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WELCOME. Surveillance and Notification System in Sivaganga District Dr. N. Ragupathy,M.D., Deputy...
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Transcript of WELCOME. Surveillance and Notification System in Sivaganga District Dr. N. Ragupathy,M.D., Deputy...
Surveillance and NotificationSurveillance and NotificationSystem in Sivaganga DistrictSystem in Sivaganga District
Dr. N. Ragupathy,M.D.,Dr. N. Ragupathy,M.D.,Deputy Director of Health Services,Deputy Director of Health Services,
Sivagangai.Sivagangai.
Integrated Disease Surveillance Integrated Disease Surveillance ProjectProject(( IDSP)IDSP)
Integrated Disease Surveillance Project (IDSP) was launched by Hon’ble Union Minister of Health & Family Welfare in November 2004.
It is a decentralized, State based Surveillance Program in the country. It is intended to detect early warning signals of impending outbreaks and help initiate an effective response in a timely manner
METHODOLOGYMETHODOLOGY
Under IDSP , data is collected on a weekly (Monday–Sunday) basis. The information is collected on three specified reporting formats, namely “S” (suspected cases), “P” (presumptive cases) and “L” (Laboratory confirmed cases) filled by the Health Workers, Clinician and Clinical Laboratory staff.
The weekly data gives the time trends. Whenever there is a rising trend of illnesses in any area, it is investigated by the Medical Officers/Rapid Response Teams (RRT) to diagnose and control the outbreak
Types of surveillance in Types of surveillance in IDSPIDSP
TypeType Basis of Basis of diagnosisdiagnosis
Who does itWho does it
SyndromicSyndromic
( FORM – ( FORM – S )S )
Clinical patternClinical pattern Paramedical Paramedical personnel and personnel and members of members of communitycommunity
PresumptivPresumptivee
( FORM – P )( FORM – P )
Typical history Typical history and clinical and clinical examinationexamination
Medical Officer of Medical Officer of PHC/CHCPHC/CHC
ConfirmedConfirmed
( FORM – L )( FORM – L )Clinical Clinical diagnosis by a diagnosis by a medical officer medical officer and positive and positive laboratory laboratory ConfirmationConfirmation
Medical officerMedical officer
Laboratory Laboratory TechnicianTechnician
REPORTINGREPORTING UNITS UNITS
TypeType No of No of Reporting Reporting UnitsUnits
Reported ByReported By
Form “ P ”Form “ P ” 7373PHC – 47PHC – 47
GH -16GH -16
Private Hospitals - 10Private Hospitals - 10
Form “ L ”Form “ L ” 1919Block PHC – 12Block PHC – 12
GH - 7GH - 7
Form “ S ”Form “ S ” 275275 HSC / VHNHSC / VHN
Diseases / Syndromes Under Diseases / Syndromes Under IDSPIDSP
Acute Diarrhoeal Acute Diarrhoeal Disease Disease
Bacillary DysenteryBacillary Dysentery Viral HepatitisViral Hepatitis Enteric FeverEnteric Fever MalariaMalaria Dengue / DHF / DSSDengue / DHF / DSS ChikungunyaChikungunya Acute Encephalitis Acute Encephalitis
SyndromeSyndrome MeningitisMeningitis MeaslesMeasles DiphtheriaDiphtheria PertussisPertussis Chiken PoxChiken Pox
Fever of Unknown Fever of Unknown Origin(PUO)Origin(PUO)
Acute Respiratory Acute Respiratory Infection(ARI) Influenza Infection(ARI) Influenza like Illness (ILI)like Illness (ILI)
PneumoniaPneumonia LeptospirosisLeptospirosis Acute Flaccid ParalysisAcute Flaccid Paralysis Dog BiteDog Bite Snake BiteSnake Bite LeporsyLeporsy HIVHIV TuberculosisTuberculosis Unusal Syndromes Unusal Syndromes
Organizational StructureOrganizational Structure
Central Surveillance UnitCentral Surveillance Unit
State Surveillance UnitState Surveillance Unit
District Surveillance UnitDistrict Surveillance Unit
Organizational Structure Organizational Structure District Surveillance UnitDistrict Surveillance Unit
District Surveillance Officer
Data Manager
Data Entry Operator
RRT TEAMRRT TEAM
1. Epidemiologist2. Clinicians3. Pediatrician4. Microbiologist5. Entomologist6. Animal Health Specialist
RAPID RESPONSE TEAM ( RRT )RAPID RESPONSE TEAM ( RRT )
Epidemiologist
Animal Health Specialist Entomologist
Clinician(Pediatrician/
Physician)Microbiologist
Information FlowInformation Flow
Sub-Centres
P.H.C.s
C.H.C.s
Dist.Hosp.
