DPHSWD Resident Advisor Orientation Helen N. Perry, PhD IDSR Team Lead

1. Integrated Disease Surveillance and Response: a strategy for strengthening national public health surveillance systems DPHSWD Resident Advisor Orientation Helen N. Perry, PhD IDSR Team Lead Public Health Systems Strengthening Branch August 8, 2011

2. IDSR is aWHO AFRO strategyCDC is key technical partner supported with USAID funding* * * *First Annual IDSR Taskforce Meeting Harare, Zimbabwe November 2, 2000

3. Mid-1990s Cholera Thousands of cases in East Africa 1996-98 Meningococcal Meningitis 300,000 cases and 35,000 deaths 1996 Yellow fever Reported outbreaks in 7 countries 1995-1996 Ebola Zaire and Gabon High case fatality rates 68% to 90%

4. IDSR priority diseases: 1998-2008 • Epidemic prone diseases • Cholera • Diarrhea with blood • Measles • Meningitis • Plague • Viral hemorrhagic fevers • Yellow fever • Diseases for elimination/eradication • Acute flaccid paralysis / poliomyelitis • Dracunculiasis • Leprosy • Neonatal tetanus • Diseases of public health importance • AIDS • Diarrhea with dehydration <5 y old • Malaria • Onchocerciasis • Pneumonia < 5 y old • Sexually transmitted infections • Trypanosomyasis • Tuberculosis • Diseases targeted by IHR (2005)

5. Planning an integrated system: a matrix of skills and activitiesPerry et al, BMC Medicine 2007

6. Guidelines for IDSR WHO-CDC IDSR Guidelines Ghana IDSR Guidelines

7. Examples of action thresholds

8. IDSR performance indicators • Summary and case-baseddata reported on time tonext level • Trend analysisfor priority diseases is current • Reportedoutbreaks are investigated • Reported outbreaks are laboratory confirmed • Response implemented for confirmed outbreak and evaluated

9. Role of laboratory in IDSR Confirm epidemics Monitor trends

10. Laboratory performance indicators • Laboratory data is reported on time. • Transport of adequate specimens to referral laboratory • Supervisionand quality control at periphery • Correct culture and antimicrobial results for bacterial specimens • Participate in outbreak investigation • Participate in External Quality Assurance Program

11. 2010 - Preparedness at country level: existence of guidelines, regulations, and policies Ref: WHO-AFRO and CDC-IDSR team (2011). Draft summary results from the IDSR Rapid Assessment of IDSR Implementation in African countries. CDC authors include C. Alu (OSELS), T.Taylor (NCEZID), K.Embrey (ASPH Fellow) and H. Perry (DPHSWD)

12. International health regulations (2005) Call for surveillance and response capacity at all levels of the health system

14. ( Draft July 15, 2010

15. Revised IDSR Technical Guidelines – October 2010 International Health Regulations (2005) Non-communicable diseases New public health priorities (e.g., pandemic influenza) Focus on community surveillance Preparedness Disease specific fact-sheets

17. IDSR and FELTP • FELTP practicum opportunities at district and national levels • Detecting public health communicable and non-communicable events • Conducting training for district level • Evaluating IDSR components • Participating in laboratory network • Innovative problem solving- • FELTP graduates become national leaders for surveillance, laboratory and response capacities

18. Summary • IDSR is a framework for strengthening public health surveillance and response at all levels of the health system • IDSR and FELTP work together to reduce illness, death and disability and contribute to healthier African and global communities

19. THANK YOU IDSR PARTNERS WHO-AFRO CDC-Atlanta USAID Africa Bureau Africa 2010 WHO ISTs Ministries of Health