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Integrated Disease Surveillance and Response

MUGANHIRI DARREN TATENDA

Outline

Definitions

Introduction

How it works

Challenges

Conclusions

Recommendations

Closer look

Definitions

Definitions

Surveillance

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.

International Health Regulations

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

One Health

One Health is an interdisciplinary, holistic and integrated approach to health problems, diseases and other threats resulting from climate change, food safety, and chemical hazards constitute a complex set of challenging events involving human, animal and environmental health.

The One Health strategy promotes the integration and coordination within and across sectors for disease surveillance, outbreak investigation and response activities undertaken by professionals from various fields.

What is IDSR?

IDSR

Definition

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.

T&Cs

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

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?

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

Key stakeholders

How it works?

Functions

Framework

Formulation

Priority Disease

Priority Diseases

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.

Priority Diseases

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)

Standard case Definitions

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

Reporting

Time

Immediately

Weekly

Monthly

Quarterly

Bi-annually

Health Levels

Challenges

Human Health Systems

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

Animal Health Systems

Liberia, Sierra Leone, Guinea

Weak health care systems

poor levels of education

limited access to media to the great population

Case Study

How?

Success stories

Uganda Ebola outbreak

Strong health systems

Adequate surveillance systems and reporting

Strong Public health Voice

Vast Media coverage

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