DISEASE SURVEILLANCE-

CONCEPTS AND CHALLENGES,

IDSR
PBH 202
 Outline
✓What is Diesease Surveillance

✓ Element of Surveillance System

✓Uses of Surveillance System

✓Characteristics of Good Surveillance System

✓Types of Surveillance System

✓Challenges and Recommendation of National Surveillance System

 What is Disease Surveillance?
✓Diseases exists in two forms- Communicable or Non-
Communicable

✓Non communicable or chronic diseases are defined are

diseases or conditions that are not transmissible from person
to person and are often characterised by a destruction of
bodily structure and/or function that necessitates an alteration
of a person’s normal life, and often persists over a long period
of time

✓Examples include- Hypertension, Diabetics, Asthma etc

 What is Disease Surveillance?

• Non-communicable diseases is linked to Non-modifiable and

Modifiable risk factors

• Modifiable risk factors include lack of physical activities, smoking,

dietary imbalance – diets low in fruits and vegetables but high in
sodium and saturated fats excessive alcohol usage, obesity,
environmental stress and socio-economic status e.t.c

• Non-modifiable risk factors- include age, sex, genetic factors e..t.c

 What is Disease Surveillance?
• Communicable diseases are defined are diseases or conditions that are
transmissible from person to person directly or indirectly (vector e.t.c)

• Communicable diseases include Malaria, Lassa fever, Covid 19

infection, HIV/AIDs, Tuberculosis e.t.c

• Irrespective of type of diseases if untreated can lead to disability or

death of infected individual.
 What is Disease Surveillance?
• Nigeria like other developing countries also witnesses increase in the
burden of non-communicable diseases due to changes in life style,
industrialization, urbanization e.t.c.

• Currently, we have double burden of diseases (Communicable diseases

and Non-communicable disease)

• Therefore, it is important to notify, monitor and evaluate trends of

diseases both in developed and developing countries
Disease Surveillance
 Definition of Disease Surveillance
• It is ongoing systematic collection of data regarding health
event, analysis, interpretation and dissemination for use for
public health action so as to reduce morbidity and mortality
as well as improve health (Centre for Disease Control)
Element of Surveillance System
 Element of Surveillance System
• Detection and Notification
1 • Data collection and storage

• Data analysis and interpretation

2 • Dissemination of findings- Stakeholder meetings,

• Public Health Action -

3
Uses of Disease surveillance
 Uses of Disease surveillance
• Characterized pattern of diseases

• Detection of Epidemics/outbreak

• Research purposes

• Disease control Programs

• Monitoring and Evaluation of health events

Characteristics of Good surveillance
system
Characteristics of Good surveillance
system
• It is simple and flexible

• It is acceptable and highly specific

• Valid

• Timely
TYPES OF DISEASE SURVEILLANCE
 Passive surveillance system
Passive Surveillance- This entails routine reporting of health
events from registries, hospitals and disease registries.

✓It is useful to monitor trend of diseases, to provide baseline data

and also monitor impact of intervention.

✓However, limitation entails- under-reporting due to

asymptomatic illnesses, limited access to facilities, lack of
appropriate laboratory faciliites e.t.c.
.
 Active Surveillance
✓It entails health personnel actively sought for cases within the
community.

✓It is done during Community Survey, Outbreak investigation, sero-

surveillance e.t.c

✓Data here is complete and of better quality

✓Limitation – Expensive-more resources are needed to conduct active

surveillance.
 Sentinel surveillance
• Surveillance is based on data on health event collected from selected
health institution or selected groups

• For example- HIV prevalence among Antenatal Clients

• This data can be used to monitor trend of events and also detect
outbreaks.

• Limitation- It can be used to detect events that happen outside the

group. It is not useful for rare conditions or uncommon dieseases.
 Rumour Surveillance System
• This type of surveillance relies on unofficial sources of information
like blogs, discussions, social media, internet, face book e.t.c

• This is being used to alert public health authorities which can be used
in early detection of disease outbreak
IDSR- Integrated Diesease Surveillance
and Response System
 IDSR- Integrated Disease surveillance and Response system

This is a comprehensive regional framework adopted in 1998,

Zimbabwe by the 46 Member States of the WHO African
Regional Office for Africa (WHO/AFRO) to strengthening
National public health surveillance and response systems in
Africa in response to emergence of outbreaks of preventable
diseases.
 Goal and Vision of IDSR
Goal of IDSR is to strengthen surveillance and response capabilities at
each level of the health system by building local capacities and leveraging
strengths and areas of expertise through partnership and coordination.

Vision of IDSR is to improve the availability and use of surveillance and

laboratory data so that public health managers and decision makers can
plan for and carry out more timely detection and response to the leading
causes of illness, death and disability in African countries and save lives.
 Objectives of IDSR
✓Strengthen the capacity of countries to conduct effective surveillance activities:
train personnel at all levels

✓Integrate multiple surveillance systems so that forms, personnel and resources can
be used more efficiently.

✓Improve the use of information to detect changes in time(timely response) to

conduct a rapid response to suspected epidemics and outbreaks

✓Improve the flow of surveillance information between and within levels of the
health system
 List of Priority disease under IDSR

✓Epidemic prone diseases- CSM, Cholera, Measles, Lassa fever and Yellow Fever.

✓Diseases targeted for Elimination and Eradication: Neonatal Tetanus, Leprosy, Lymphatic
Filariasis, Guinea worm and Poliomyelitis.

✓Other diseases of public health importance- Diarrheoa without blood, Malaria, Plague,
Tuberculosis, Pertussis, Onchocerciasis , Pneumonia, Diarrhea with blood, HIV/AIDS,
Sexually Transmitted Infections and Hepatitis B
Challenges of Routine National Surveillance system
Challenges with Manpower-

a. Under reporting of data- linked to the following factors

✓Lack of awareness of responsibility to report. •

✓Lack of awareness of which diseases must be reported.

✓Lack of awareness of how or to whom to report. •

✓Assumption that someone else (e.g., the laboratory) will report

b. Negative attitude toward reporting:

c. Lack of feedback
Challenges with Material

d. Multiplicity of reporting forms and format

e. Lack of communication equipment

f Absence of case management protocols

g. Inadequate laboratory facilities

Challenges – Money

L. Inadequate funding
Recommendations for Improving Notifiable Disease
Surveillance
Recommendations for Improving Notifiable Disease Surveillance
Manpower-
A. Improving level of awareness among health workers

✓Most important, all persons who have a responsibility to report must be aware of this
responsibility.

✓This can be achieved through training and re-training, provision of job-aids, guidelines
and standard operating procedures on documentation and reporting.

B Provision of incentives. - Incentives given in a Professional authoritative

manner to health care providers can improve quality of reporting
Recommendations for Improving Notifiable Disease Surveillance

MATERIAL

C. Simplify reporting.- Reporting should be as simple as possible. If paper forms

are used, they should be widely available and easy to complete, and they should ask
only for relevant information

D. Provision of Communication Gadgets and Laboratory Equipment

Recommendations for Improving Notifiable Disease Surveillance

D. Frequent feedback- The role of feedback cannot be overemphasized. Feedback

can be written (e.g., a monthly newsletter) or oral (e.g., updates at regular
meetings of medical staff or at rounds). The feedback should be timely,
informative, interesting, and relevant to each reporter's practice
Practice questions
 Sample questions-
✓What is Diesease Surveillance

✓ Element of Surveillance System – List 5

✓Uses of Surveillance System- List 5

✓Characteristics of Good Surveillance System- List 5

✓Types of Surveillance System- Classify and describe briefly

✓Challenges and Recommendation of National Surveillance System- List 5

Thank you