EARLY WARNING OUTBREAK RESPONSE SYSTEM (EWORS)

INTRODUCTION

Communicable diseases are still severe public health problems in Viet Nam. Epidemic occurs every year, such as Dengue fever, Typhoid fever, HEV, Cholera, etc.

Routine surveillance system in Viet Nam included weekly and monthly reports is a passive surveillance system based on nofitiable cases from hospitals. As there are many difficulties for hospitals at lower level in diagnosing a confirmed case, such as lack laboratory supply, limitation of professional health staff, current surveillance system becomes delayed, inaccurate and insufficient. However, health staffs can recognize easily many simple symptoms, such as fever, diarrhea, cough, haemorrhagic, etc. By integrating those simple symptoms, a software program can help recognize the occurrence of possible outbreaks and control them early and effectively. US. Naval Army Medical Research Unit II (US. NAMRU2) has designed the software named EWORS (Early Warning Outbreak Response System) to collect data of communicable disease symptoms consulting room, analyze them and predict the possible outbreak.

This symptom based surveillance system has been applied in many countries in the world because of its advantages: simple, practical, feasible. After Indonesia, Laos, this experimental surveillance system has been implemeted in Viet Nam since 2001.

STUDY SITES

There are five study sites in Ho Chi Minh City (Children Hospital No 1, Children Hospital No 2, Tropical Diseases Hospital) and in An Giang Province (Provincial General Hospital and Phu Tan District Hospital).

In future, study will be expanded to 4 sites in Dong Nai province and Khanh Hoa province

CONTENTS OF STUDY

1. Data collection and dissemination

Study Object: All patients with main symptom associated to communicable diseases in the outpatient area of hospitals

Method: Interviewing, examining and filling out EWORS form (with 30 main signs and symptoms of communicable diseases)

- In outpatient area, nurses fill out the demographic information and doctor fill out the clinical information about the symptoms and signs

- All forms is sent to computer room at the same day.

- Data is collected, entried daily by using EWORS software at computer room of every hospital

- All data will be transferred to host computer in Pasteur Institute everyday

2. Apply EWORS software to analyze in host sever

- Data and the trend of symptoms and signs by age, period, location will be analyzed daily by using EWORS software

- Trend of possible outbreak will be early recognized

- Pasteur Institute send the feedback reports to all member hospitals weekly and monthly

EWORS PROVIDES

- A base-line measure of disease occurrence for trend analysis. Trend analysis also provides a unique opportunity to describe changing patterns in epidemic transmission

- Real time transfer of data for rapid outbreak response measures. The EWORS concept is predicated on “the same day” transfer of information from network hospital sites to a central HUB (regional/national).

- Reliable (syndromic conditions) information. EWORS employs a syndromic approach to a working diagnosis, which allows to reliable analysis of aggregate data to determine appropriate response measures. Also, syndromic EWORS reporting insures epidemic recognition involving similar signs and symptoms associated with the same outbreak.