Introduction to the Integrated Disease Surveillance Project : Introduction to the Integrated Disease Surveillance Project IDSP training module for state and district surveillance officers
Module 1 www.medicos11.com
Learning objectives : Learning objectives Define surveillance and explain important terminology in surveillance
List all the components of the surveillance activities
Specify the major objectives of the Integrated Disease Surveillance Project
List types of surveillance carried out under the Integrated Disease Surveillance Project by different categories of staff
Name all reporting units in the rural and urban areas of a district
List all conditions under surveillance through primary health centre/community health centresystem
Health goals - India : Health goals - India Eradicate polio 2005
Eliminate leprosy and yaws 2005
Establish IDSP, NHA/Health Stats 2005
Zero-level growth of HIV/AIDS 2007
Eliminate Kala-Azar 2010
? Mortality by 50% - TB, malaria and other 2010
? Prevalence of blindness to 0.5% 2010
? IMR to 30/1000, MMR to 100/100,000 2010
Eliminate lymphatic filariasis 2015
Public health surveillance : Public health surveillance Surveillance is defined as the ongoing systematic collection, collation, analysis and interpretation of data and dissemination of information to those who need to know in order that action be taken
Important information in surveillance : Important information in surveillance Who get the disease?
How many get them?
Where they get them?
When they get them?
Why they get them?
What needs to be done as public health response?
Why do we need to do surveillance? (1/2) : Why do we need to do surveillance? (1/2) Recognize cases or cluster of cases to trigger intervention to prevent transmission or reduce morbidity and mortality
Assess the public health impact of health events or determine and measure trends
Demonstrate the need for public health intervention programme and resources during public health planning
Why do we need to do surveillance? (2/2) : Why do we need to do surveillance? (2/2) Monitor effectiveness of prevention and control measures and prevent outbreaks
Identify high risk groups or geographical areas to target interventions an guide analytic studies
Develop hypotheses that lead to analytic studies about risk factors for disease causation, propagation or progression
Key elements of a surveillance system : Key elements of a surveillance system Detection and notification of health events
Investigation and confirmation
Collection of data
Analysis and interpretation of data
Feedback and dissemination of results
Response – Action for prevention and control
1997-8: National Surveillance Programme for Communicable Diseases (NSPCD) : 1997-8: National Surveillance Programme for Communicable Diseases (NSPCD) Nodal point
National Institute for Communicable Diseases
Implementing agencies
States and union territories
Main components
Infrastructural strengthening - Laboratories
Human resources development
Uniform and regular reporting
Monitoring and evaluation
Operational - 101 districts (Merged in IDSP Phase-I)
Objectives of NSPCD : Objectives of NSPCD Strengthen district and state capabilities to promptly identify and respond to disease outbreaks
Establish an early warning mechanism
Laboratory strengthening and networking for rapid confirmation of diagnosis
Effective use of surveillance data using rapid means for communication
Institute appropriate and timely response for prevention and control of outbreaks
Objectives of NSPCD : Objectives of NSPCD Improving technical capabilities of medical and paramedical personnel
Up-gradation of laboratories at district, state and regional level
Improving communication and data processing system
Constitution of rapid response teams at district and state levels for early response
Collaboration with ICMR, WHO and other concerned agencies/departments
Weaknesses in disease surveillance : Weaknesses in disease surveillance Lack of integration of private sector
Poor laboratory capacity
Blind spots in urban areas
Slow, inefficient sharing of surveillance information at district level
Limited capacity to undertake analysis and response at district level
Non-inclusion of non communicable diseases
Surveillance strategy in the Integrated Disease Surveillance Project (1/2) : Surveillance strategy in the Integrated Disease Surveillance Project (1/2) District level is the basic functional unit for integrating surveillance functions
All surveillance activities are coordinated and streamlined
Resources are combined to collect information from single focal point at each level
Several activities are combined into one integrated activity to take advantage of similar surveillance functions, skills, resources and target populations
Surveillance strategy in the Integrated Disease Surveillance Project (2/2) : Surveillance strategy in the Integrated Disease Surveillance Project (2/2) Integrates public and private sector by involving private practitioners and communities
Addresses communicable and non communicable diseases
Covers both rural and urban health systems
Collaborates with private and public medical colleges
Objectives of the Integrated Disease Surveillance Project : Objectives of the Integrated Disease Surveillance Project To establish a decentralized district based system of surveillance for communicable and non-communicable diseases so that timely and effective public health actions can be initiated in response to health changes in the urban and rural areas
To integrate existing surveillance activities to avoid duplication and facilitate sharing of information across all disease control programmes and other stake holders so that valid data is available for health decision making in the district, state and national levels
Important components where additional inputs will be provided : Important components where additional inputs will be provided Strengthening of laboratories
Improved information management system
Human resource development
Developing supporting structure for integration
What is integration? : What is integration? Sharing of surveillance information of disease control programmes
Developing effective partnership with heath and non health sectors in surveillance
Including communicable and non communicable diseases in the surveillance system
Working with the private sector and non governmental organization
Bringing academic institutions and medical colleges into disease surveillance
Classification of surveillance in IDSP : Classification of surveillance in IDSP Syndromic
Diagnosis made on the basis clinical pattern by paramedical personnel and members of community
Presumptive
Diagnosis is made on typical history and clinical examination by medical officers
Confirmed
Clinical diagnosis by medical officer and or positive laboratory identification
Conditions under regular surveillance : Conditions under regular surveillance
Other conditions under surveillance : Other conditions under surveillance
State-specific diseases : State-specific diseases Madhya Pradesh, Uttaranchal
Diphtheria, neonatal tetanus, leprosy
Maharashtra
Diphtheria, neonatal tetanus, leptospirosis
Andhra Pradesh
Filariasis
Karnataka
Filariasis, KFD & HGS, leptospirosis
Tamil Nadu
Leprosy, leptospirosis
Kerala
Leptospirosis
Mizoram
Cancer, substance abuse, acid peptic disease, pneumonia
The limited number of conditions under surveillance : The limited number of conditions under surveillance Limited number of core diseases
Improves quality of surveillance
Reduces workload
Diseases of regional importance
Under surveillance in addition to the core list
Review and modification of the list according to needs at least once in two years
Viral hepatitis and acute respiratory tract infection
Also under consideration at various levels
May be included subsequently
Surveillance activities at each level : Surveillance activities at each level
Reporting units for disease surveillance : Reporting units for disease surveillance
Role of district surveillance officers and medical officers : Role of district surveillance officers and medical officers Supervision and quality control of active surveillance by field staff
Passive surveillance for diseases on the list
Supervision of compilation and transmission of periodical reports
Integration of sentinel private practitioners
Emergency response to surveillance reports received
Facilitation of outbreak investigation and response
Phases of implementation for the Integrated Disease Surveillance Project : Phases of implementation for the Integrated Disease Surveillance Project Phase I (2004-05)
Madhya Pradesh, Andhra, Himachal, Karnataka, Kerala, Maharashtra, Mizoram, Tamil Nadu & Uttaranchal
Phase II (2005-06)
Chattisgarh, Goa, Gujarat, Haryana, Orissa, Rajasthan, West Bengal, Manipur, Meghalaya, Tripura, Chandigarh, Pondicherry, Nagaland, Delhi
Ph III (2006-07)
UP, Bihar, J&K, Punjab, Jharkhand, Arunachal, Assam, Sikkim, A&N Island, D&N Haveli, Daman & Diu, Lakshadweep