UDSP_05061011th_Mar2025_V4 [Autosaved]_Final.pptx

UDSP

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2. Unified Disease Surveillance Platform Roll-out of Vaccine Preventable Diseases (VPD) Surveillance www.udsp.in 5 March 2025

3. ITIMS - Registration

4. Welcome, Context Setting & Introductions

5. Phones on silent – please recheck now If you have to take a call, please do so outside the hall Feel free to ask questions, no question is irrelevant Our commitment - we will answer all questions, if not today then later personally Packed agenda, respect timings Discussions are great, but we may have to cut short some of the discussions as people have to leave in the evening. Those who have not checked-out yet, please do so during the tea break, after group photo Copies of CIF, if you do not have – please arrange these. Printer available at registration desk 5 Ground Rules

6. Unified Disease Surveillance Platform – An Overview Dr. Vikasendu Agarwal

7. COVID Portal – Lessons Learned Integration with GoI ICMR & S3 Portal Learnings Surveillance needs keep changing, necessitating a flexible system Symptoms – Questions Lab Tests – Type, Parameters, Samples Facilities – Labs & Hospitals Geography under surveillance Human Resources conducting the surveillance Learnings Surveillance needs keep changing, necessitating a flexible system Diseases – Communicable/ NCD/Registries Geography focus Community - Facility–Lab linked surveillance Changing protocols from time to time Symptoms – Questions Lab Tests – Type, Parameters, Samples Automatic alerts are required Single source of truth – Integrated with all national+state platforms

8. Instructions to UDSP on lines of COVID Portal Letter No. 133/C.M.-1/2022 dated 07 Dec 2022 Letter No. C.M.-78/Five-5-2022 dated 17 Jan 2023

9. Unified Disease Surveillance (UDSP) Landscape

10. Define Parameterize Link Design Define Parameterize Linkages Design Campaign Configuration – 4-Stage Process Diseases Test type Sample Type Symptoms Questions Configure T ests on basis of Gender Age Age Group Units Normal Value, Range Disease Vs Symptom Disease Vs Tests Symptoms Vs Questions Where When Who Whom How What

11. Benefits of using UDSP 11 Real-time visibility on incidence of diseases across the state. Ability to create and manage Rapid Response team for CAPA. Ability to create an outbreak warning system. Possibility of electronic/interface-based data capture from private labs Additional Benefits Incentive based on EHR generation by Health Facilities & Labs. No paper-based/Email reporting for these 12 Notifiable, Covid & Dastak Diseases. Ease to Citizens for accessing their individual QR-based lab report/s. Improved Quality of Health Care Delivery.

12. VPD Surveillance Overview & UDSP Integration Dr. Ajay Gupta & Dr. Manoj Shukul

13. VPD Surveillance on UDSP (Work Initiation) 13 Instructions to use UDSP for reporting of all VPDs were issued by PS (MH & FW) sir in the STF held on 12 January 2023

14. Poliomyelitis Hepatitis-B Measles Rubella Diarrhoea due to Rotavirus Japanese Encephalitis Severe form of childhood Tuberculosis Diphtheria Pertussis Tetanus Hemophilus Influenza Type b related diseases Pneumococcus related diseases 14 Vaccine-Preventable Diseases VPDs Under Surveillance Poliomyelitis - AFP Surveillance Measles Rubella Diphtheria Pertussis Tetanus Japanese Encephalitis ( as part of AES Surveillance) Viral Hepatitis B & C (Already part of Perennial Campaign) MR/FR Surveillance VPD Surveillance

15. VPD Surveillance Flow 15 Reporting Units/ Informers to DIO/DSO/SMO/MO Case investigation by Nodal Officer Sample collection/advise by Nodal Officer/LT Case verification by DIO/DSO/SMO Notification Case Investigation Sample Collection Verification and Follow up Actions Active Case Search (If applicable) Sample Dispatch to Laboratory Lab Report

16. Surveillance Update 16

17. AFP Surveillance Performance Indicators Suspected Measles Cases Reported, Outbreaks Flagged & MR Cases Reported Indicator 2023 2024 2025* No. of AFP Cases 9210 9986 1415 AFP Rate 9 10 9 Non-Polio AFP Rate 9 10 7 % Timely Investigation within 48 hrs. of notification 95% 96% 97% % Stool collected within 14 days of onset 90% 92% 96% * Data as on 3 Mar

18. FR/MR Surveillance Update – Uttar Pradesh YEAR 2024 2025* Total MR Summary (OB + CB) : Total Suspected MR Cases Reported 16714 1876 Lab Confirmed Measles Cases 999 145 Lab Confirmed Rubella Cases 519 69 MR Outbreak Summary : No. of Outbreaks Flagged 870 54 No. of Outbreaks Investigated 311 34 Lab Confirmed Measles Outbreaks 79 10 Lab Confirmed Rubella Outbreaks 8 2 Lab Confirmed Mixed Outbreaks 3 OB = Outbreak, CB = Case Based *data as on 3 Mar

