COURSE 2 - MODULE 1- PART 1
Identify and record cases of priority diseases, conditions and events
MODULE 1-PART 1: Learning Objectives
Participants will be able to recall and understand:
1. Indicator-based Surveillance (IBS) approach to detect diseases, conditions, and events for reporting to the next level of the health system
2. Improve surveillance and response activities in their catchment area
3. Involve the community in disease surveillance
4. Improve local laboratory capacity to detect priority diseases, events, and conditions
Outline of COURSE 2 - Module 1 Part 1 (1)
• Introduction to IDSR Matrix-"identify“
• Use of Indicator-based Surveillance (IBS)
approach to detect diseases, conditions,
and events
• How diseases, conditions, and events
come to the attention of the health system
• Use of standard case definitions to identify
diseases for reporting to the next level
Outline of COURSE 2 - Module 1 Part 1 (2)
• Update district procedures for surveillance
and response
• Describe the role of the laboratory in
detecting priority diseases, events and
conditions
• Summary: Course 2-Module 1- Part 1
Purpose of Module 1 - Part 1
To provide guidance on:
• How to use standard case definitions to detect
priority diseases, conditions and events
• The procedures required to plan for improvements
of surveillance and response activities at all levels
of the health system
Introduction to IDSR Matrix-"identify“[Refer to the WHO 3rd Edition IDSR Technical Guidelines, Booklet 1, Annex A, pages 26-31]
Introduction
• Surveillance priorities may be communicable and non-communicable diseases, conditions or events that include national or local priorities
o E.g. Acute outbreaks and deaths or events
• Essential function of a PHS system is to be able to detect public health threats and events or hazards
What is ‘Standard Case Definition’
• A standard case definition is an agreed-upon set of criteria used to decide if a person has a particular suspected disease or condition.
The definition specifies clinical criteria and specifications on time, place and person.
• Mostly used in IBS approach to detect diseases/conditions/events
How diseases, conditions, events come to the attention of the health system -1
• A person falls ill and seeks treatment from a HF.
• Community members report unusual events or
occurrences at local levels such as:
o a cluster of deaths
o unusual disease pattern to the health facility
• Health staff who conduct active record reviews of
registers (clinical and laboratory)
How diseases, conditions, events come to the attention of the health system -2
• Media reports (Radio, television, newspapers), or
social media
• Vital events records show an increase in maternal
deaths
• Unusual reports of illness among health care workers
• An unusual death or number of deaths among
animals or birds
or
• An unusually high number of sick animals presenting
with the same symptoms
Explain IBS and EBS approaches used to detect diseases, conditions, and events -1
• The IDSR strategy uses both Indicator-based
Surveillance (IBS) and Event-Based Surveillance
(EBS) approaches to detect diseases, conditions,
and events
• All countries should establish EBS system
alongside with the IBS at all levels of the health
system
o i.e. At national, regional/provincial, district, health
facility and community levels
IBS and EBS approaches used to detect diseases, conditions, and events -2
• The IBS involves use of standard case definitions
to identify diseases, conditions, and events,
whilst EBS uses alerts detection, triaging and
verification to detect events
• IBS and EBS are integral component of the
routine IDSR activities of the surveillance staff
• Both IBS and EBS should use existing resources
and infrastructure set aside for routine IDSR
strategy
Use of Indicator-Based Surveillance Approach to detect diseases,
conditions and events
Use standard case definitions to identify diseases for reporting to the next level
• All cases (suspect, probable and confirmed) should always be recorded in a recognized facility register or logbook, and the IDSR reporting forms
Importance of standard case definition
• To help decide if a person has a presumed
disease
• To ensure that every case is diagnosed in the
same way, regardless of where or when it
occurred
• To initiate action for reporting and investigation
• Using standard case definitions is also important
in implementing the International Heath
Regulations (2005).
