IDSP – Integrated Disease Surveillance Project

Dr. Rizwan S A, M.D.,
IDSP – Integrated Disease Surveillance Project
Outline of Presentation
• What is Surveillance?
• IDSP
–
–
–
–
–
–
–
–
–
–
–
–

Phases of implementation
Components
Object...
Surveillance
Surveillance
• Surveillance is defined as the ongoing systematic
collection, collation, analysis and interpretation of
dat...
Important information in surveillance
•
•
•
•
•
•

Who gets the disease?
How many get them?
Where they get them?
When they...
Key elements of a surveillance system
•
•
•
•
•
•

Detection and notification of health events
Investigation and confirmat...
IDSP
Phases of implementation
• Phase I (2004-05)
– Madhya Pradesh, Andhra, Himachal, Karnataka, Kerala, Maharashtra,
Mizoram, ...
Components
• Integrating & decentralizing disease surveillance &
response mechanisms
• Strengthening Public Health Laborat...
Objectives
• To establish a decentralized district based system of
surveillance for communicable and non-communicable
dise...
What is integration?
• Sharing of surveillance information of various disease control
programmes
• Developing effective pa...
Classification of surveillance in IDSP
• Syndromic
– Diagnosis made on the basis of clinical pattern by
paramedical person...
Conditions under regular surveillance
Type of disease

Disease

Vector borne diseases

Malaria

Water borne diseases

Diar...
Other conditions under surveillance
Type of surveillance
Sentinel surveillance

Categories

Conditions
HIV/HBV/HCV

Other
...
State-specific diseases
• Madhya Pradesh, Uttaranchal
– Diphtheria, neonatal tetanus, leprosy

• Maharashtra
– Diphtheria,...
Syndromic surveillance
• Fever
–
–
–
–
–

•
•
•
•
•

<7 days with no localizing signs
with rash
with altered sensorium/con...
Flow of information
Information flow of the weekly
surveillance system
Sub-centres

Programme
officers

C.S.U.
S.S.U.

P.H.C.s
C.H.C.s

Pvt. p...
Surveillance activities at each level
Activities

Periphery

District

State

+++

++

-

Consolidation of data

+

+++

+...
District Surveillance Committee
District Program Manager
Polio, Malaria, TB, HIV - AIDS

CMO
(Co. Chair)

Representative
W...
State surveillance committee
Director Public
Health (Co. Chair)

Director Medical Education

Director Health Service
Repre...
National surveillance committee
Director General
Health Services
(Co. Chair)

Director General
ICMR
PD
(IDSP)

National Pr...
Linkages of the central surveillance unit at the
central level
W.H.O.

Outbreak investigation
and rapid response

E.M.R.

...
Reporting
Reporting Forms
• Form ‘S’ (Suspect Cases)
• Health Workers (Sub Centre)

• Form ‘P’ (Probable Cases)
• Doctors ...
Laboratory Reporting
Form

Level of Laboratory

Responsibility of
Reporting

Form L1 Peripheral Laboratory at PHC/CHC

Lab...
Warning Signals of an impending outbreak
• Clustering of cases/deaths in Time/Place
• Unusual increase in cases/ deaths
• ...
Surveillance Action
Preset trigger level with specific response for various levels

• Trigger Level 1 - Suspected limited ...
Strengths of IDSP - 1
1.

Functional integration of surveillance components of
vertical programmes

2. Reporting of suspec...
New Initiatives - 1
1. Alerts through IDSP call center
Call Centre operational with 1075 toll free number since
February 2...
New Initiatives - 2
3. Media Scanning Cell
• Objective:
– To provide the supplemental information about outbreaks
• Method...
Thank You
Integrated Diseases Surveillance Project - IDSP India
Integrated Diseases Surveillance Project - IDSP India
Integrated Diseases Surveillance Project - IDSP India
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Integrated Diseases Surveillance Project - IDSP India

