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surveillancerrr a topic of epidemiology .pptx
- 2. Surveillance and Notificationof Communicable Diseases
- 4. Objectives By theend of the session the participants will be to: Define the term surveillance. Discuss the principles of surveillance and notification Describe different methods. Identify nurses’ role in surveillance Health indicators Discuss health indicators including: Define the term: Health indicators what is Crude Birth Rate what is Crude Death Rate
- 5. Surveillance • Surveillance isthe ongoing, systematic collection, analysis, and interpretation of outcome specific data for use in planning, implementing and evaluating public health policies and practices. • "sur" means "from above" and "veiller" means "to watch”
- 6. Key function ofdisease surveillance – Early warning of the potential threat to public health – Monitoring (Disease specific or multi-disease program) – Providing information to plan public health interventions – Stimulating research
- 7. Example of surveillance •Early warning signs the CDC made the public for taking prevention there is an outbreak of: – SARS – Bird flue (Avian Influenza) – Potential threat from biological or chemical agents – Ebola
- 8. Types of surveillance Active: •verify, investigate and validate the diseases in the community and to detect more cases in the community • more accurate, timely, short periods, more resource intensive Passive: • doesn't verify and investigate: send the data without verification. • passive surveillance may give you the information you need for future planning
- 9. Types of surveillance SentinelSurveillance • Encompasses a wide range of activities focused on monitoring key health indicators in general or in special populations. • May be passive or active • Key health events • Clinics or other sites at which health events are monitored
- 10. 10 Surveillance: General principle HealthCare System Public Health Authority Data Information Decision Action Feedback Reporting Evaluation Analysis & Interpretation Ghaiath Surveillance (JPFCM, Jan. 2010)
- 11. Elements of thesurveillance System All surveillance system involve six key elements 1. Detection and notification of a health event. 2. Investigation and confirmation (Epidemiological, Clinical, Laboratory) 3. Collection of data 4. Analysis and interpretation of data 5. Feedback and dissemination of results 6. Response….A link to public health programs, specifically actions for prevention and control. Source: Adapted from WHO 1999a
- 12. Outbreak Detection andResponse Without Preparedness 0 10 20 30 40 50 60 70 80 90 1 4 7 10 13 16 19 22 25 28 31 34 37 40 Delayed Response DAY CASES Opportunity for control Late Detection First Case
- 13. Outbreak Detection andResponse With Preparedness and rapid response 0 10 20 30 40 50 60 70 80 90 1 4 7 10 13 16 19 22 25 28 31 34 37 40 Rapid Response DAY CASES Early Detection Potential Cases Prevented First Case
- 15. Sources of datacollection • Mortality reports • Morbidity reports • Epidemic reports • Reports of laboratory utilization (including laboratory test results) • Reports of individual case investigations • Reports of epidemic investigations • Special surveys (e.g., hospital admissions, disease registers, and • serologic surveys) • Information on animal reservoirs and vectors • Demographic data • Environmental data
- 16. Vital Statistics Surveillance(VSS) • Records of births and deaths: a basic but critical cornerstone of public health surveillance • Mortality data over past century show decrease in rate of deaths due to infectious diseases; rate of death from non- infectious causes remain steady • Infant mortality rate (number of deaths among infants per 1,000 live births) long used as indicator of overall population health • Birth data used to monitor incidence of preterm birth, risk factor for variety of adverse health outcomes
- 17. Vital Statistics • InPakistan vital statistics are available from National institute of Population studies (NIPS) Islamabad, Pakistan. www.nips.org.pk • In Pakistan Demographic and Health survey is conducted each year and published by NIPS.
- 18. Disease Reporting/surveillance • Astructured approach to strengthen national communicable disease surveillance systems could include: – Assessment – Prioritization – SWOT Analysis of existing system – Developing a strategic action plan – Implementation – Monitoring – Evaluation
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- 21. Monitoring • Monitoring inthe context of surveillance and response systems refers to the routine and continuous tracking of the implementation of planned surveillance activities (monitoring the implementation of the plan of action) and of the overall performance of surveillance and response systems.
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- 23. Evaluation • Evaluation isthe periodic assessment of the relevance, effectiveness and impact of activities in the light of the objectives of the surveillance and response systems.
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- 26. Indicators • Indicators arevariables that can be measured repeatedly (directly or indirectly) over time and provide measures of change in a system. • Indicators: – provide useful information on the status of the system and flag areas that need improvement – usually expressed as simple counts, proportions, rates or ratios
- 27. Types of indicators •Indicators can be classified in various ways. In the logical framework approach (LFA), there are five types of indicators: • Input • Process • Output • Outcome • Impact
- 28. Indicators Types • Inputindicators are the resources needed to implement the system • Trained personnel, finance, standards and guidelines, communication facilities, forms for surveillance, computers, stockpiles for emergency response, and any other logistics as deemed necessary.
- 29. Types of Indicators •Process indicators are used to monitor and track implementation of the planned activities which are critical for attaining the surveillance core functions • such as training, supervision, development of guidelines and tools, etc.
- 30. Indicators Types • Outputindicators are measures of the immediate results of the activities. • Such as reports of surveillance data, feedback • Outcome indicators are measures of the quality of the surveillance system and the extent to which the surveillance objectives are achieved. • Such as use of surveillance data for policy and program decisions, and appropriateness of outbreak response.
- 31. Indicators Types • Impactindicators are measures of the extent to which the overall objectives of the system are being achieved.
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- 33. Ways to improveSurveillance System • Improve Awareness of Practitioners • Simplify Reporting • Frequent Feedback • Widen the Net • Active Surveillance
- 34. 34 Nurses role insurveillance • Assessment of communicable disease risks to identify major public health threats. • Prioritization of public health threats to ensure that surveillance is limited to the important public health events. • Assessment of existing systems to review strengths, weaknesses, and opportunities for strengthening the systems. • Development of a strategic plan of action based on the findings of the assessment.
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- 37. Crude death rate •Crude Death Rate (CDR) =___number of deaths during time period____ X 100,000 total population at mid-point of time period • EXAMPLE: • CDR for Peshawar 2012 = __number of deaths in Peshawar in 2012_ X 100,000 total population Peshawar 2012 • Numerator = number of deaths in Peshawar in 2012 = 301 • Denominator = total population Peshawar 2012 = 30,726 • Constant = 100,000 • Time period = 2012 • CDR for Peshawar 2012 = __301__ X 100,000 = 979.6/ 100,000 population 30,726
- 38. Crude birth rate •Crude Birth Rate (CBR) = number of live births during time period_ X 1,000 total population at mid-point of time period • EXAMPLE: • CBR for KPK 2012 = number of KPK live births in 2012 X 1,000 population of KPK in 2012 • Numerator = number of KPK live births in 2012 = 27,206 • Denominator = population of KPK in 2012= 1,819,046 • Constant = 1,000 • Time period = 2012 • CBR for KPK 2012 = __27,206__ X 1,000 = 14.9/ 1,000 population 1,819,046
- 39. References • Baig M,Shaikh B. Disease Surveillance System: A Mandatory Conduit for Effective Control of Infectious Diseases in Pakistan. Asia-Pacific Journal of Public Health. 2012;24(4):586-594.