Integrated disease surveillance program.pptx

disease surveillance

1. Integrated disease surveillance program Dr.V.K.Gampa

2. Framework Introduction Mission Objective Milestones Program Components Organization structure Data Management

3. introduction is a decentralized, state based surveillance program in the country detect early warning signals of impending outbreaks and help initiate an effective response in a timely manner Provide essential data to monitor progress of on-going disease control program and help allocate health resources more efficiently.

4. mission To strengthen the disease surveillance in the country by establishing a decentralized State based surveillance system for epidemic prone diseases to detect the early warning signals, so that timely and effective public health actions can be initiated in response to health challenges in the country at the Districts, State and National level.

5. Objectives To strengthen/maintain decentralized laboratory based IT enabled disease surveillance system for epidemic prone diseases to monitor disease trends and to detect and respond to outbreaks in early rising phase through trained Rapid Response Team (RRTs )

6. milestones S NO. YEAR EVENTS 1 Nov. 2004 IDSP  Launched with world bank assistance 2 Apr, 2006 Data reporting through e-mail 3 June, 2006 administratively and financially merged with NCDC. (National Centre for Disease Control (NCDC), Delhi.) 4 Sept, 2007 Weekly reporting of disease alerts/ outbreaks  5 Feb, 2008 24X7, toll free call centre ( 1075) 6 April/May, 2008 Data reporting  on Portal (www.idsp.nic.in.) 7 July 2008 Media Scanning and Verification Cell 8 Oct,. 2012 under NHM with outlay from domestic budget 9 2013 The Strategic Health Operations Centre 10 2015 Block level data entry in phased manner 11 2015 Offline data entry at IDSP portal in phased manner

7. Program Components 1. Integration and decentralization of surveillance activities -through establishment of surveillance units at Centre, State and District level. 2. Human Resource Development – Training of State Surveillance Officers, District Surveillance Officers, Rapid Response Team and other Medical and Paramedical staff on principles of disease surveillance. 3. Information Communication Technology - for collection, collation, compilation, analysis and dissemination of data. 4. Strengthening of public health laboratories 5. Inter sectoral Co-ordination for zoonotic diseases

8. ORGANIZATION STRUCTURE

9. Central Surveillance Unit A senior officer from NCDC- National Program Officer coordinate the project activities under six sections namely 1)Budget & Finance, 2)Laboratory strengthening, 3)Information Technology and Communication, 4)Data Management and Monitoring, 5)Human Resource Development 6) Non-Communicable Disease (NCD) Surveillance. Advisor Epidemiologist, Advisor Microbiologist, Management Expert, Documentation Officer, Communication Officer, and Consultant (IT) Team leader , Epidemiologists, Consultant (HR), Microbiologist and Media Scanning Assistant

10. State Surveillance Unit State surveillance officer - Dr. Shiva Balaji Reddy Administrative assistant Consultant (technical) Consultant (finance) Data manager Data entry operator

11. District Surveillance Unit District surveillance officer Epidemiologist Data manager Data entry operator

12. District rapid response team District health officer District surveillance officer Epidemiologist Epidemic MO Peadiatrician Disrict malaria officer Chief bacteriologist

13. Conditions under surveillance Regular surveillance Sentinel surveillance Regular periodic surveys Vector Borne Disease Sexually transmitted diseases/Blood borne diseases NCD Risk Factors Water Borne Disease Other Conditions -Water Quality, Outdoor Air Quality State specific diseases Respiratory Diseases Vaccine Preventable Diseases Diseases under eradication Other Conditions –RTA Other International commitments : Plague, Yellow fever Unusual clinical syndromes (Causing death / hospitalization):

14. Types of Surveillance in IDSP Syndromic – Diagnosis made on the basis of symptoms/clinical pattern by paramedical personnel and members of the community. Presumptive –Diagnosis made on typical history and clinical examination by Medical Officers. Confirmed – Clinical diagnosis confirmed by an appropriate laboratory test.

15. FLOW OF INFORMATION CSU SSU DSU Medical college District Hospital CHC PHC Sub- centres District Public health Lab. Private hospitals CSU -Integrated administratively and financially with National Centre for Disease Control SSU -One in each State/UT with a regular officer identified as State Surveillance Officer (SSO) Supported by 7 contractual staff. DSU -One in each district with a regular officer as District Surveillance Officer (DSO). Supported by 3 contractual staff

16. Data REPORTING Weekly (Monday–Sunday) S form P form L form Data compilation & analysis District/State Surveillance Units

17. Reporting IN OUTBREAK Daily reporting in outbreak to monitor the situation Weekly reporting after the outbreak has subsided, for at least two incubation period of the disease. A Unique code (outbreak ID) from 1 st  week of January 2016 to each outbreak in the Weekly outbreak Report for easy data storage and retrieval State/code of District/ Year/Week/4-digit number for the Disease outbreak E.g. MH/WD/2017/21/0001

18. Reporting units in Wardha Sr. No. Block No. of Reporting units S Form P form L form 1 Wardha 27 7 8 2 Deoli 24 7 4 3 Hingaghat 24 5 5 4 Seloo 27 6 2 5 Samudrapur 22 4 3 6 Karanja 18 3 1 7 Ashti 16 2 2 8 Arvi 23 4 3 Total 181 38 28

19. Training in idsp TOT- Six days TOT program health personnel and members of rapid response team.  Introduction to surveillance with special reference to IDSP, basic epidemiology, collection and transmission of laboratory specimens and bio-safety issues and details in response to outbreaks. FETP- two week training DSOs/ Epidemiologists to enhance their epidemiological skills in outbreak investigations. Induction training Microbiologists, Entomologists, finance consultant and other support staff under IDSP.

