ESTABLISHING AN
EPIDEMIOLOGICAL SURVEILLANCE SYSTEM FOR COMMUNICABLE DISEASES OF COUNTRY
National project coded KHCN.11.03
Introduction
Difference
between current and new surveillance system
Step
by step to establish an epidemiological communicable disease surveillance
system
Activities
of communicable disease surveillance system
Evaluation
Application
INTRODUCTION
Current communicable disease
surveillance system was implemented many years ago, with the routine reports
including weekly, monthly, quarterly and yearly reports. The most advantage of
current surveillance system is a broad health service network, from the top to
the lowest level. Besides, many national programs have their good surveillance
system, such as polio control program, HIV/AIDS control program, etc.
However, current surveillance system
still faces some difficulties, such as (i) The diagnosis of diseases mainly
depends on clinical signs, therefore the information of morbidity and mortality
is not sufficiently precise; (ii) Reports from government health services or
private health services have not strictly been carried
out and timely transferred to the health authorities; (iii) Report system have
not been computerized yet; and (iv) Surveillance information has not timely and
effectively been applied for outbreak prediction and response.
Hence, Pasteur Institute in
- Strengthening health staff team of
surveillance, biostatistics and report of all level
- Training on surveillance skill for
local staffs
- Using microbiological diagnosis for main
communicable diseases, including Cholera, Amoebiasis, Shigellosis, Typhoid
fever, Dengue fever, Viral hepatitis,
Encephalitis, Meningitis, Measles, Leptospirosis.
- Improving data dissemination system through
computer-net (reporting and feedback)
DIFFERENCE BETWEEN CURRENT
AND NEW SURVEILLANCE SYSTEM
Although based
on available surveillance system, the experimental one was improved many
properties:
- Staff: Professional staffs in charge
of surveillance activities
- Training: Continuous training course
on clinical, laboratory and epidemiology
- Organization: Closing collaboration
between clinical, laboratory and epidemiology system in all levels
- Technique: Computerization procedure
of data analysis and dissemination
- Frequent monitoring of surveillance
activities of lower level
STEP BY STEP TO ESTABLISH
AN EPIDEMIOLOGICAL COMMUNICABLE DISEASE SURVEILLANCE SYSTEM
Procedure of
surveillance system establishment included activities of organization, supply
supporting, surveillance and monitoring (Figure 1)
Step
1. Setting up team in
charge of surveillance
Step
2. Training and equipment supporting
- Training on surveillance, clinical
diagnosis, laboratory and computer skill
- Supporting essential machine and equipment
for surveillance, diagnosis, laboratory and computer
Step
3. Implementing
surveillance activities
- Detecting based on clinical and
laboratory diagnosis criteria
- Reporting based on regulation of biostatistics,
report and feed-back
- Disseminating data through
computer-net (Pasteur-net)
Step
4. Monitoring of
surveillance activities of lower level
SURVEILLANCE ACTIVITIES
Surveillance
data were routinely collected from health services including commune health
center, district and province hospital and referral hospital.
A laboratory
system was established in order to confirm first case of the endemic, the
suspected cases of communicable diseases. This system, responsible by the
technician of laboratories, included specimen collection and transportation
procedure, laboratory test performance, and tested result reporting. The
laboratory results were updated to the weekly and monthly communicable diseases
report form.
These weekly and
monthly epidemiological and laboratory reports were disseminated to the upper
level of preventive system, especially by computer net in the district and
provincial level.
Requirements of
surveillance data
- Accurate
- Sufficient
- Punctual
Requirements of
surveillance activities:
- Closing collaboration between three
systems (epidemiology, clinical and laboratory) and four levels
(institute, province, district, commune)
- Sufficient epidemiology information
of each reported case
- Application computer into statistic
procedure
EVALUATION
- Accepted by 100% staffs from commune
health center, hospitals, and district and province preventive medicine
center
- Sufficiently and accurately detecting
diseases
- Punctually disseminating data.
Helpful for outbreak response.
- By using the surveillance data, the
typhoid fever intervention pattern was established. Positive blood
culture typhoid fever patients and their relatives were surveyed and
monitored in hospital and in their houses. They were treated based on the
antibiogram result of blood and stool culture.
- Representative for disease pattern
of area
- Simple beacause set up basing on
avalable one
APPLICATION
This
surveillance system has been applied into surveillance activities of many
public health programs such as
- National Program for Dengue Control
- National Project coded KC.10.11
about “Entero Infectious Diseases Control in Mekong Delta”
- MBDS project
- Routine surveillance system in
TienGiang province
Fig 1. Pattern of establishing of surveillance
system
Fig 2. Pattern of data collection, reporting
and feed back system