19. No. of Cases = 1,518 Age & Dose Analysis of Positive MR cases – UP (2024)

20. Update on MR Outbreak Response Immunization (ORI) – Uttar Pradesh 2022 ( wk 47 onwards) 2023 2024 (As on 24 Feb 2025) 2025* (As on 24 Feb 2025) No. of MR positive OBs 187 619 90 09 No. of OBs in which ORI done 187 (100%) 619 (100%) 90 (100%) 08 (100%) No. of children (6 mnth to below 9 mnth ) - Target 4,852 17,466 676 No. of children (6 mnth to below 9 mnth ) – Achievement 2,061 (42%) 12,489 (72%) 568 (84%) No. of children (9 mnth to 5 yrs ) - Target 1,76,187 6,12,676 1,00,547 8,609 No. of children (9 mnth to 5 yrs ) – Achievement 1,31,209 (74%) 5,06,881 (83%) 92,295 (92%) 7,840 Average Children < 5 yrs. Immunized / OB covered 713 839 1032 980

21. DTH PTS NNT Year 2024 2025* 2024 2025* 2024 2025* Suspected Cases Reported 2412 131 544 62 17 3 Deaths in Suspected Cases 455 6 8 6 14 1 Laboratory Confirmed 711 19 43 - - Deaths in Laboratory Confirmed 211 3 Clinically Compatible 1701 112 501 62 - - DPT (Diphtheria, Pertussis, Neonatal Tetanus) Update – Uttar Pradesh *data as on 3 Mar

22. Age & Dose Analysis of Suspected DTH Cases – UP (2024) No. of Cases = 2,412

23. Outbreak Investigation, Response and Control An outbreak is defined as the occurrence of an illness in a community, clearly in excess of the expected numbers. Outbreaks are defined differently for different VPDs. For polio, diphtheria, neonatal tetanus or JE, even a single case is defined as an outbreak. For pertussis, a sudden increase in the number of cases is considered to be an outbreak. For Measles-Rubella outbreak: Five or more suspected measles-rubella cases reported in block or equivalent (or contiguous block/area) in rural areas and ward/ equivalent in urban areas in the past four consecutive weeks (28 days); OR One or more suspected measles-death/s in a block or equivalent in rural areas and ward/equivalent in urban areas.

24. Steps in Outbreak Investigation Step 1: Confirm the outbreak Visit the area; ascertain its geographical spread Confirm diagnosis – Clinical, Epidemiological, Laboratory Step 2: Conduct house to house search to find additional cases and manage the cases Step 3: Line list and notify the cases Step 4: Describe the outbreak Time, Place and Person Step 5: Analyze the data Step 6: Use the data for action Health system strengthening, coverage improvement, case management, capacity building of staff, risk communication Step 7: Write the report Step 8: Give feedback Findings from the outbreak investigation and actions initiated Step 9: Initiate action Step 1 Step 2, 3, 4 and 5 Step 6, 7, 8 and 9

25. MR Elimination: Public Health response to Lab Confirmed MR Outbreak Active case search in the community to detect additional suspected cases Vit A supplementation during house-to-house searches of additional suspected cases Head count survey of unvaccinated/under vaccinated children in < 5yrs Special advisory from GoI has been shared on 23rd November 2022, towards covering missed out/dropped out beneficiaries and administering additional dose of MR vaccine on outbreak response immunization (ORI) mode with the age group being decided by local epidemiological situation. One dose of MR should be administered to all 6 months to <9 months children in those areas where the measles cases in the age group of <9 months are above 10% of the total measles cases.

26. Roles and Responsibilities of Medical Officer in VPD Surveillance Ensure timely case notification, investigation, sample collection and shipment maintaining the cold chain, case management and public health response Ensure that the samples are sent to DIO/ DSO/SMO office at the district and request the same to provide the results as soon as it is available Generate awareness and maintain sensitization of reporting network in the area regularly on VPD surveillance Conduct training w orkshops for all the staff: Audio-visuals may be used Frequent sensitization and active case search visits to reporting sites and provide feedback Ensure effective communication network among the practitioners by way of sending text messages, WhatsApp, phone calls, publishing newsletters etc In case of outbreaks, ERT should be activated and ensure conduct of outbreak investigation and public health response Explore the possibility of adding new reporting sites in the outbreak/adjoining area, based on the health seeking behavior of suspected cases.