  1. 1. IDSP – Integrated Disease Surveillance Project Dr. Rizwan S A, M.D.,
  2. 2. IDSP – Integrated Disease Surveillance Project
  3. 3. Outline of Presentation • What is Surveillance? • IDSP – – – – – – – – – – – – Phases of implementation Components Objectives Classification of surveillance Conditions under regular surveillance Flow of information Surveillance activities at each level Surveillance committees at each level Reporting Surveillance action Strengths New initiatives
  4. 4. Surveillance
  5. 5. Surveillance • Surveillance is defined as the ongoing systematic collection, collation, analysis and interpretation of data and dissemination of information to those who need to know in order that action be taken.
  6. 6. Important information in surveillance • • • • • • Who gets the disease? How many get them? Where they get them? When they get them? Why they get them? What needs to be done?
  7. 7. Key elements of a surveillance system • • • • • • Detection and notification of health events Investigation and confirmation Collection of data Analysis and interpretation of data Feedback and dissemination of results Response – Action for prevention and control
  8. 8. IDSP
  9. 9. Phases of implementation • Phase I (2004-05) – Madhya Pradesh, Andhra, Himachal, Karnataka, Kerala, Maharashtra, Mizoram, Tamil Nadu & Uttaranchal • Phase II (2005-06) – Chattisgarh, Goa, Gujarat, Haryana, Orissa, Rajasthan, West Bengal, Manipur, Meghalaya, Tripura, Chandigarh, Pondicherry, Nagaland, Delhi • Phase III (2006-07) – UP, Bihar, J&K, Punjab, Jharkhand, Arunachal, Assam, Sikkim, A&N Island, D&N Haveli, Daman & Diu, Lakshadweep
  10. 10. Components • Integrating & decentralizing disease surveillance & response mechanisms • Strengthening Public Health Laboratories • Using Information Technology and Networking in disease surveillance • Human Resource Development
  11. 11. Objectives • To establish a decentralized district based system of surveillance for communicable and non-communicable diseases, so that timely and effective public health actions can be initiated in response to health changes in the urban and rural areas • To integrate existing surveillance activities to avoid duplication and facilitate sharing of information across all disease control programmes and other stake holders, so that valid data is available for health decision making in the district, state and national levels
  12. 12. What is integration? • Sharing of surveillance information of various disease control programmes • Developing effective partnership with heath and non health sectors in surveillance • Including communicable and non communicable diseases in the surveillance system • Working with the private sector and non governmental organization • Bringing academic institutions and medical colleges into disease surveillance
  13. 13. Classification of surveillance in IDSP • Syndromic – Diagnosis made on the basis of clinical pattern by paramedical personnel and members of community • Presumptive – Diagnosis is made on typical history and clinical examination by medical officers • Confirmed – Clinical diagnosis confirmed by appropriate laboratory identification
  14. 14. Conditions under regular surveillance Type of disease Disease Vector borne diseases Malaria Water borne diseases Diarrhoea, Cholera, Typhoid Respiratory diseases Tuberculosis Vaccine preventable diseases Measles Disease under eradication Polio Other conditions Road traffic accidents International commitment Plague Unusual syndromes (Causing death/hospitalization) Meningo-encephalitis Respiratory distress Hemorrhagic fever Other undiagnosed condition
  15. 15. Other conditions under surveillance Type of surveillance Sentinel surveillance Categories Conditions HIV/HBV/HCV Other conditions Regular periodic surveys STDs Water quality Noncommunicable disease risk factors Anthropometry Physical activity Blood pressure Tobacco, blood pressure Outdoor air quality Nutrition Blindness Additional state priorities Up to five diseases
  16. 16. State-specific diseases • Madhya Pradesh, Uttaranchal – Diphtheria, neonatal tetanus, leprosy • Maharashtra – Diphtheria, neonatal tetanus, leptospirosis • Andhra Pradesh – Filariasis • Karnataka – Filariasis, KFD & HGS, leptospirosis • Tamil Nadu – Leprosy, leptospirosis • Kerala – Leptospirosis • Mizoram – Cancer, substance abuse, acid peptic disease, pneumonia
  17. 17. Syndromic surveillance • Fever – – – – – • • • • • <7 days with no localizing signs with rash with altered sensorium/convulsions, bleeding skin/gums >7 days Cough >2 weeks Acute Flaccid Paralysis Diarrhea Jaundice Unusual events causing death/hospitalization
  18. 18. Flow of information
  19. 19. Information flow of the weekly surveillance system Sub-centres Programme officers C.S.U. S.S.U. P.H.C.s C.H.C.s Pvt. practitioners D.S.U. Dist. hosp. Nursing homes Private hospitals Med. col. Private labs. P.H. lab. Other Hospitals: ESI, Municipal Rly., Army etc. Corporate hospitals
