SURVEILLANCE ITS TYPES AND USES IN PUBLIC HEALTH

Dr Mayur Vala Resident PSM Department PDU Medical College Rajkot

Surveillance

Content:
- Definition - History - Types - Public health Aims - Criteria for undertaking - Prerequisite for effective surveillance system - Conducting a Surveillance - Evaluation - Uses
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Definition:
System of close CONTINUOUS observation of all aspects of occurrence and distribution of disease through systematic collection, tabulation, analysis and TIMELY dissemination of all relevant data pertaining to disease control and prevention. Simply surveillance is DATA COLLECTION FOR ACTION

The continuous scrutiny of all aspect of occurrence and spread of the disease that are pertinent to effective control.

Surveillance

Data collection for Action flow chart

Data collection

Implementation

Tabulation

Recommendation

Analysis

Interpretation
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History:
Origin: From French word, surveiller sur over veiller watch First use of Public Health Action: - William Farr Recognition by WHO: - In 21st World Health Assembly in 1968

Types:
- Routine
Active
Passive

- Sentinel
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Routine:

Active-

- A system in which project staff make periodic field visit to

health care facilities to identify new cases of diseases or deaths from disease that have occurred.
- Go and get data/information Adv.: More accurate than passive Local outbreaks are identified Assume complete reporting Disadv.: Required skilled personnel Expensive

Surveillance

Passive- Surveillance in which available data on reportable disease are used or reporting is mandated or requested with the responsibility for the reporting often falling health care provider or district health officer. - Simply pt. comes to the clinic and provide information Adv.: Simple Less burdensome Inexpensive Disadv.: Under-reporting May not be representative May fail to identify outbreaks
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Sentinel:
-Method of identifying missing cases and thereby supplementing the notified cases.

- Helps in estimating total amount of disease in community.

Surveillance

Public Health Aims:

Assess the Public health status Define Public health priority Evaluate Public health programme Stimulate research

Criteria for undertaking:

Public health importance - Burden of disease - Severity, mortality - Epidemic potential, threat - Cost, socio-economic impact Feasibility - Cost - Availability of data
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Prerequisites of effective surveillance system

Standard case definition Enumeration of reporting units System for disease surveillance

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Conducting a surveillance:
1. Collection
* Requires reporting from individual to health department to state health department. * Reporting known or suspected cases is considered to be an obligation of Physicians, dentists, nurses, and other health professionals Medical examiners Administrators of hospitals, clinics, nursing homes, schools, and nurseries. Laboratory directors Any individual who knows of or suspects the existence of a reportable disease

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2. Analysis
In term of Time, Place and Person # Time - To detect actual changes in disease incidence - Comparing report for current week with preceding weeks - To analyze long term trends, year wise # Place - To determine where cases are occurring # Person - By Age, Sex, Risk factors, etc
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3. Interpretation
- When there is difference in expected pattern of diseaseinvestigate further - Not all apparent increase in disease occurrence represent true increase - Local health dept. determine amount of excess necessary for action

4. Dissemination
- Timely disseminate to health care provider, lab director, health agency

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Evaluation of surveillance system:

WHY?? - To draw conclusion about its present state - To make recommendation about its future potentials. In a thorough evaluation, the following facets of the system should be addressed : The public health importance of the health event under surveillance The objectives of the system The systems usefulness Qualities of the surveillance system Cost or resource requirements for system operation
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1. Importance:
The importance of a health event can be assessed with the following measures: The current impact of the health event Total number of cases: incidence, prevalence Severity of illness: case-fatality rate, death-to-case ratio Mortality: overall and age-specific mortality rates, years of potential life lost Morbidity: hospitalization, disability Health care costs Its potential for spread Its preventability
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Cont

2. Objectives:
Consider first what information is needed for effective prevention and control, then to determine which objectives are most appropriate.

3. Usefulness:
We address whether a surveillance system makes a difference. We may assess usefulness by answering the following: What actions have been taken to date? Who has used the information to make decisions and take actions? What other future uses might the information have?

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Cont.

4. Qualities:
Several qualities or attributes affect the usefulness of surveillance system. - Simplicity - Flexibility - Acceptability - Sensitivity - Positive predictive value - Timeliness - Costs

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Uses:
1. Monitoring health events: -We monitor health events for the following purposes: - To detect sudden changes in disease occurrence and distribution - To follow secular (long-term) trends and patterns of disease - To identify changes in agents and host factors - To detect changes in health care practices 2. Link to Public Health Action: - Investigation and control - Planning - Evaluating prevention and control measures - Generating hypotheses and stimulating public health research 3. Testing hypotheses: 4. Archive of disease activity:
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Thank You .

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