Role of communities in case detection
• Facilitate early detection of priority diseases,
conditions and events using simplified case
definitions
• Community members should be oriented in
surveillance to actively participate in:
o Detecting, Reporting, Responding to and
Monitoring Health Events Related to
Human Or Animal in their Catchment Area
One Health Approach in identification of events-1
• Applies a holistic approach in detecting and
responding to possible public health events
• Detection at all levels to strengthen
collaboration across sectors,
• Jointly share responsibility of detecting events
which might have impact on human, animal
and environment
One Health Approach in identification of events-2
• Examples include:
o Detection of a rabid animal, which can facilitate
investigations of human cases of disease
o Reports of disease caused by exposure to
chemical hazards within the environment
o Detection of events at Points of Entry
• “All events detected should be shared with other
sectors as part of the One health approach”
Make standard case definitions available at health facilities and communities-1
• Distribute standard case definition (SCD) to
health facilities for use, as well as registers for
recording including Rumour Log Book
o SCD can be in the form of a poster or a small
pocket-sized booklet
• Health Facility (HF) personnel at all levels
including Points of Entry (PoE) should know and
have available SCD
Make standard case definitions available at health facilities and communities-2
• Distribute community level case definitions using
key signs and symptoms
• Ensure that health staff and CBS volunteers
know the process for reporting including reporting
levels
Update district procedures for surveillance and response
Update district procedures for surveillance and response-1
Activities to be done include:
1. At least once a year, update the information about
catchment area HF, PoE and labs
2. Include location of major public health programs in
your area that provide clinical services or public
health activities
3. Include list of the HF, PoE and other locations that
can report health information to the district
4. Update the list of focal surveillance officers in the
district
Update district procedures for surveillance and response-2
Activities to be done include:
5. Conduct risk mapping of all public health hazards
as specified by IHR (2005),
6. Identify potential Community representatives that
can be engaged in Community-based
Surveillance (CBS)
7. Distribute updated data collection forms, reporting
tools, line listing registers and technical guidelines
Role of the laboratory in detecting priority diseases,
conditions and events
Role of the laboratory in detecting priority diseases, conditions and events-1
• Several diseases or conditions have signs and
symptoms that are similar.
o For example, a child with fever and rash might be
diagnosed with measles, even though there could
be several causes for the child’s clinical
presentation.
• Laboratories should be used to detect pathogens that
have potential to spread.
Role of the laboratory in detecting priority diseases, conditions and events-2
• Laboratory confirmation in surveillance is essential
because laboratory results help to:
o Accurately diagnose illness in an individual patient,
o Verify the cause (or aetiology) of a suspected
outbreak
NB: It is necessary to initiate public health measures
even before laboratory confirmation has been
received
Specimen collection, storage and transportation procedures-1
• Collect appropriate specimen as per the standard
operating procedure of the specific disease.
• All specimens must be packed and labelled correctly
and accompanied with the correct laboratory forms.
• Minimize delays between collection of the specimen
and processing in the laboratory.
• Ensure health facilities have trained personnel and
adequate materials to enable sample collection.
Specimen collection, storage and transportation procedures-2
• A well-defined transportation process is required to
enable health facilities to understand how and where to
send samples.
• Disseminate information about triple packing and
shipping of infectious material as per national and
international SOPs.
Refer to Section 11 of the WHO 3rd edition IDSR
Technical Guidelines Booklet Six for recommended
laboratory procedures for confirming specific priority
diseases and conditions.
Specimen collection, storage and transportation procedure
• Demonstration:
o Laboratory specimen collection and storage materials
o Procedures for specimen collection, storage and transportation for selected diseases common in the country
Procedures in establishing a laboratory network
• Local focal persons at each level should maintain an updated list of the laboratories that have the capacity to perform required laboratory testing.
• Support laboratories within the network, through an MoU with laboratories outside that have the capacity for specific diagnostic procedures.
Sample List of national laboratories for confirming priority diseases and conditions
Priority disease, conditions and events Focal Person, Name of Lab, address, phone number, email
Polio Example: John Zimbe; National Laboratory, 145 Kenyatta Road,Pretoria, SA; 234-701342555
Cholera
HIV
Tuberculosis
Measles
Plague
Human influenza caused by a new subtype
Rift Valley disease
Dengue fever
Public health events of national or international concern
Anthrax
Chikungunya
Typhoid fever
Sample List of national laboratories for confirming priority diseases and conditions
• The IDSR strategy uses both Indicator-based Surveillance (IBS) and Event-Based Surveillance (EBS) approaches to detect diseases, conditions, and events.
• Use standard case definitions to ensure that cases and suspected cases are recorded accurately across your district.
• Update the information about your catchment area at least once a year so that you know who your target population is and the ongoing public health activities.
• Make sure local laboratories are included in the surveillance and laboratory networks.
Summary: Module 1-Part 1Course 2 - Module 1-Part 1
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