  20. 20. Surveillance activities at each level Activities Periphery District State +++ ++ - Consolidation of data + +++ +++ Analysis and interpretation + +++ +++ +++ +++ + Feedback + +++ ++ Dissemination + ++ ++ Action ++ +++ + Detection and notification of cases Investigation and confirmation
  21. 21. District Surveillance Committee District Program Manager Polio, Malaria, TB, HIV - AIDS CMO (Co. Chair) Representative Water Board Chief District PH Laboratory Superintendent Of Police District Data Manager (IDSP) Chairperson* District Surveillance Committee Representative Pollution Board IMA Representative NGO Representative District Training Officer (IDSP) Medical College Representative if any District Panchayat Chairperson District Surveillance Officer (Member Secretary) * District Collector or District Magistrate
  22. 22. State surveillance committee Director Public Health (Co. Chair) Director Medical Education Director Health Service Representative Water Board State Program Managers Polio, Malaria, TB, HIV - AIDS NGO State Data Manager IDSP Chairperson* State surveillance committee Medical Colleges State Coordinator Head, State Public Health Lab Representative Department of Home State Training Officer Representative Department of Environment * State health secretary IMA Representative State Surveillance Officer (Member Secretary)
  23. 23. National surveillance committee Director General Health Services (Co. Chair) Director General ICMR PD (IDSP) National Program Managers Polio, Malaria, TB, HIV - AIDS JS (Family Welfare) Chairperson* National surveillance committee IMA Representative Director NICD NGO Director NIB Consultants (IndiaCLEN / WHO / Medical College /others) Representative Ministry of Environment * Secretary health and secretary family welfare Representative Ministry of Home National Surveillance Officer (Member Secretary)
  24. 24. Linkages of the central surveillance unit at the central level W.H.O. Outbreak investigation and rapid response E.M.R. NCDC Non-communicable diseases surveillance MIS and report CSU ICMR NVBDCP RNTCP National Programs CBHI RCH Programme monitoring NACP
  25. 25. Reporting Reporting Forms • Form ‘S’ (Suspect Cases) • Health Workers (Sub Centre) • Form ‘P’ (Probable Cases) • Doctors (PHC, CHC, Pvt. Hospitals) • Form ‘L’ (Lab Confirmed Cases) • Laboratories
  26. 26. Laboratory Reporting Form Level of Laboratory Responsibility of Reporting Form L1 Peripheral Laboratory at PHC/CHC Laboratory Assistants/Technician through MO I/c Form L2 District Public Health Laboratory, Labs of District Hospital, Private and other Hospitals & Private Labs. I/c Microbiologist/Pathologists Form L3 Labs in Medical Colleges, other tertiary institutions, Reference Labs. Head, Microbiologist Department
  27. 27. Warning Signals of an impending outbreak • Clustering of cases/deaths in Time/Place • Unusual increase in cases/ deaths • Even a single case of measles , AFP, Cholera, Plague, Dengue, or JE • Ac. febrile illness of unknown etiology • Two or more epidemiologically linked cases of outbreak potential • Unusual isolates • Shifting in age • High or sudden increase in vector density • Natural Disaster
  28. 28. Surveillance Action Preset trigger level with specific response for various levels • Trigger Level 1 - Suspected limited outbreak – local response • Trigger Level 2 - Epidemic – local & regional response • Trigger Level 3 - Wide spread Epidemic – local, regional & state level response
  29. 29. Strengths of IDSP - 1 1. Functional integration of surveillance components of vertical programmes 2. Reporting of suspect, probable and confirmed cases (Standard case Definition) 3. Strong IT component for data analysis 4. Trigger levels for graded response 5. Action component in the reporting formats 6. Streamlined flow of funds to the districts 7. Standard Formats, Operations & Training Manuals 8. Involvement of Private Sector
  30. 30. New Initiatives - 1 1. Alerts through IDSP call center Call Centre operational with 1075 toll free number since February 2008 2. E-learning The objective of e-learning is to enhance the skills to a wide arena of health personnel. Proposed components: – Discussion Forums – Online Survey & Assessment – Feedback – FAQs Currently e-learning modules are being prepared
  31. 31. New Initiatives - 2 3. Media Scanning Cell • Objective: – To provide the supplemental information about outbreaks • Method: – National and local newspapers, Internet surfing, TV channel screening for news item on disease occurrence. • Benefits of Media Scanning: – Increases the sensitivity & strengthen the surveillance system – Provide early warning of occurrence of clusters of diseases
  32. 32. Thank You

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