Arsenicosis case identification, diagnosis and management protocol for early patient medicare administration and treatment

Many countries in the world, especially South Asia e.g., Bangladesh, India, Nepal, Vietnam, China and Myanmar are facing ground water arsenic contamination problems and it has been recognized as an emerging threat and challenge to public health (Ahmad et al, 2004). Pakistan, following the arsenic crisis in Bangladesh and in other neighboring countries, has recognized the need of assessing drinking water quality for arsenic contamination in late nineties (PCRWR 2002). Ground water arsenic contamination has emerged as a serious socio-economic and human health concerns all over the world, including Pakistan. Likewise , around 25-36 % population of two provinces in Pakistan is exposed to drinking water arsenic contamination over 10 ppb. It may be reasonable to disregard the presence of some arsenic in the water, but beyond 50 ppb is considered dangerous (NAPAM 2005). Keeping in view the adverse impacts of arsenic contamination on human health, various initiatives by different governmental and non-governmental departments and organizations were taken, without resource integration and prudent coordination mechanisms amongst the various stakeholders (IUCN, 2007). These practices resulted in wastages of scarce resources, rather than pooling up all the resources and getting maximum. During this process some experiences have been gained related to planning, implementation, monitoring and management of arsenic mitigation. As arsenic contamination causes serious health issues, therefore, the timely identification and diagnosis of arsenicosis patients remained a major problem due to absence of standard operating procedures / protocols . The arsenicosis patients identification was being observed and realized after the appearance of arsenicosis symptoms, like skin pigmentation etc, on the body parts of the effected persons. Over and above, there was no set procedures to administer the treatment and case management of such arsenicosis patients. Therefore, well designed protocols or standard operating procedures have been documented which may assist while carrying out identification of suspected arsenicosis patients. This paper will provide road map for arsenicosis diagnostic procedures, treatment administration , case management and behavioral change communication by creating awareness amongst such affected communities, prior getting prey of arsenicosis victim.