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One Health Epidemic Risk
Management in Kazakhstan with
Open-Source EIDSS
Alexey Burdakov 2, Stanislav Kazakov3, Aizhan Esm...
Introduction
 Kazakhstan has natural foci of especially
dangerous pathogens such as plague, tularemia,
anthrax, hemorrhag...
Concept
 Objective
 Prevent emergencies of a sanitary-epidemiological nature
 Minimize the damage to the environment an...
Regional Sanitary-Epidemiological Passport
(RSEP)
Animal Market in Taraz,
Kazakhstan
Population Density,
Kazakhstan
CCHF F...
Open Source Electronic Integrated Disease
Surveillance System (EIDSS)
 Disease surveillance system developed to improve n...
EIDSS National Disease Surveillance
System in Kazakhstan
 Implementation in Kazakhstan includes
 All rayons (districts),...
Crimean-Congo Haemorrhagic Fever Risk
Forecast Example
 EIDSS database loaded with
3 indicator groups for 2007-2011
 Pop...
Regional Sanitary-Epidemiological Passport
(RSEP) Development Plan
 STAGE 1: Development of a mathematical RSEP model for...
Results
 Proposed concept and methodology for the epidemic risk assessment and
management in the Republic of Kazakhstan’s...
References
 Esmagambetova, Aizhan; Kazakov, Stanislav; Burdakov, Alexey; Ospanov, Kenes;
Kyraubaev, Kakimzhan; Sansyzbaev...
Acknowledgement
 Presentation and research was co-sponsored by Black & Veatch
 Open Source EIDSS development and impleme...
Q&A
 Contact the authors
 Alexey Burdakov burdakovav@bv.com
 Stanislav Kazakov kz2kazakov@mail.ru
 Aizhan Esmagambetov...
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One Health Epidemic Risk Management in Kazakhstan With Open-source Eidss Alexey BURDAKOV

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Presentation at 3rd GRF One Health Summit 2015
Session Integrative Health Risk Management

Published in: Health & Medicine
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One Health Epidemic Risk Management in Kazakhstan With Open-source Eidss Alexey BURDAKOV