27. Landscape for Vaccine Preventable Disease on UDSP Case Registration (Reporting Units) CIF Entry (CHC/ PHC Nodal Officer) CIF Review & Entry (DIO/ DSO/ SMO) Sample Routing Referral Case Close S1 S2 S4 S5 S-Step Referral S3 Result Upload Case Informed to DIO/DSO/SMO/MO

28. Vaccine Preventable Disease (VPD) Pilot Testing - May 2024 As per directions given in meeting under chairmanship of Mission Director NHM dated 16 Feb 2024 : 5 following districts facility undertaken to perform field testing for VPD activity of ( Pertussis, Diphtheria, AFP, NNT, Fever & Rash ). CHC Siyau , Bijnor CHC Bisrakh , Gautam Budh Nagar. CHC Bhathat , Gorakhpur. CHC Kachhwa , Mirzapur . CHC Chopan , Sonbhadra . Participants involved are DIO, DSO, MOIC, SMO, SRTL, DSS, DEO. LIVE CIF forms (of VPD) are used to enter on UDSP portal. Successful entries was made with no issue.

29. Instructions to Rollout VPD Surveillance 29 Instructions to rollout UDSP for reporting of all VPDs were issued by PS (MH & FW, ME) sir in the meeting held on 25 January 2025

30. VPD Surveillance on UDSP – Role Wise Data Flow Dr. Vikasendu Agarwal

31. Landscape for Vaccine Preventable Disease on UDSP Case Registration (Reporting Units) CIF Entry (CHC/ PHC Nodal Officer) CIF Review & Entry (DIO/ DSO/ SMO) Sample Routing Referral Case Close S1 S2 S4 S5 S-Step Referral S3 Result Upload Case Informed to DIO/DSO/SMO/MO

32. Data Flow on UDSP for Vaccine Preventable Disease 32 Facility Platform UDSP URL https:/facility.udsp.in

33. Search Patient (Reporting Facilities) 33

34. Add Patient (Reporting Facilities) 34 * Add Patient is applicable only when patient not found after search

35. 35 Case Registration (Reporting Facilities) * Case Registration is applicable only when patient not found after search

36. 36 VPD Campaign Selection (Reporting Facilities)

37. 37 Patient Selection for Survey (Reporting Facilities)

38. 38 Survey Questions (Reporting Facilities)

39. 39 Clinical Diagnosis (Reporting Facilities)

40. 40 Patient Selection for Referral to CHC by Reporting Facilities

41. 41 Refer to CHC Facility by Reporting Facilities

42. 42 Case Investigation (CHC/PHC Login)

43. 43 Referred Patient Selection by CHC

44. 44 Follow up Survey by CHC

45. 45 Sample Routing to Labs by CHC

46. Mention Case ID (EPID) on Lab Request Form 38

47. 47 Patient Selection for Referral to District Level by CHC

48. 48 Refer to District Level by CHC

49. 49 Case Review & Updation (District Login)

50. 50 Referred Patient Selection by District Admin (DIO/DSO/SMO)

51. 51 Follow up Survey (DIO/DSO/SMO)

52. 52 Case Closure by DIO/DSO/SMO after Follow-up Period

53. 53 Data Access

54. 54 Case Investigation form (generated from UDSP)

55. Case Deletion (in case of Duplication) 38

56. Case Deletion (in case of Duplication) 38

57. Case Transfer Request 38

58. Q&A

59. Hands-on Exercise

60. A laptop & facilitator are present at each table. We are going to go through case scenarios Log -in credentials for a PHC (Reporting Unit), CHC (Nodal Officer), District Admin (DIO) have been kept on the table, kindly use these to log-in to the portal All tables need to go through one entire flow. Stepwise, with frequent pauses for discussions. 60 Hands-on Exercise

61. Login with PHC Credentials Registration Diphtheria Case Referral Login using CHC Credentials CIF Sample Collection Referral Login using District Credentials Review & Update by District Team Download & Save PDF CIF Share on WhatsApp group with Group/Table Name 61 Exercise 1

62. Login with CHC Credentials Registration MR Case CIF Sample Collection Referral Login using District Credentials Review & Update by District Team Download & Save PDF CIF Share on WhatsApp group with Group/Table Name 62 Exercise 2

63. Login with District Credentials Registration AFP Case CIF Sample Collection Download & Save PDF CIF Share on WhatsApp group with Group/Table Name 63 Exercise 3

64. Roll-out Plan Dr. Ajay Gupta | Dr. Vikasendu Agarwal | Dr. Manoj Shukul

65. Upon returning to the district – two types of orientation need to be organized within next two weeks (20 th March 2025) For all reporting units – register on UDSP and orient on their role For all nodal officers (MOs) – Orientation and hands-on exercise on using UDSP for VPD Surveillance To be conducted in the presence of Div. Surveillance Officer From 1 st April 2025 onwards, only VPD cases reported via UDSP will be considered by the State. All analyses and reviews will be conducted based on this data. 65 Next Steps