Surveillance for Public Health Issues in Specific Situation.pptx

Surveillance for Public Health Issues in Specific Situation.pptx

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  Surveillance for PublicHealth Issues in Specific Situation M. Atoillah
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  Introduction • Public healthsurveillance is a tool to estimate the health status and behavior of the populations • Because surveillance can directly measure what is going on in the population, it is useful both for measuring the need for interventions and for directly measuring the effects of interventions. • The purpose of surveillance is to empower decision makers to lead and manage more effectively by providing timely, useful evidence.
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  DEFINITIONS AND BASIC CONCEPTS Active surveillance:a system employing staff members to regularly contact heath care providers or the population to seek information about health conditions. Active surveillance provides the most accurate and timely information, but it is also expensive. Passive surveillance: a system by which a health jurisdiction receives reports submitted from hospitals, clinics, public health units, or other sources. Passive surveillance is a rela- tively inexpensive strategy to cover large areas, and it pro- vides critical information for monitoring a community’s health. However, because passive surveillance depends on people in different institutions to provide data, data quality and timeliness are difficult to control.
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  DEFINITIONS AND BASIC CONCEPTS outine healthinformation system: a passive system in which regular reports about diseases and programs are completed by public health staff members, hospitals, and clinics. Health information and management system: a passive sys- tem by which routine reports about financial, logistic, and other processes involved in the administration of the public health and clinical systems can be used for surveillance.
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  DEFINITIONS ANDDEFINITIONS AND BASIC CONCEPTS BASIC CONCEPTS •Categorical surveillance: an active or passive system that focuses on one or more diseases or behaviors of interest to an intervention program. These systems are useful for program managers. However, they may be inefficient at the district or local level, at which staff may need to fill out multiple forms on the same patient (that is, the HIV program, the tuberculosis program, the sexually transmitted infections program, and the Routine Health Information System). At higher levels, allocating the few competent surveillance experts to one program may leave other programs under- served, and reconciling the results of different systems to establish the nation’s official estimates may be difficult.
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  DEFINITIONS AND BASIC CONCEPTS • Integratedsurveillance: a combination of active and passive systems using a single infrastructure that gathers information about multiple diseases or behaviors of interest to several intervention programs (for example, a health facility–based system may gather information on multiple infectious diseases and injuries). Managers of disease- specific programs may be evaluated on the results of the integrated system and should be stakeholders. Even when an integrated system is functioning well, program managers may continue to maintain categorical systems to collect additional disease-specific data and control the quality of the information on which they are evaluated. This practice may lead to duplication and inefficiency.
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  DEFINITIONS AND BASIC CONCEPTS Syndromic surveillance:an active or passive system that uses case definitions that are based entirely on clinical features without any clinical or laboratory diagnosis (for example, collecting the number of cases of diarrhea rather than cases of cholera, or “rash illness” rather than measles) Behavioral risk factor surveillance system (BRFSS): an active system of repeated surveys that measure behaviors that are known to cause disease or injury (for example, tobacco or alcohol use, unprotected sex, or lack of physical exercise).
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  ESTABLISHING AND MAINTAININGA SURVEILLANCE SYSTEM Public health surveillance is the ongoing systematic collection, analysis, and interpretation of data, closely integrated with the timely dissemination of these data to those responsible for preventing and controlling disease and injury
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  ANALYSIS AND DISSEMINATION OFSURVEILLANCE DATA • Surveillance information is analyzed by time, place, and person. Knowledgeable technical personnel should review data regularly to ensure their validity and to identify information f use to top managers. • Simple tables and graphs are most useful for summarizing and presenting data. Timely dissemi- nation of data to those who make policy and implement intervention programs is critical to the usefulness of surveil- lance data.
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  SURVEILLANCE AS A TOOLTO IMPROVE PUBLIC HEALTH
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  SURVEILLANCE FOR SPECIFIC CONDITIONS • Surveillancesystems are important tools for targeting, monitoring, and evaluating many health risks and interventions. • Environmental Public Health Surveillance • Injury Surveillance • Surveillance for Biologic Terrorism • Complex Emergency Surveillance • Surveillance in Refugee Populations • Chronic Disease Surveillance Systems
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  Environmental Public Health Surveillance • Surveillancefor environmental public health practice requires the collection, analysis, and dissemination of data on hazards, exposures, and health outcomes • Health outcomes of relevance include death, disease, injury, and disability
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  Environmental Public Health Surveillance •Hazards include toxic chemical agents, physical agents, biomechanical stressors, and biologic agents that are located in air, water, soil, food, and other environmental media. Exposure surveillance is the mon- itoring of members of the population for the presence of an environmental agent, its metabolites, or its clinically inapparent (for example, subclinical or preclinical) effects
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  Surveillance for Biologic Terrorism • Surveillancefor biologic terrorism is conducted primarily for outbreak detection and management. Surveillance must support early detection of an incident of biologic terrorism and its characterization in the same manner as for the detection and control of naturally occurring outbreaks of infectious diseases
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  Complex Emergency Surveillance • The keyelements in planning a disaster surveillance system are establishing objectives, developing case definitions, determining data sources, developing simple data collection instruments, field testing the methods, developing and testing the analysis strategy, developing a dissemination plan for the report or results, and assessing the usefulness of the system • The surveillance needs are different in the preimpact, impact, and postimpact phases
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  • The roleof surveillance in disaster situations • predisaster activities (for example, hazard mapping, provision of guidelines, and training for medical and rescue teams) • continuous monitoring and surveillance for priority health problems in affected populations (for example, in the post- tsunami surveillance in Tamil Nadu, India, a one-page instrument was used for 10 priority health conditions for daily active surveillance in displaced populations at camps) • prospective surveillance of affected populations focusing on the natural history of exposure and health effects and long- term effects of stress disorders among survivors
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  Surveillance in Refugee Populations • severalimportant characteristics: • Large numbers of people were in fixed camps or on the move searching for food and shelter. These needs were usu- ally addressed by external aid agencies and many times caused local environmental degradation (fuel, temporary housing, water pollution, and so on). • Refugees, after the initial phase, competed with indigenous populations for scarce jobs, leading to social strife and stress. Refugees were also exploited and suffered violence— additional factors leading to stress and social maladjust- ment.
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  • several importantcharacteristics: • Data that were relatively simple to gather and analyze provided health workers and administrators information needed to plan and monitor assistance and its impact. • Close collaboration with other local and international relief organizations (such as the United Nations High Commissioner for Refugees, the International Red Cross, the United Nations Children’s Fund, WHO, and USAID) was essential to instituting and sustaining a meaningful sur- veillance system for refugees that led to interventions.
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  • several importantcharacteristics: • No administrative structure to provide and coordinate assistance of the necessary magnitude existed before the crisis, and thus, it had to be created after the fact. • Assistance was complicated by the uncertainty associated with military activity, crime, and hostile governments. • The major goal of these activities is to identify and eliminate preventable causes of morbidity and mortality. Planning requires effective use of existing knowledge about characteris- tic or predictable demographic patterns, easily applied health indicators, and avoidable errors of omission or commission. As in disasters, the principles of surveillance (data collection, data analysis, response to data, and assessment of response) and other public health techniques should be an integral part of relief efforts.
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  Chronic Disease Surveillance Systems Some developing countrieshave found it difficult to acquire and analyze accurate mortality statistics regularly, let alone morbidity and quality-of-life information. Ensuring develop- ment, implementation, and widespread use of noncommuni- cable disease data for better decisions on resource allocation is critical to improving the quality of lives and promoting a more equitable future for health within and between countries Until recently, surveillance for risk factors was an activity commonly associated with developed countries