VPD S urveillance

1. VPD Surveillance

2. Surveillance is the … Ongoing systematic collection, collation, and analysis of health data and the dissemination of that information to those who need to know so appropriate action can be taken

3. Surveillance is the continued vigil over the occurrence and distribution of disease and conditions which increase the risk of disease transmission Surveillance is information foraction

4. A surveillance system should: • Describe each person having an infection or disease • Determine source of infection and mode of • transmission • Identify exposed, susceptible person to whom the • infection may have been transmitted • Specify frequency of occurrence of infection • in different population groups • Prepareand distribute surveillancereports

5. A major objective of disease surveillance is… To determine the extent of infections and the risk of disease transmission …so control measures can be applied effectively and disease can be prevented

6. Five functions of a surveillance system • Case detection and notification • Investigation and confirmation • Data collection and consolidation • Data analysis • Information dissemination • All done to guide public health action

7. Additional supporting functions • of disease surveillance: • Setting standards (e.g case definition) • Training and supervision • Setting up laboratory support • Establishing communication network • Optimizing resource management • Improve coordination/integration

8. Surveillance tasks differ depending upon the level District level Provincial level Central or National level

9. Surveillance at the district level • Diagnosis and case management • Reporting of cases • Simple tabulation and graphing of data

10. Surveillance at the Provincial level • Case management for more difficult cases • Analyze data from peripheral level for epidemiological links and trends • Monitor data to check if control targets have been met • Investigate suspected outbreaks. • Feed back to the district • Report to central level

11. Surveillance at the National level • overall support and coordination of national surveillance activities. • provision of laboratory diagnosis data • analyze data from intermediate level for: • epidemiological links • trends • achievement of control targets. • support intermediate level for outbreak control • feed back to intermediate level, and report to WHO regional office

12. Information gathered from Disease Surveillance can be used to… • Estimate the magnitude of health problem • Determine geographic distribution • Portray natural history of a disease • Detect epidemics • Monitor changes in infectious agents • Evaluate control measures • Facilitate and improve planning • Generate hypothesis and stimulate research

13. Sources of data for surveillance • Notifiable disease reports • Laboratory results • Vital records • Sentinel surveillance • Birth/death registries • Surveys • Vaccine utilization records • Vaccine adverse event reporting system

14. Types of surveillance Passive surveillance: data are routinely collected and forwarded to more central levels Active surveillance: data are sought out by visiting or contacting a reporting site Comprehensive surveillance: data are collected from numerous sites throughout a country in order to achieve representation of whole population Sentinel surveillance: selected sites report data, can be used to monitor trends and collect detailed information, but may not represent the entire country Community-based, facility-based and laboratory-based surveillance: involve detection and notification by communities, health facilities and laboratories

15. Prioritize which diseases need surveillance, diseases: • does the disease result in a high disease impact? (morbidity, • mortality, disability) • does the disease have a significant epidemic potential • (cholera, measles) • is the disease a specific target of a national / international • control program • will the collected information lead to significant public • health action?

16. What needs to be addressed for each disease • under surveillance? • The case definition should be • Clear • Appropriate • Consistent throughout the surveillance system • The reporting mechanism should be • Clear • Efficient • Appropriate reporting periodicity • Available to all relevant persons • The analysis of data should be • Appropriate • Allow for proper presentation • Used for decision-making

17. The people doing the surveillance should • Have a good understanding of the value of surveillance • system • Understand their surveillance task • Have sufficient resources • The personnel involved should receive appropriate • Training • Supervision • The feed-back from central levels should be • Appropriate in format • Sufficient and frequent enough • Motivating

18. The surveillance partners immunizationprogram staff epidemiologists Pediatrician/ PPA lab staff mass media private sector (informal health care providers) NGO sector agencies & institutions LHWs Community

19. National National Manager EPI WHO Sr. MO NS Cell LAB Provincial ERC Courier Province Provincial Manager EPI WHO Medical Officer Stool specimens from AFP cases District DSC/SO EDO(H) THs/DHQ/THQ/RHCs/BHUs Pediatricians/Clinician Private sector DC LHWs in community AFP Surveillance System - Pakistan

20. Thank you