Title: WHOMEDITERRANEAN ZOONOSES CONTROL PROGRAMME NATIONAL TRAINING COURSE ON INTERSECTORAL BRUCELLOSIS SU
1 General Concepts of Surveillance
Cairo, Egypt, 18 May 2004
Dr. John J. Jabbour, EpidemiologistSurveillance
Officer, STBWHO, EMRO
2Topics to be discussed
- Definition of surveillance
- Purpose
- Steps of surveillance
- TB surveillance
- Analysis of TB data
3CONTEXT
- The worldwide decrease of financial resources
available for health services has induced
considerable changes in the management of health
systems and programs.
4THEN
- Optimize resources based on precise planning and
evaluation. - Establish detailed and precise quantitative
information system. - Implement an effective surveillance system in
collaboration between all the sectors involved.
5Epidemiological Surveillance
- The use of epidemiology to single out, plan,
manage, and evaluate the important services for
the health status of a population (Prevention,
control and treatment).
6Definition
- Surveillance system is an ongoing and systematic
collection, compilation, analysis and
interpretation of data with prompt dissemination
to those who need to know for relevant action to
be taken. - IT IS THE COLLECTION OF DATA FOR ACTION.
7Main Purpose of a Surveillance System
- To determine the need for immediate or longer
range actions and, - To provide information to optimize the use of
resources/logistics available through - data analysis.
- identification of priorities.
- design of alternative actions
- Determination of their likely costs and benefits
8- Epidemiological surveillance, therefore, in its
modern sense is not only passive disease
reporting, but comprehensive disease monitoring
with the objectives of ascertaining - The existence,
- The spatial and temporal distributions and,
- The frequency.
9Surveillance Doesnt Exist Per Se
- It is designed according to
- Specific health problems,
- Goals to be pursued, and
- Activities to be implemented in response to
certain health conditions in the population of
interest.
10In Terms of Tuberculosis
- Strategies are focused on
- control of the disease through the proper
application of DOTS.
11Steps in Surveillance System
12Tools of Surveillance
- Reporting system
- Routine or passive (Quarterly Fax)
- Active (Seroprevalence surveys)
- Sentinel (selection of sites, duration and
frequency of reporting) - Case/outbreak investigation
- Studies or surveys
13In Planning for Surveillance
- TB Case-definition suspects, confirmed
- Institutions involved in the system local,
regional and central public health services,
laboratories, data management and epidemiological
centers. - Facilities used by the system physical resources
such as vehicles, computers, archives and others.
14Collect Data
- Recording and reporting tool
- Structured and simple
- Completeness and timeliness (punctuality)
- Allocate resources for data collection
- Financial Transportation
- Human
- Passive or active reporting
- Clear and detailed flowchart of information
15Analyze Data
- Specialists as statisticians and epidemiologists
- Use friendly software and programs
- National and sub-national analysis
- Detailed reports for decision makers
- Feedback reports for reporting sites and all
related parties in the system technical reports,
periodic reports of health status and activities
performed, newsletter, bulletins, etc.
16Reporting Automation Allows To
- Satisfy the needs for rapid and periodic
transmission. - Increase the capability of information diffusion
and exchange (e.g. by INTERNET). - Exchange large number of information at very low
costs.
17Surveillance Output
- Allow decision makers to decide if a disease is a
major problem. - Allow decision makers to determine the dynamic of
disease/infection occurrence and the relative
efficiency and efficacy of resources used for
their control. - Give the decision makers an early warning on new
events that are potential problems.
18Take Action
- Prompt actions
- Actions are implemented at the area of the
outbreak. - Creation of multidisciplinary team for
investigation and intervention. - Collaboration of all concerned national
authorities in the intervention activities.
19Surveillance of TB
- Surveillance data is usually collected at the
health facility or community level and aggregated
up through the administrative units to arrive at
national or sub-national estimates.
20Data Collection Instruments
- Two forms
- EMR Quarterly DOTS Fax
- Annual TB Data Collection Form
21Strengthening Surveillance
- Nominal reporting
- District reporting
22 of Population Covered by DOTS, EMR 2003
23CDR in EMR Countries 2003
24Sputum Conversion, EMR 2002
25Treatment Outcome, EMR 2002
26TSR 02 vs. CDR 03 in EMR Countries
27(No Transcript)