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Performance Review of Disease Surveillance for the Year 2006

Performance Review of Disease Surveillance for the Year 2006. 2006 Annual Review Meeting Public Health Division, GHS HQ Erata Hotel, 8-9 March 2007. Dr. Lawson Ahadzie Deputy Director (Public Health) & Head, Disease Surveillance Department Ghana Health Service. Introduction.

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Performance Review of Disease Surveillance for the Year 2006

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  1. Performance Review of Disease Surveillance for the Year 2006 2006 Annual Review Meeting Public Health Division, GHS HQ Erata Hotel, 8-9 March 2007 Dr. Lawson Ahadzie Deputy Director (Public Health) & Head, Disease Surveillance Department Ghana Health Service

  2. Introduction • Mandate of Disease Surveillance Department (DSD) : • Responsible for keeping surveillance on priority diseases, providing response to epidemics and disease outbreaks and rumours and helping in undertaking public health intervention measures for reducing the burden of other priority diseases

  3. Programme Areas • Meningitis • Cholera • Yellow Fever • Measles • Avian/ Human Influenza • Acute Flaccid Paralysis (AFP) • Community Based Surveillance • Surveillance of 23 Priority Diseases • Response to Rumours and Unusual Health Events

  4. Presentation Outline • Key Activities undertaken in 2006 • Performance indicators/Coverages • Challenges and • Strategic Plan (2007 – 2011)

  5. Key Activities - #1 • Case-based surveillance for key diseases • Regular monitoring of timeliness and completeness of weekly and monthly reports • Data Quality Audit in 2 districts • Enhanced surveillance for meningococcal meningitis • Case-control studies in KEEA and Ga East districts to assess the behavioral patterns which were most likely to expose individuals to Cholera

  6. Key Activities - #2 • Investigation of Yellow Fever Outbreaks in Juabeso and Sene districts of Western and Brong Ahafo region respectively • Advocacy for Yellow fever vaccines and logistics support for Yellow fever mass vaccination campaigns • Yellow fever mass vaccination campaign conducted in Sene district

  7. Key Activities - #3 • Finalized Preparedness and Response Plan for Avian/Human Influenza • Implemented Avian/Human Influenza Preparedness Plan • Advocacy for support for funds for implementation of the plan • Training of Health Staff • Procurement of logistics • Collaboration with Veterinary Staff in AI active surveillance • Investigation of (a false alarm) of suspected case of Human case of H5N1 Influenza.

  8. Key Activities - #4 • Supported Integrated Measles Mass campaign • Active surveillance for AFP • Completed Revision of CBS booklets • Development of a CBS Implementation Guidelines • Production of Weekly Epidemiological Bulletin

  9. Performance/Coverage

  10. Reported Meningitis Cases, Deaths and Case Fatality Rate by Region, 2006

  11. Trend of Meningitis Cases and Case Fatality Rate (CFR) in Ghana, 2000 - 2006

  12. Reported Cholera Cases Deaths and CFR by Regions, 2006

  13. Trend of Cholera Cases and Case Fatality Rate (CFR) in Ghana, 2000 - 2006

  14. Percentage Districts Reporting At Least One Suspected Case of Yellow Fever with Blood Specimen by Year, 2002–2006

  15. Confirmed Yellow Fever Cases in Ghana by Year, 2001-2006

  16. Yellow fever Performance contd. • Received 1,400,000 yellow fever vaccines from the World Health organization vaccine • Mass vaccination Yellow fever campaign conducted in Sene district with a coverage of 90.2% of the targeted population of 91,476 people aged one year and above

  17. Measles Surveillance Performance • Total measles laboratory specimens processed from January to December 2006 was 420 • 94 districts (68%) have sent at least one specimen to the laboratory for (target: at least 80% of districts) . • 20% of suspected cases investigated have been laboratory confirmed as positive for measles High % (target ≤10%) is as result of outbreaks in Greater Accra and Northern region

  18. Annualized Non-polio AFP Rate and Timeliness of AFP Stool by Region, Jan - Dec 2006

  19. AFP Core Surveillance Indicators in Ghana, 2000 - 2006

  20. Wild Polio Cases Detected in Ghana by Year, 1996 - 2006

  21. AFP Surveillance Performance contd. • No wild polio virus has been isolated since September 2003 • This with improved surveillance qualified the country for certification of polio free status in 2007

