bats are most active at dusk and at night. If you find a bat on the ground during the day, do not touch it with your bare hands! Use gloves, a shovel, or a plastic container to properly dispose of the animal. If alive, contact a wildlife control operator for assistance.

If you find a bat in your home and you think it may have been in the room with a sleeping person, a small child, or someone with a mental impairment, do not let the bat go! It needs to be tested for rabies and should not be touched. Reach out to your local DHEC Environmental Affairs rabies program for guidance and check out the DHEC Bat Webpage.

DHEC Observes National Alzheimer’s and Brain Awareness Month

June is Alzheimer’s and Brain Awareness Month, and DHEC recognizes the vital work that healthcare facilities, healthcare professionals, and caregivers do in providing treatment and improving the quality of life of those afflicted with brain trauma and disorders. There are currently over 95,000 people living with Alzheimer’s disease and other related dementias (ADRD) in South Carolina. According to the South Carolina Alzheimer’s Disease Registry, 25% of the ADRD population in the state resides in a long-term care facility (LTCF), including nursing homes and assisted living facilities, while the remaining 75% live independently or with loved ones in the community.

It comes as no surprise that COVID-19 has been an unexpected hurdle in providing special care to each resident or patient afflicted with these diseases. The risk for persons with Alzheimer’s disease and other dementias poses a unique challenge for caregivers, families, and facilities. Changes to routines, use of unfamiliar personal protective equipment (PPE), and disruption to daily schedules can lead to fear and anxiety resulting in increased depression and worsening behavioral changes, such as agitation, aggression, and wandering. While the Centers for Disease Control and Prevention (CDC) recommends specific guidance to facilities for infection control and prevention, it also recommends keeping environments and routines as consistent as possible for patients and residents suffering from ADRD and other brain disorders.

As facilities and caregivers continue to care for patients and residents, the following tips can help improve brain health for those afflicted with these diseases while preventing the spread of COVID-19:

  • Maintain the same environments and routines for the patients or residents while introducing frequent hand washing, social distancing, and use of cloth face coverings (if tolerated).
  • Introduce virtual games and activities for enrichment and memory care.
  • Use face coverings wisely. Face coverings should not be used for anyone with breathing issues or who is unconscious, incapacitated, or unable to remove the mask without assistance.
  • Keep staff consistent in memory care units at facilities.
  • Structured activities may need to occur in the resident’s or patient’s room, or be scheduled at staggered times throughout the day in order to maintain social distancing.
  • Provide safe ways to remain active, such as staff going on walks around the unit or outside with the patient or resident.
  • Limit the number of people in common areas while practicing social distancing.
  • Frequently clean often-touched surfaces, especially hallways and common areas.

Those suffering from ADRD may not be able to communicate that they are feeling ill. It is important to be informed and able to recognize symptoms in order to protect our most vulnerable from COVID-19. Early signs to recognize for a patient or resident who cannot communicate their symptoms are cough, shortness of breath, difficulty breathing, fatigue, or vomiting. Emergency warning signs are trouble breathing, new confusion, inability to wake or stay awake, and bluish lips or face.

Family and friends that would still like to visit loved ones in facilities are encouraged to use messaging systems such as emails, phone calls, cards and letters, recorded video messages, care packages, and even song and poem dedications through the facility intercom. The Centers for Medicare & Medicaid Services (CMS)’s Civil Monetary Penalty (CMP) Reinvestment Program is a great funding opportunity for facilities wishing to procure technical equipment for communication purposes. Nursing homes can also benefit from applying to CMS’ COVID-19 Communicative Technology grant that provides funding for residents to communicate with loved ones.

Lexington Medical Center (LMC) Extended Care recently took advantage of this COVID-19 grant opportunity and purchased two iPads and three iN2L tablets for the nursing home. Though the facility encourages families to make phone calls and chat with loved one outside of the facility’s windows, the technology procured through the grant allows more residents the opportunity to connect with loved ones and to do is in the most convenient, readily accessible, and intimate way. The facility already averages 700 calls per month, not including the calls made by residents with their personal devices. The use of the virtual technology for tele-videos, texts, calls, games, and a myriad of other activities connects loved ones together and helps augment the quality of life for these residents, especially those most vulnerable to brain dysfunction and memory loss.

“Without this COVID-19 communicative grant funding and the opportunity for communities to purchase needed devices, our residents might not have the opportunity to see their family nor would their family see them, which could be detrimental to everyone,” states Debbie Bouknight, Lexington’s Life Enrichment Director. “It is both heartwarming and sometimes heartwrenching, but so worth it to see the interactions happen. I feel we would see far more decline in our residents’ physical and emotional well-being if they did not have these video visit opportunities.