ProgrammeOfficers
Pvt. Practitioners
D.S.U.
P.H.Lab.
Med.Col.
Other Hospitals: ESI, Municipal Rly., Army etc.
S.S.U.
C.S.U.
Nursing Homes
Private HospitalsPrivate Labs.Corporate Hospitals
LINKAGES BETWEEN ORGANISATIONLINKAGES BETWEEN ORGANISATION
Sub-Centre
VillageDSU /DDHS PHC/CHC
ASHA/Volunteers
HealthWorkers
BMO/MO BHS / HI
DSO / DDHS/ DMO
Data AnalysisOutbreak InvestigationOutbreak ResponseTraining & IEC
OPD SurveillanceReport to DSOOutbreak ResponseTraining & IECEvaluation &Monitoring
Compile DataCollect samplesReport to PHCEarly Response
Collect DataRecordingReport to SCAwareness
Person
Place
Time
Cases
0
5
10
15
20
25
1 2 3 4 5 6 7 8 9 10
0
200
400
600
800
1000
1200
0-4 '5-14 '15-44 '45-64 '64+
Age Group
Evaluate information
Pathogen? Source? Transmission?
TriggersTriggers Response levels for the diseases under Response levels for the diseases under
surveillancesurveillance Predetermined surveillance related action at Predetermined surveillance related action at
different trigger levelsdifferent trigger levels Trigger levels depend on Trigger levels depend on
type of diseasetype of disease Case fatality Case fatality number of evolving casesnumber of evolving cases Region specific -- depending on incidence of Region specific -- depending on incidence of
disease and previous reporting trendsdisease and previous reporting trends
Levels of Response to Levels of Response to different triggersdifferent triggers
Trigger Trigger SignificanceSignificance
Levels of ResponseLevels of Response
Level-1Level-1 Suspected / Suspected / limited outbreaklimited outbreak
Local response by Local response by HW/MOHW/MO
Level-2Level-2 OutbreakOutbreak Local and district Local and district response by DSO response by DSO and RRTand RRT
Level-3 Level-3 Confirmed Confirmed outbreakoutbreak
Local, district and Local, district and state outbreakstate outbreak
Level-4Level-4 Wide spread Wide spread epidemicepidemic
State level State level response to an response to an epidemicepidemic
Level-5Level-5 Disaster responseDisaster response Local, district, state Local, district, state and centreand centre
Alerting / Notification Alerting / Notification SystemSystem
The PHCs having rising trends in reported The PHCs having rising trends in reported cases are alerted through Phone , SMS, cases are alerted through Phone , SMS, Alert Reports.Alert Reports.
Based on the Data received , Rapid Based on the Data received , Rapid Response Team investigates the area Response Team investigates the area which is considered as having impending which is considered as having impending outbreak.outbreak.
PHCs ,Blocks , Health Unit Districts nearer PHCs ,Blocks , Health Unit Districts nearer to affected area alerted by sending EWS ( to affected area alerted by sending EWS ( Early Warning Signals ) report.Early Warning Signals ) report.
SURVEILLANCE SYSTEM SURVEILLANCE SYSTEM OTHER THAN IDSPOTHER THAN IDSP
MEASLES & AFP MEASLES & AFP SURVEILLANCESURVEILLANCE
FEVER SURVEILLANCE FEVER SURVEILLANCE ROUTINE SURVEILLANCEROUTINE SURVEILLANCE