  22. Avian/Human Influenza • 3 meetings of National Task Force on Avian Influenza at WHO Conference Room • 3 meetings of Human Influenza Health Sub Committee • Participated in 6 International meetings of experts in Bamako, Mali. • Orientation of regional teams on Surveillance and case management of Avian Influenza • Training of core trainers in Avian Influenza Preparedness and Response in Burkina Faso

  23. Avian/Human Influenza contd. • 2 staff from Noguchi trained in the laboratory investigation of Avian/ Human Influenza at Egypt. • Procurement of 500 sets of Personal Protective Equipment • Secured 200,000 us dollar grant from African Development Bank to support Avian Influenza Activities • No cases of HPAI were identified in either humans or animal populations in the country

  24. Database on Number of Communities with CBS Volunteers and CBS Volunteers Trained as at the end of 2006

  25. Timeliness of Monthly Reporting, January to Dec, 2000-2006

  26. Summary of Selected Surveillance Performance Indicators, Ghana, 2002-2006

  27. Summary of Selected Surveillance Performance Indicators, Ghana, 2002-2006

  28. Key Challenges - 1 • Data Quality Issues • Non use of case based form for investigating and reporting cases • Disparities in reporting on Case based, Weekly and Monthly forms • Regions do not update national level when lower levels update • Immunization status of suspected measles cases not recorded on reporting form

  29. Key Challenges - 2 • Tendency of health staff to organize reactive mass immunization campaign for meningitis without determining the causative organism causing the outbreak • Lumbar punctures not performed on meningitis cases by clinicians • Shortage of meningitis vaccine globally • Occasional shortages of Cholera case management logistics at the Central Medical Stores during the year

  30. Key Challenges - 3 • Inadequate AFP surveillance stools • 60-Day Follow-up of AFP is not being done on all cases • Transportation of laboratory specimens to wrong laboratories • Feedback from Disease Surveillance Department does not filter down to reporting facilities

  31. Strategic Plan 2007 - 2011

  32. Policy Objective • Strengthen the surveillance, epidemic preparedness and response mechanisms in order to reduce frequency and outcome of epidemics for example cholera, meningitis, yellow fever and threats of new epidemics such as Avian Influenza

  33. Strategic Objectives • To improve rates (timeliness and completeness) of submission of surveillance data • To strengthen surveillance data management and use of surveillance information for decision-making for action including monitoring and evaluation of intervention programmes at all levels • To strengthen the capacity of the communities to report the occurrence of selected priority diseases and unusual health events as well as sub-district and district staff to respond promptly to the reports from communities within their catchment areas

  34. Strategic Objectives - #2 • To strengthen preparedness and technical capacity of health teams to predict, detect, investigate and respond to disease outbreaks • To strengthen the capacity and involvement of laboratories in the disease surveillance system

  35. Key Activities for 2007 - 2011 #1 • Revise IDSR Technical Guidelines to include emerging diseases • Revise IDSR Training modules • Document all AFP cases from 1996 at all levels of the health system in preparation for polio-free certification • Conduct regular data quality audit in selected regions and districts

  36. Key Activities for 2007 - 2011 #2 • Development of policy document and guidelines on Viral Hepatitis • Revise and Update templates for Epidemic Preparedness and Response Plan for all levels • Revise, Update and Implement Epidemic/Pandemic Preparedness and Response Plan for Avian/Human Influenza • Develop guidelines for surveillance at the Ports of Entry

  37. Key Activities for 2007 - 2011 #3 • Set up sentinel surveillance for selected priority diseases • Provide support for laboratory diagnosis and confirmation of epidemic prone diseases • Sensitize on performance of lumbar puncture by regions • LP documentary distributed to the regions • Intensify technical support to lower levels • Produce weekly and monthly Epidemiological Feedback Bulletins to reflect data submitted and performance of surveillance system

  38. Key Activities for 2007 - 2011 #4 • Update and computerize list of communities • Develop simple CBS data analysis format • Mobilize logistics to support CBS • Link up with Ministries, Departments and Agencies which are responsible for environmental sanitation to be more proactive

  39. Summary of Selected Surveillance Performance Indicators, Ghana, 2007-2011

  40. Summary of Selected Surveillance Performance Indicators, Ghana, 2007-2011

  41. Thank You

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