More ideas of how you can connect with loved ones during COVID-19 are available here.

DHEC would like to express its gratitude to all facility staff and loved ones keeping our Alzheimer’s and other dementias population healthy during COVID-19. Residents and patients suffering from these diseases are not just physically vulnerable during this pandemic, but they are also highly susceptible to mental anguish and confusion due to the necessary changes being made at facilities for infection control and prevention. We recognize the extraordinary cooperation between facility staff and families in ensuring excellent care for the quality of life of those afflicted with ADRD, as well as adapting to new forms of communication that keep loved ones both connected and safe.

Links

CDC – Considerations for Memory Care Units in Long-term Care Facilities

CDC – Supporting Your Loved One in a Long-Term Care Facility

USC, Arnold School of Public Health – Alzheimer’s Disease Registry

South Carolina Alzheimer’s Disease Report 2019: Annual Report

Alzheimer’s Association Facts Video

June 19th is #WorldSickleCellDay

Today (June 19th) is World Sickle Cell Day!  Every year, the international health community recognizes Sickle Cell Disease (SCD) as a debilitating genetic disease that impacts families across the globe. Keeping individuals and communities informed about the struggles that come with daily management of SCD, can help raise awareness as well as debunk stereotypes and stigmas associated with persons who have SCD.   

SCD affects millions of people worldwide and is particularly common among people originating from sub-Saharan Africa, Saudi Arabia, India, South America and Central America, and Mediterranean countries, such as Turkey, Greece and Italy.

SCD affects approximately 100,000 Americans and occurs in about 1 out of every 365 African-American births. Individuals living with SCD suffer from both acute and chronic complications that require frequent contact with the medical system. These complications include acute sickle cell pain, fever, and acute chest syndrome (ACS), which is the term used for a number of different findings that includes chest pain, cough, fever, hypoxia and new lung infiltrates.

Here are some quick facts about SCD:

  • Sickle Cell Disease is a group of inherited red blood cell disorders. The red blood cells become hard and sticky and look like a C-shaped farm tool called a “sickle” and the cells die early, which causes a constant storage of red blood cells. Healthy red blood cells are round and move through small blood vessels to carry oxygen to all parts of the body.
  • To get SCD, the trait must be inherited from both parents who already have the SCD trait. People with the trait usually do not have any of the signs of the disease and live a normal life, but they can pass the trait to their children.
  • SCD is diagnosed with a simple blood test.  It is most often found at birth during routine newborn screening tests. Early diagnosis and treatment are important.
  • There are several treatment options available for individuals living with different complications of SCD, but the only cure for SCD is a bone marrow or stem cell transplant.  Transplants are very risky, and can have serious side effects, including death.  For the transplant to work, the bone marrow must be a close match (usually a brother or sister). 

SCD and COVID-19

Amid the COVID-19 pandemic, there is significant concern that the overlap of lung disease from COVID-19 with ACS may result in increased complications and amplification of healthcare utilization among individuals with SCD. Patients with SCD often have underlying cardiopulmonary co-morbidities that may predispose them to poor outcomes if they become infected with COVID-19. Source: hematology.org. 

Below are recommendations from the Sickle Cell Disease Association of America (SCDAA) for patients with SCD regarding COVID-19:

  • Patients and parents should be educated about COVID-19 signs and symptoms and the importance of physical distancing to limit chances of exposure and infection.
  • Patients and parents should receive counseling to continue to monitor for fever or other signs of infection. Call  hospital, doctor, or nurse first for advice on where to go for an evaluation.
  • Be sure that patients have an ample supply of all prescribed medication at home (including analgesics) to manage both acute and chronic pain.
  • Patients should adhere closely to the correct use of medications.

SCD Partnerships

DHEC is committed to educating the community and public about the availability of resources and services for individuals and families living with sickle cell disease.  DHEC’s Division of Children and Youth with Special Health Care Needs (CYSHCN), provides assistance to persons with sickle cell disease by covering services, such as, medical expenses, physician visits, durable medical equipment, medical supplies, and prescription drugs.  Assistance is offered to both children and adults who meet eligibility requirements. 

Additionally, CYSHCN engages with the four Sickle Community Based Organizations in the state — the James R. Clark Memorial Sickle Cell Foundation, – Louvenia D. Barksdale Sickle Cell Anemia Foundation, – Orangeburg Area Sickle Cell Foundation and – COBRA Human Services Agency Sickle Cell Program – to ensure persons living with SCD have access to community resources and support services.