  1. 1. One Health Epidemic Risk Management in Kazakhstan with Open-Source EIDSS Alexey Burdakov 2, Stanislav Kazakov3, Aizhan Esmagambetova1, Andrey Ukharov2, Damir Kopzhasarov1 1 Committee for Consumer Rights Protection of the Ministry of National Economics of the Republic of Kazakhstan, Astana, Kazakhstan 2 Black & Veatch, Overland Park, KS, United States of America 3 Scientific and Practical Center for Sanitary Epidemiological Expertise and Monitoring, Almaty, Kazakhstan October 5, 2015 GRF 2015 Davos, Switzerland
  2. 2. Introduction  Kazakhstan has natural foci of especially dangerous pathogens such as plague, tularemia, anthrax, hemorrhagic fevers, etc.  World Health Organization (WHO) categorizes Kazakhstan as a high-risk country for Crimean-Congo hemorrhagic fever (CCHF)  CCHF natural foci are present in only 3 of 14 regions, and only in 27 administrative districts out of 169  Former USSR countries has standard practice of sending aggregated digital data on 64 infectious diseases  Data is listed according to 3 levels: 1 - district, 2 - region, 3 – country  Data has digital and statistical nature, and describes the epidemic situation over the past period (month, year)  Data gives no clue as to the causes and factors contributing to the growth or reduction of the infectious incidence rate levels in specific areas Map of Kazakhstan Source: www.who.int 2
  3. 3. Concept  Objective  Prevent emergencies of a sanitary-epidemiological nature  Minimize the damage to the environment and health of the population  Proposed to develop Regional Sanitary-Epidemiological Passport (RSEP)  Generated automatically for each and every district of Kazakhstan in real-time  Based on multi-year databases  Contains infectious incidence rate dynamics according to the primary (marker) infections (7 nosologies)  Includes a forecast for 1-2 years  Supports predictive GIS maps of natural and soil foci for especially dangerous pathogens (7 nosologies) with a 3-5 year forecast  To be introduced as a new working tool for field epidemiologists in each district (town) of Kazakhstan 3
  4. 4. Regional Sanitary-Epidemiological Passport (RSEP) Animal Market in Taraz, Kazakhstan Population Density, Kazakhstan CCHF Foci Map Plague Foci Map Anthrax Outbreaks in Kazakhstan, 1960-2000 Utilization of Health Services METHODS Plague Tularemia CCHF Plague Tularemia CCHF Plague Tularemia CCHF 2014 2013 . . . 2014 2013 . . . 2014 2013 . . . Data Processing and Forecasting HistoryCurrentForecast Increasing (Critical level) Epidemic Risks Stable (Acceptable level of sanitary background impact) Decreasing (Less than maximum during last 10 years) Regional Sanitary-Epidemiological Passport (RSEP) Regional Sanitary-Epidemiological Passport Concept 4
  5. 5. Open Source Electronic Integrated Disease Surveillance System (EIDSS)  Disease surveillance system developed to improve national disease surveillance  Collect, share and analyze human, veterinary, vector and laboratory data  One integrated database  Integration with global data repositories of international entities (WHO, potentially FAO and OIE)  Collect case-by-case data for diseases of priority  Data is collected at the district level and rapidly transferred to the national level  Near real-time manner  EIDSS is based on cutting-edge expertise from CDC, WRAIR, with more than 100 thousand man-hours  Open source portal: eidss.codeplex.com  EIDSS is currently deployed nationally  Azerbaijan, Georgia, Kazakhstan, Iraq  Ongoing implementation  Armenia, Thailand, Ukraine (pending) EIDSS Implementations Worldwide 5
  6. 6. EIDSS National Disease Surveillance System in Kazakhstan  Implementation in Kazakhstan includes  All rayons (districts), oblasts (regions) and national level  586 workstations  around 800 trained surveillance and laboratory professionals  covering all 64 reportable diseases (EDP and non-EDP) KAZAKHSTAN - 400+ sites HumanVector Diseases: 8249 EIDSS Implementation in Kazakhstan 6
  7. 7. Crimean-Congo Haemorrhagic Fever Risk Forecast Example  EIDSS database loaded with 3 indicator groups for 2007-2011  Population counts by districts  Tick infection rate  CCHF human incidence per 10,000 persons  Number of people reporting tick bite complaints  Forecast for 2013:  High outbreak risk estimates – 88.9% accurate  Medium and low outbreak risk estimates – 81.3% accurate CCHF Forecast Map Example 7
  8. 8. Regional Sanitary-Epidemiological Passport (RSEP) Development Plan  STAGE 1: Development of a mathematical RSEP model for Almaty region  Plague, tularemia, tick-borne encephalitis, soil foci of anthrax, brucellosis, and others  STAGE 2: RSEP developed at stage 1 will be applied to  South Kazakhstan Province (high population density, high (higher than the average) level of infectious diseases; borders the Republic of Uzbekistan)  West Kazakhstan Province (borders the territories of the Russian Federation)  East Kazakhstan Province (borders the Russian Federation and the PRC, which have the common natural foci of plague, tularemia, tick-borne encephalitis, and others)  STAGE 3: Verification and Implementation  Development of regulatory legal base and guiding documents  Exchange of experiences with the concerned countries of the Central Asian region and the Caucasus  Scientific hypothesis verification in 2017  Implementation and use as a new working tool for field epidemiologists at district and regional levels Animal Market in Taraz, Kazakhstan Population Density, Kazakhstan CCHF Foci Map Plague Foci Map Anthrax Outbreaks in Kazakhstan, 1960-2000 Utilization of Health Services Plague Tularemia CCHF Plague Tularemia CCHF Plague Tularemia CCHF 2014 2013 . . . 2014 2013 . . . 2014 2013 . . . Data Processing and Forecasting HistoryCurrentForecast Increasing (Critical level) Epidemic Risks Stable (Acceptable level of sanitary background impact) Decreasing (Less than maximum during last 10 years) Regional Sanitary-Epidemiological Passport (RSEP) RSEP 8
  9. 9. Results  Proposed concept and methodology for the epidemic risk assessment and management in the Republic of Kazakhstan’s administrative territories for implementation as a new working tool (RSEP)  Validated the concept and methodology on CCHF receiving 81.3% accuracy (statistical significance is 0.95)  Epidemic risk assessment and management methodology can be applied regionally and internationally  Added value to the One Health approach:  Methodology brings together data from sanitary-epidemiological, socio-economic, veterinary, human and vector areas  Focuses on plague, tularemia, anthrax, CCHF, brucellosis, cholera and other marker diseases, many of which are zoonotic  Open-source EIDSS can support national epidemiological e-surveillance systems for both human and veterinary disease 9
  10. 10. References  Esmagambetova, Aizhan; Kazakov, Stanislav; Burdakov, Alexey; Ospanov, Kenes; Kyraubaev, Kakimzhan; Sansyzbaev, Erlan; Sadovskaya, Veronika; Ukharov, Andrey (2014). Accuracy of EIDSS Software Prognosis on CCHF Natural Foci Activity in Kazakhstan. Edward Mensah (ed.), Online Journal of Public Health Informatics, Vol 6, No 1 (2014), OJPHI, USA.  Burdakov, Alexey; Wahl, Tom; Oukharov, Andrey; Bekshin, Zhandarbek; Kazakov, Stanislav; Grigorev, Uriy (2014). Strengthening national One Health disease surveillance with open-source EIDSS. Eskild Petersen (ed.), International Journal of Infectious Diseases, April 2014, Volume 21, Supplement 1, Page 274, Elsevier Inc., USA.  Burdakov, Alexey; Oukharov, Andrey; Wahl, Tom (2012). Transforming national human and veterinary disease surveillance systems from paper into integrated electronic form in the FSU countries. Eskild Petersen (ed.), International Journal of Infectious Diseases, June 2012, Volume 16, Supplement 1, Pages e123–e124, Elsevier Inc., USA. 10
  11. 11. Acknowledgement  Presentation and research was co-sponsored by Black & Veatch  Open Source EIDSS development and implementation is funded by the Defense Threat Reduction Agency (DTRA) of the U.S. DoD 11
  12. 12. Q&A  Contact the authors  Alexey Burdakov burdakovav@bv.com  Stanislav Kazakov kz2kazakov@mail.ru  Aizhan Esmagambetova yesmagambetovai@gmail.com  Andrey Ukharov oukharov@bv.com  Damir Kopzhasarov damir_aslanovi4@mail.ru  Open for collaboration 12

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