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Definitions
What is surveillance?
Surveillance is the ongoing, systematic collection, analysis, and interpretation of health data. It includes the timely dissemination of the resulting information to those who need them for action.
Surveillance is also essential for planning, implementation, and evaluation of public health practice.
The purpose of the International Health Regulations (IHR) is to Prevent, Protect against, Control and Provide public health response to the international spread of disease in ways that are relevant and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade.
One Health
IDSR involves carrying out disease surveillance activities using an integrated approach. An integrated approach means that data on all important diseases will be collected, analysed, interpreted and reported in the same way, by the same people who normally submit routine report forms on health-related data.
Definition
(IDSR) is not proposing establishment of a new system, but is providing guidance on how to prepare to conduct surveillance and response activities.
IDSR was developed by WHO/AFRO to help member states to assess their national surveillance, epidemic preparedness and response systems and to identify where improvements are needed. The assessment provides results that can be used to solve problems with resources, the quality and timeliness of surveillance data, and how the information is used.
Integrated Disease Surveillance strategy adopted by Member states in 1998
• IDSR Technical Guidelines developed in 2001 with emphasis on:
– Epidemic prone diseases
– Diseases targeted for elimination and eradication
– Diseases of public health importance
• Revised IDSR Technical Guidelines (2010) include :
– Non communicable diseases
– Public Health Emergencies of International Concern (IHR 2005)
History
IDSR is a passive surveillance system as the data used are collected during routine health work.
Active surveillance, on the other hand, uses data collected after a request from higher authorities for specific information.
Active or Passive?
Environmental health officers and sanitarians
• District health management teams
• Nursing officers,
• Health facility managers
• Medical and nursing educators
• Communication officers
• Logisticians
• Laboratory personnel
• Community leaders
• Other public health experts
• Other health partners including NGOs
Key Stakeholders
Priority diseases are diseases that fulfill one or more of the criteria
Priority disease criteria
-They have a high potential for causing epidemics
-They have been targeted for eradication or elimination
-They have significant public health importance (causing many illnesses and deaths)
-They can be effectively controlled and prevented.
Epidemic Prone diseases
Acute Haemorrhagic fever, Anthrax, Typoid fever, Shigella
Diseases targeted for eradication
Lymphatic filariasis, Leprosy
Other major Diseases
malnutrition, Injuries, Maternal and Mental deaths
International concern
SARS, Smallpox, any Public health event (infectious, zoonotic)
Case definitions makes sure that every case is diagnosed in the same way. Standard case definitions let health staff compare the numbers of cases of the disease or condition that occurred in one time or place with the number occurring in another time or place.
Reporting
Cluster - a larger-than-expected number of cases with similar symptoms, but without clear evidence (at this time) that they are connected in any way. The increase in cases in a cluster could simply be a coincidence, but it could also be a sign that an epidemic is beginning
Health emergencies or conditions to report immediately
Clusters of respiratory illness (including upper or lower respiratory tract infections and difficulty in breathing)
Clusters of gastrointestinal illness (including vomiting, diarrhoea, abdominal pain, or any other gastrointestinal distress)
Influenza-like symptoms and signs, such as fever, cough and runny nose
Clusters of symptoms or signs indicating the possibility of meningitis (stiff neck, sensitivity to bright light, severe headache, etc.)
Clusters of rash-like symptoms
Non-traumatic coma (unconsciousness which is not due to an injury), or sudden death
Immediately
Weekly
Monthly
Quarterly
Bi-annually
Unrealiable reporting,
Negative consequences of reporting,
Poor inter-sectoral communication.
Poor diagnostic infrastructure,
Lack of trained personnel,
lack of hospital-based tests
Poor knowledge of zoonotic diseases among medical practitioners,
Non-specific clinical signs
Difficulties of travel to hospital, poor knowledge and awareness,
‘non-institutional’ health providers
Unreliable reporting, negative consequences of reporting, poor inter-sectoral communication
Poor diagnostic infrastructure, lack of trained personnel, lack of field-based tests
Lack of equipment/training for collection of diagnostic samples
Communication and transportation difficulties
Lack of incentive for owners to report
Weak health care systems
poor levels of education
limited access to media to the great population
Uganda Ebola outbreak
Strong health systems
Adequate surveillance systems and reporting
Strong Public health Voice
Vast Media coverage