Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Innovation in Surveillance of Communicable and Non-Communicable Diseases

1,091 views

Published on

Innovation in Surveillance of Communicable and Non-communicable Diseases

http://nirmalkandel.com/wp-content/uploads/2014/03/Innovation-in-Surveillance.pdf

Published in: Health & Medicine
  • Be the first to comment

Innovation in Surveillance of Communicable and Non-Communicable Diseases

  1. 1. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 1 | 3rd National Scientific Conference on Epidemiology Innovation in Surveillance of Communicable and Non-Communicable Diseases Dr Nirmal Kandel , MBBS, MA (Anthropology), MPH, EMBA Public Health Specialist
  2. 2. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 2 | Outlines  Surveillance, Uses and Components  Traditional Surveillance Design  Advances  Stepwise Approach – NCDs Surveillance  Universal Health Coverage and Surveillance
  3. 3. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 3 | What is Surveillance • Systematic, ongoing… – Collection – Analysis – Interpretation – Dissemination • …of health outcome data Health action • investigation • control • prevention
  4. 4. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 4 | Why we do surveillance  Estimation the size of health problem  Detection of outbreaks  Characterize disease trends  Evaluate interventions and preventive programmes  Provide information for health planning and financing  Identifying training needs in terms of categories and levels  Identify and prioritize research needs
  5. 5. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 5 | Surveillance Support Functions Standards and guidelines Trainings Supervisions Communication facilities Resources (including logistics) all type Monitoring and Evaluation (M & E) and Coordination Surveillance System Structure Legislation (laws and regulations); including IHR (2005) Surveillance strategy Improve preparedness for surveillance and response Surveillance implementation and stakeholders Networking and partnerships Core Functions of Surveillance Case detection, registration and Confirmation Reporting Data Analysis and interpretation Epidemic preparedness Response and control Feedback and evaluate Surveillance Quality Completeness and Timeliness Usefulness and Simplicity Acceptability and Flexibility Sensitivity and Specificity Positive predictive value Representativeness Components of Surveillance System
  6. 6. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 6 | Surveillance Design  Traditional disease notification  Outbreak investigation  Cluster investigation  Active and Passive Surveillance  Enhanced surveillance  Sentinel surveillance  Emerging infectious diseases – diagnosis-based surveillance – syndromic surveillance  Molecular biology and surveillance  Event Based Surveillance  Non – Traditional Surveillance
  7. 7. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 7 | Traditional Disease Surveillance SOURCE:Figure courtesy of Dr. Larry Madoff
  8. 8. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 8 | Advances in Surveillance  Syndromic Surveillance  Electronic Health Records  Non traditional approaches  Event Based surveillance and Early Warning System  Integrated Diagnostic System  Pre-symptomatic Detection
  9. 9. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 9 | Before going quick question…think
  10. 10. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 10 | Syndromic Surveillance “Syndromic surveillance” is defined as the collection and analysis of “health-related data that precede diagnosis and signal with sufficient probability of a case or an outbreak to warrant further public health response” Source: Global Infectious Disease Surveillance and Detection:Assessing the Challenges -- Finding Solutions,Workshop Summary
  11. 11. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 11 | Syndromic Analyses Automated analyses identify unusual patterns and increases are investigated
  12. 12. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 12 | Electronic Health Monitoring SOURCE: Lombardo (2006)
  13. 13. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 13 | Non Traditional Approaches  EIS and GOARN  Promed Mail  GPHIN  Health Map  MedIsy
  14. 14. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 14 | EIS and DON Event Information Sites (EIS) for National IHR Focal Points
  15. 15. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 15 | Advances in Indonesia
  16. 16. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 16 | Bulletins
  17. 17. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 17 | GLEWS  One World – One Health and Emerging Disease Surveillance – GLEWS - http://www.glews.net/
  18. 18. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 18 | Surveillance Networks  Global Infectious Disease Surveillance and Early Warning Systems – Promed
  19. 19. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 19 | Framework for Internet Based Surveillance
  20. 20. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 20 | Building Available Infrastructure Source:Voxiva
  21. 21. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 21 | How it works
  22. 22. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 22 | Comprehensive Integrated Diagnostics System
  23. 23. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 23 | Medical Tricorder “integrated diagnostic system” for field use that can detect viruses, bacteria, toxins, The current prototype relies on automated real-time PCR
  24. 24. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 24 | Host Based Pre-symptomatic Detection Event Source: Johnston (2006)
  25. 25. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 25 | Personalized Medicine Based Biosignatures
  26. 26. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 26 | Some Innovations Used…….
  27. 27. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 27 | Some Innovations Used…….
  28. 28. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 28 | Use of Social Networks I trace the passenger during Pandemic 2009 H1N1 under IHR (2005)
  29. 29. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 29 |
  30. 30. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 30 | Step 3 (Biological) Complexity Step 2 (Physical) Step 1 (Verbal) Core Expanded Optional At each step The WHO STEPwise approach to surveillance of non-communicable disease risk factors Sequential approach, step by step
  31. 31. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 31 | • Coronary heart disease • Stroke • Peripheral vascular disease • Several cancers • COPD/emphysema Endpoints Intermediate Risk Factors •Hypertension •Blood lipids •Obesity / Overweight • Diabetes • Tobacco • Diet • Alcohol • Physical Activity Behavioural Risk Factors Non-modifiable Risk Factors •Age •Sex •Genes Socio-economic, Cultural & Environmental Conditions Figure 4 Example of Major Selected Non-Communicable Disease (NCD) Risk Factors and Determinants Source: World Health Organization (WHO)
  32. 32. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 32 | Age Foetal life Adult LifeAdolescenceInfancy and childhood •SES •Nutrition •Diseases •Linear growth •Obesity •Obesity •Lack of activity •Diet •Alcohol, •Smoking •SE potential •Established adult risk factors (behavioural/biological) •SES •Maternal nutritional status & obesity, •Fetal growth Accumulated risk Range of individual risk Accumulated risk Life course approach for the prevention of non communicable diseases
  33. 33. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 33 | Surveillance Focus  Risk factor surveillance - for estimation and Prevention  Actual Burden of Diseases – Hospital records (HMIS) – Mortality Statistics (Verbal Autopsy) – Insurance data – Funeral Services – Drug Data
  34. 34. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 34 |
  35. 35. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 35 | Universal Health Coverage Universal Health Coverage – is defined as ensuring that all people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
  36. 36. Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 36 | Thank You

×