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AEFI data management training course

Obtaining & handling AEFI data from surveillance systems. AEFI data management training course. Aspects discussed. The AEFI surveillance cycle and key players. - National/ Subnational prgm. mgr. - Health worker. - Caregiver - Health worker. AEFI committee.

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AEFI data management training course

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  1. Obtaining & handling AEFI data from surveillance systems AEFI data management training course

  2. Aspects discussed

  3. The AEFI surveillance cycle and key players - National/ Subnational prgm. mgr. - Health worker - Caregiver - Health worker AEFI committee Surveillance: The ongoing systematic collection and analysis of data and the provision of information which leads to action National/ Subnational programme manager - Health worker - District level manager

  4. AEFI Surveillance system Objectives Depending on the local context, define what is the purpose of the surveillance system and what is intended to be monitored (for example a system to detect - ALL AEFI, Serious AEFI, Events of Special interest or events related only to new vaccines introduced, etc) Roles and responsibilities • Who will identify the AEFI and collect information • Who and where to report, and timeline • Who and how to process data and analyze • Who will monitor the outputs of the system and periodicity

  5. Obtaining data through AEFI surveillance

  6. Passive AEFI surveillance system • Recognition • Encouraging Reporting • Use of forms and procedures • For corrective action • To reinforce usefulness of reporting • To reassure patients and HCWs

  7. Passive surveillance:

  8. Passive surveillance: AEFI Routing, Timeline and Actions Health Worker (Primary or Hospital) Site Complete first part of report form Immediate report in reporting form • Confirm AEFI, Assign code number, complete ALL details in the reporting form and e mail to EPI • Dist level planning meeting on investigation • Investigate the AEFI case (ask IPH for help only if necessary) • Complete the investigation form • Initiate collection of Medical report, vaccine, logistic samples, Laboratory report eg CSF, Serum (or other biological products) Example District public health authority District • For completed reporting form 24 Hours (e mail) • For investigation form 7 days (Hard copy with supporting doc) National • Immediately review reporting form and see if addl cases occurred in other places of the country • With report form, create national linelist and national database to share with MoH • Support field investigation if needed • Analyze the investigation form, consult with AEFI expert committee if needed. Send inv form to NRA • Upload data to WHO UNICEF JRF after approval by MoH EPI WHO UNICEF JRF Investigation form within 7 days of completing field investigation AEFI Committee NRA Vigiflow • Upload data to Global database (Vigiflow) after approval from MoH • If needed • Inform UNICEF and MAH (with copy to MoH) • Inform manufacturer and authorized importers (with copy to MoH) National linelist MoH (Ministry of health) Note: Timelines indicated are upper limits Feedback Global sharing after approval

  9. Stimulated passive surveillance system

  10. Active surveillance

  11. How to do active surveillance

  12. Forms and formats associated with AEFI surveillance

  13. Standardized forms • Collect relevant data in a specific format • In accordance with the surveillance objectives • In compliance with regulatory requirements • Allows for efficient and complete data processing, analysis and reporting • Facilitates the exchange of data across projects and organizations, esp. through standardization • Design should met users demands, avoid duplication and be clear and simple

  14. ALL forms and formats related to AEFI

  15. The AEFI reporting and linelisting form Key forms for data analysis

  16. AEFI investigation form and AEFI lab request form

  17. AEFI feedback form and Optional forms

  18. Steps for data analysis Tabulation - by place, person, time, antigens and type of event Completing the AEFI reporting form for ALL events that have been brought to the notice of the health care system Linelisting - will help initial identification of clustering or any unusual or significant reporting events that need further analysis Analysis: Time, place and person Calculating the relevant rates using correct denominators and multipliers Comparing the rates ie expected vs observed • AEFI rates • Reported AEFI rates for each antigen in a given time period (month, quarter-year or year). • AEFI rates by first, second or third dose if the antigen is administered more than once. • AEFI by the location of occurrence • AEFI by the type of event • AEFI by seriousness

  19. Purpose of analysing AEFI data at different levels

  20. Quick analysis with forms received … • Define the extent of the problem • Time: What are the dates of onset of cases? • Place: Where do cases originate from? • Person: Who are they? • Number of AEFI reports received monthly (serious and non serious AEFIs including clusters) • Estimating rates (per 1000, 10,000 or 100,000 – by vaccine or event) and comparing with known rates • Classification of reported AEFI by types • Classification of AEFI by antigen • Classification of events by causality assessment • Unusual AEFI

  21. Routine data analyzed can provide information on Increase in the number of AEFI reported Geographic location of the cases Identifying clusters Ad-Hoc analysis Helpful when new issues have been identified by the system Retrospective analysis may reveal that similar problem existed before What can a quick look at data tell us?

  22. Data monitoring, quality control and feedback Program managers should keep track (monitor), identify issues (quality control) and intervene (provide feedback) on • Data generation • Data Flow • Data Quality • Data Cleaning • Data Analysis • Timeliness and completeness • Country relevant performance indicators

  23. Key considerations

  24. How does such data analysis help?

  25. Suggestions: Local level data analysis Who should analyse data: The person need not be a data management specialist, instead it could be any person in charge of immunization program implementation

  26. Suggestions: Subnational level data analysis Who should analyse data: The person need may or may not be a data management specialist, instead it could be any person in charge of decision making

  27. Suggestions: National level data analysis Who should analyse data: The person should ideally be a data management specialist, the data analysed should be processed and presented to the decision making authority

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