Disease surveillance and Monitoring.pptx

Community Medicine Disease Surveillance and Monitoring

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2. DISEASE SURVEILLANCE & MONITORING Dr. pretty venis SENIOR RESIDENT DEPT. OF COMMUNITY MEDICINE SMMCHRI 2

3. DISEASE SURVEILLANCE The process of systematic ongoing collection, collation and analysis of data for public health purposes and the timely dissemination of public health information for assessment and public health response as necessary. - WHO Continuous / Ongoing 3

4. Examples Epidemiological surveillance Demographic surveillance Nutritional surveillance etc. 4

5. WHY? INFORMATION FOR ACTION 5

6. Components (a) Collection of data (b} Compilation of data (c) Analysis and interpretation (d) Follow-up action (e) Feedback. 6

7. TYPES OF SURVEILLANCE 7

8. Active surveillance Passive surveillance 1. Data is actively collected. Data is passively reported. 2. Health system staff goes to gather data. 2. People come to the health centre and information is collected through different registers. 3. Eg : House to house visit for blood smear by health worker. 3. Eg : Out-patient & In-patient department. 4. Elimination/ Eradication 4. Disease control. 5. Mainly NVBDCP & NLEP. 5. Most National Health Programs in India. 6. More expensive. 6. Less expensive. 7. Poliomyelitis, Leprosy, neonatal tetanus. 7. Diphtheria, Hepatitis, Mumps. 8

9. Sentinel surveillance A method for identifying the missing cases and thereby supplementing the notified cases Identifies new + old cases  DISEASE PREVALENCE Limited network of carefully selected reporting sites- selected physicians and facilities 9

10. Uses of Sentinel surveillance Minimizes reporting bias. When in need of high quality data about specific diseases which cannot be obtained via a passive system. To identify trends or outbreaks. To monitor disease burden in a community Done for HIV in National AIDS Control Program (STD & ANC Clinics) 10

11. Uses of Surveillance Magnitude of a problem- morbidity & mortality DISEASE TREND Early identification of outbreaks PREVENTION, RESPONSE & CONTROL Estimate needs PRIORITIZATION Program intervention  PLANNING Identify high risk areas ACTION Monitor quality of programs EVALUATION 11

12. MONITORING Episodic oversight of activities to ensure that they are proceeding according to plan. If not, immediate corrective measures can be taken. Examples:- Monitoring air pollution Water quality Nutritional status (growth chart) 12

13. Uses of Monitoring Extent to which patients comply with or adhere to advice from health professionals. Performance of Health services. 13 Episodic / Periodic

14. MONITORING SURVEILLANCE 1. Episodic oversight of activities. 1. Continuous scrutiny 2. Can be done by Technicians. 2. Done by Professionals. 3. One time activity. 3. Continuous cycle. 4. Stops once disease is eliminated/ eradicated. 4. Continues even after disease is eliminated/eradicated. 5. No feedback. 5. Provides feedback. 6. No in-built action component. 6. In-built action component present. 7. Eg : Monitoring of air, water & noise pollution. 7. Demographic surveillance, epidemiological surveillance, nutritional surveillance. 14

15. Integrated Disease Surveillance Project (IDSP) What? - It is a decentralised state based disease surveillance project When? – November 2004 by GoI ; Funding- World Bank Why? - To detect and respond to the outbreaks at the earliest. How? – Through a systematic approach to record health events and disease outbreaks and then report them to the next level for analysis , interpretation and action. 15

16. Mission To detect early warning signals of impending outbreaks - effective response in a timely manner in urban and rural areas. To monitor progress of ongoing disease control programme and help allocate health resources more efficiently. 16

17. History 17 1 3 5 6 4 2 The Integrated Health Information Platform ( IHIP ) is the next generation highly refined version In 1997-98 A pilot project National Surveillance Program for Communicable Diseases (NSPCD ) In Nov 2004 “Integrated Disease Surveillance Project ( IDSP )” Sep,2007 Weekly reporting initiated. Making of IDSP as part of  National Rural Health Mission (NRHM)   in 2007-08. Continuation of the IDS Project as Integrated Disease Surveillance Programme (IDSP) as a central scheme during 12 th  Plan Period

