Epidemiological Surveillance

DR. Nanees Ahmed Ismail

M.D Public Health
Dr. Hisham Mohammed Mahaba
M.D Public Health
 Epidemiological Surveillance
• Definition: On going systematic collection,
analysis, and interpretation of data essential
for planning, implementation, evaluation of
public health practice, with timely
dissemination of these data for application
in preventive and control measures
• ‫التفحص المستمر لجميع أوجه حدوث وانتشار المرض‬
‫ات الصلة الوثيقة بالمكافحة الفعالة‬
 Data collected in surveillance
system
• 1. Morbidity and mortality reports.
• 2. Individual case reports.
• 3. Disease surveillance reports.
• 4. Laboratory results.
• 5. Availability of drugs, toxoids, vaccines,
immunoglobulines, insecticides needed for
control.
• 6. Data about levels of immunity in the
population e.g. vaccination coverage.
 Goal of surveillance system
• To ensure the availability of timely
information about disease frequency:
( Who, Where, When)
 Case definition

Case definition

Confirmed Probable Possible

clinical +/- positive clinical Positive clinical
positive lab ? lab no lab available
 Criteria for selection of disease
• 1.The disease constitute a public health
problem.
• 2 Endemic disease or has a relation to active
foci in another country
• 3. The appearance of new disease
• 4. Low or absence of immunity in the
population.
• 5. Available vectors of disease.
• 6. Available environment for spread.
 Definitions
• Epidemic: The occurrence of increased
numbers of cases in a locality than that
expected for time an d place
• Endemic : The continuous presence of a
disease in a locality
• Pandemic : The epidemic involves more
than one country.
• Sporadic
 Predisposing factors for
epidemics
• 1. New entry of pathogen
• 2. Increased number of agents or change in
virulence.
• 3. Increased number of susceptible
individuals
• 4. Increased vectors of disease
• 5. Increase in social factors favorable for
spread of disease
• 6. Change in host immunity.
 Emergency epidemic
• 1. Expectation of occurrence of large
numbers of cases
• 2. The disease high mortality rates.
• 3. The risk of socioeconomic disruption
• 4. Local health authorities are unable to deal
with the epidemic
• 5. International threat of disease
transmission
 Purpose of surveillance of
disease
• To detect
– Epidemic
– Rare disease
– Change in host practice
• To describe
– Trends
– Pattern of disease
• To evaluate
– Preventive and control measures
– Hypothesis of disease occurrence
• To identify risk factors
• To monitor change in disease agents (lab)
• To plan priorities of health programs
 Types of surveillance of disease
• 1. Passive ( routine reporting ): wait to
receive data
• 2. Active : Go and collect data
• 3. Sentinel reporting system.
 Components of surveillance
system
• What: case definition and investigations
• Who: Provide information( active and
passive) and analyze data
• When: time of reporting
• Where: Health office
• How: information collected, analyzed,
disseminated.
• To whom: reports are sent.
 Characteristics of surveillance
system
• 1. Simplicity : structure and ease of
operation.
• 2. Flexibility: can adapt change in case
definition, new disease conditions, variation
in reporting sources.
• 3. Acceptability:Reflects the willingness of
individuals and organization to participate
into surveillance system. Indicators
(participation rate, completion, timely
reporting.)
 Characteristics of S.S continued
• 4. Sensitivity:
– a.ability to detect cases
– b. ability to detect epidemics
– i.e. the proportion of total number of cases
detected by S.S
– It is affected by persons with disease condition
seek medical care or not
– Skill in diagnosis
– Reporting system
 Characteristics of S.S continued
• 5. High predictive value of positive
– persons reported to have the condition have
high probability of actually being diseased
– Frequent false positive cases increase waste of
resources.
– Falsely detected epidemics cause costly
investigations.
 Characteristics of S.S continued
• 6.Representative : the ability to generalize
the findings of S.S to population (area
studied) and occurrence of disease over
time.
• 7. Timeliness
– Reflects the speed or delay between steps in S.S
– Time between disease onset and reporting
– Time required for identification of trends ,
outbreaks, or effects of control measures
– Time for proper action.