20. MEDIA SCANNING AND VERIFICATION CELL  established on 24 th  July 2008 under IDSP at NCDC, Delhi  It is “Early Warning System” It works  through daily screening of press both local and national, TV (national and regional channels), Radio and other media channels which reports on suspected outbreaks or unusual health events. The information is shared to the districts affected and DSO is expected to investigate and revert through the internet about the correctness and action taken is managed by trained Epidemiologists and Public Health Consultants working in Central Surveillance Unit of IDSP Media Surveillance increases the sensitivity of the official surveillance systems.

21. INFORMATION,COMMUNICATION TECGNOLOGY Satellite connectivity Indian Space Research Organization broadband connectivity through BSNL online data entry (IDSP Portal www.idsp.nic.in) A 24X7 call centre toll free number 1075 Video conferencing at State Surveillance Units and Central Surveillance Units

22. Idsp PORTAL

23. Strengthening of public health laboratories Strengthening of district public health labs equipment, manpower and funds for consumables Perform testing for lab confirmation of epidemic prone diseases Support outbreak investigations in the district Report weekly surveillance data on L forms. a) Blood culture for Typhoid b) Stool culture for cholera and other common enteropathogens c) IgM ELISA for Dengue (in endemic areas) d) ELISA for Hepatitis A & E e) ELISA / rapid test for Leptospirosis (in endemic areas) f) Tests for other outbreak prone diseases prevalent locally

24. Strengthening of public health laboratories Referral lab network for investigation of outbreaks in the linked districts . - Cholera and other enteropathogens : culture and sensitivity and serotyping - Typhoid: Blood Culture & antimicrobial sensitivity (including isolate confirmation with specific antisera - Bacterial meningitis-rapid latex agglutination test, CSF examination-wet mount, gram stain and culture    & antimicrobial Sensitivity - Hepatitis A&E- IgM ELISA - Measles- IgM ELISA - Dengue- IgM ELISA - Leptospirosis -ELISA/Rapid test - Diphtheria-Smear examination, culture and toxigenecity testing - Any other tests for locally prevalent epidemic prone disease (to be identified by the state)

25. REFERENCES National center for disease control. Ministry of health & family welfare. www.idsp.nic.in National center for disease control. Directorate general of health services. Ministry of health & family welfare, GOI. ncdc.gov.in

26. Directorate general of health services (Ministry of health & family welfare National centre for disease control Centre for medical entomology & vector management Centre for AIDS& related diseases Director Division of parasitic diseases Division of microbiology Division of epidemiology Division of zoonosis Integrated disease surveillance project Division of planning, budget & administration Division of biochemistry & biotechnology Division of malaria coordination NCDC Organogram

27. Cd alert monthly newsletter by NCDC disseminate information on various aspects of communicable diseases to medical fraternity and health administrators.  The first issue was published in August 1997 on emerging and reemerging diseases give an inside view of the disease including the global scenario, Indian scenario and also the diagnostic facilities of the particular disease within our country.   tool for the Rapid response Teams for management and containment operations in outbreak/ epidemic situations

28. History IDSP launched in 2004 with world bank assistance for a period upto March 2010. The project was restructured and extended up to March 2012 Earlier World Bank funds were available for Central Surveillance Unit (CSU) at NCDC & 9 identified states rest were funded from domestic budget continues during 12th Plan (2012-17) under NHM with outlay of Rs. 640 Crore from domestic budget only A Central Surveillance Unit (CSU) at Delhi, State Surveillance Units (SSU) at all State/UT head quarters and District Surveillance Units (DSU) at all Districts.

29. History CONT…   IT network connecting 776 sites in States/District HQ and premier institutes has been established with the help of National Informatics Centre (NIC) and Indian Space Research Organization (ISRO) for data entry, training, video conferencing and outbreak discussion data on epidemic prone disease are being collected from reporting units including  government and private sector hospitals and medical colleges on ‘S’ syndromic , ‘P’ probable & ‘L’ laboratory formats using standard case definitions through e-mail/portal (www.idsp.nic.in).

30. History CONT… analyzed by SSU/DSU for disease trends investigated by the RRT to diagnose and control the outbreak  A 24X7 call center to receive disease alerts on a Toll Free telephone number (1075)- February 2008 Media scanning and verification cell was established under IDSP in July 2008 It detects and shares media alerts with the concerned states/districts for verification and response District laboratories are being strengthened for diagnosis of epidemic prone diseases.  2 lakh per annum per lab for reagents and consumables. 

31. comments Strenghts - Weekly reporting Online data entry Sentinel surveillance centers Weaknesses- No designated vehicle Training & retraining