18. “Integrated” in IDSP Sharing of information. Including both communicable and non-communicable diseases. Bring in academic institutions and Medical colleges. Partnership b/w health & non-health sectors as well as private sector and NGOs. 18

19. ORGANIZATIONAL STRUCTURE CENTRE STATE DISTRICT 19

20. IDSP 20

21. “Diseases surveillance” in IDSP When? – On a weekly basis How? - 3 formats “S”(Suspected cases) –Health workers “P”(presumptive cases)- Clinician “L”(Laboratory confirmed cases)-Laboratory staff Where? – Reporting units  sub-centres, PHCs, CHCs, government & private sector hospitals and medical colleges. 21

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24. Role of PHC MO Overall in charge in his/her area. Supervises work of health workers periodically. Provides regular feedback to health workers responsible. 24

25. How to train a health worker and why? Why? - Health workers are expected to submit weekly reports to the concerned PHC MOs. Provide feedback to the key informants who have reported the cases. How? - Syndromic surveillance using the “S” form. 25

26. Role of Health workers Collection & collation of weekly surveillance data Analysis & interpretation of weekly surveillance data Reporting Public Health action 26

27. 1. Collection of data Date & personal details Record initially with pencil. Start new page in register every Monday; continue till Sunday. Count numbers in each Column  WEEK TOTAL; Left corner  REPORTING WEEK 27

28. Syndromes under surveillance 1. Fever: Less than 7 days duration without any localizing signs With rash With altered sensorium or convulsions Bleeding from skin or mucus membrane Fever more than 7 days with or without localizing signs 2. Cough more than 3 weeks duration 3. Acute flaccid paralysis 4. Diarrhoea 5. Jaundice 6. Unusual events causing death or hospitalization. 28

29. 2. Analysis & Interpretation of weekly data Look for- clustering of cases, sudden increase in number of cases of any particular syndrome over past few weeks, any unusual event/deaths Alert should be sent to MO PHC immediately and put in place control measures. 29

30. 3. Reporting “S” Form is to be filled by Health workers. Routine - 3 copies to be filled of which 2 are to be submitted to PHC MO every Monday. Reporting week - Monday to Sunday; 52 weeks in total; Week 1- 1 st week of January. Immediate reporting of unusual cases- to PHC MO in addition to routine. 30

31. Steps to fill Form “S” Name of State, District & Block. Calendar year Name of Health worker and supervisor Name of the reporting unit Week Total for each syndrome Zero to be written if no case reported. 31

32. 4. Public Health action Distribution of ORS packets to patients in case of diarrhoea outbreak Testing fever cases (with RDT kits) Providing treatment to fever cases Providing health education etc. 32

33. Summary Surveillance- Continuous / Ongoing process; Information for action Monitoring- Episodic / Periodic process 3 Forms used under IDSP- “S”, “P” and “L” forms Health workers submit reports to their PHC MO on a weekly basis 33

34. References Park K. Park's Textbook of Social and Preventive Medicine.26 th edition. Banarasidas Bhanot : Jabalpur: India. 2021:46-7 Suryakantha AH. Community Medicine with recent advances.6th edition. Jaypee Brothers Medical Publishers (P) Ltd; New Delhi: 2022:26-31 Disease surveillance under IDSP: Manual for Health Workers, NCDC, 2015 34

35. Post-test evaluation Question 1 What is disease surveillance? Data collection Collection of information for public health action Data dissemination Public health action 35 Dr. pretty venis

36. Post-test evaluation Question 2 What are different types of forms for surveillance under IDSP? Presumptive Syndromic Lab-confirmed All of these 36

37. Post-test evaluation Question 3 Which form is filled by Health Workers? Form L Form M Form S Form P 37

38. Post-test evaluation Question 4 How frequently is this form filled by Health Workers? Daily Weekly Monthly Quarterly 38