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Internetbased Information System for Communicable Disease Control and Prevention in China

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Internet-based Information System for Communicable Disease. Control and Prevention in China ... Weakness of the old communicable disease reporting system ... – PowerPoint PPT presentation

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Title: Internetbased Information System for Communicable Disease Control and Prevention in China


1
Internet-based Information System for
Communicable Disease Control and Prevention in
China
  • Dr Longde Wang
  • Chinese Preventive Medicine Association
  • 1 May, 2009

2
? Development and Application of
Internet-based Information System - outcome of
multidisciplinary integration
  • Intensify the reporting system for communicable
    disease by applying the modern informatics and
    computer technology

3
Weakness of the old communicable disease
reporting system ? Time delay, underreporting
and duplicated reporting
  • Reporting mode of the old system

Only report the number of cases
monthly
every ten days
By post
Report Case
4
The nationwide internet-based communicable
disease reporting system the biggest in the world
? As of the end of 2008,100 of CDCs, 96.98
of county-level and above level hospitals, 82.21
of township hospitals around China were covered.
The system users were about 68,000.
The system contributed to prevent large outbreak
of communicable disease in recent years in China.
5
From massive data to useful information
----timely analysis and release
  • Daily and weekly analysis to enhance the
    information feedback to serve disease control

6
Advantages of the system
More timely reporting
Before
4.9 days
After
From case diagnosed by hospital to card received
by county-level CDCs
0.6 days
From case diagnosed by hospital to case info
received by China national CDC
7
More sensitive reporting
More cases reported since 2004
Internet-based Reporting Since Jan. 1, 2004
Reported Incidence of Category A and B Infectious
Diseases in 1993-2008(1/10,0000)
8
Notifiable infectious disease case reporting card
Basic info of the case
Date of onset, diagnosis and death
Case Diagnosis
Reporter Revised diagnosis if there is
9
  • GIS introduced in the reporting system
  • ? To analyze the distribution of disease
  • ? To track the trend of disease

10
Work flow of the Internet-based Information System
  • Unified management of data collection,
    management, utilization and release

11
Componentfunction module
12
Implementation of the system
  • CDCs at all levels started to report SARS cases
    through the system at Apr 26, 2003
  • Hospitals with accessible internet started to
    report SARS cases through the system at May 26,
    2003
  • All CDCs and Hospitals with accessible internet
    started to report cases of all notifiable
    communicable diseases through the internet-based
    reporting system at Jan 1, 2004

13
Reporting system was quickly restored in severely
affected areas after Earthquake, Sichuan
Province, 2008
  • 466 reporting units in 14 counties in Sichuan
    damaged in the earthquake
  • A cellphone reporting system quickly developed
    and applied to report the disease in the damaged
    areas

Direct report from the displaced person camps (32)
Covering report from dependent medical
institution (307)
14
? Pneumonia of unknown etiology surveillance
system -to protect public health and safety
15
Problem in the control of acute communicable
disease in China
  • Problem
  • failed to detect source of infection early
  • Why
  • Reporting information based on diagnosis, which
    was often delayed
  • Consequently
  • Epidemic spread due to unable to take control
    measures timely

16
Rationale for setting up a surveillance and
reporting system for pneumonia of unknown etiology
  • Key point for controlling the acute respiratory
    communicable disease
  • detect the case early
  • Common characteristics of acute respiratory
    communicable diseases such as SARS, HPAI and
    plague -pneumonia manifestation
  • Lessons from SARS epidemic due to laboratory
    leakage in 2004

17
Definition of the Pneumonia Case of Unknown
Etiology
  • A patient with all of the following criteria
    without specific laboratory diagnosis
  • Fever (temperature ?38?)
  • Radiological evidence of pneumonia or acute
    respiratory distress syndrome (ARDS)
  • Normal white blood cell count (WBC range
    410109 cells per L), leukopenia (WBC lt4109
    cells per L), or lymphopenia (lymphocyte count
    lt0.8109 cells per L) at clinical presentation
  • Absence of clinical improvement after 3-5 days
    treatment with broad-spectrum antibiotics

18
Diagnosis , reporting and treatment flow chart of
pneumonia of unknown etiology
All Medical facilities
Consultation by the expert group of the
hospital (single case in 12 hrs disease
cluster immediately)
Pneumonia case of unknown etiology
Routine Surveillance by all level CDCs
Report
Cluster of pneumonia cases of unknown etiology
Field investigation in 24 hours
Consultation by county expert group
Not exclude SARS OR AI
Specimen collection
Exclude SARS or AI
Consultation by expert group at prefecture level
Not excluded SARS OR AI
correct as diagnosed diseases or other unknown
etiology diseases (correct in one month). Final
check authority is by the expert group of
provincial level.
Consultation by expert group at provincial level
SUSPECTED/CLINICAL DIAGNOSIS/CONFIRMED CASES of
SARS or AI (first, sporadic and unknown infection
source cases of SARS in every province, annual
first case of AI in every province diagnosed by
MOH)
Work according to the guideline of MOH
19
Strengths of surveillance system for pneumonia of
unknown etiology
  • Widened the contents of disease surveillance
  • Established the pre-epidemic preparedness and
    control mechanism
  • Improved the efficiency of disease control
  • A internet-based syndromic surveillance system
    established for the first time in China
  • An innovation on the surveillance model allowed
    the early detection of acute respiratory
    infectious disease

20
Causes of pneumonia of unknown etiology Cases
from 20052008
Date of case reported as pneumonia of unknown
etiology was 5 days earlier than reported as HPAI
averagely.
21
Conclusions
  • The internet-based reporting system has
  • provided a fast approach for monitoring and
  • quality control of the surveillance system
  • promoted the innovation of communicable disease
  • surveillance models
  • improved the timeliness and accuracy of
    communicable disease reporting
  • improved the capacity of communicable disease
    analysis
  • and early outbreak detection

22
Thanks for your attention!
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