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DISEASE SURVEILLANCE

Dr. Srinivas MD

Prof and Head Epidemiology

The Tamil Nadu Dr. M.G.R. Medical University

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�IDSP TO AN INTEGRATED HEALTH INFORMATION PLATFORM (IHIP) �

Launched in project mode (World Bank supported 2004)

Later became program mode & renamed as IDSP

IDSP is a decentralized, state-based surveillance system; lowest reporting unit is sub-centre

Intended to detect early warning signals for selected communicable diseases & respond within a reasonable time to reduce morbidity and mortality

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IDSP – KEY CHALLENGES

  • Irregular and under-reporting from the grass-root level

  • This impacted the data analyses and public health action by district team

  • The revised surveillance program, namely - Integrated Health Information Platform (IHIP), on April 1st, 2021

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IHIP

A web enabled near real-time reporting system accessible at all levels from villages to national level.

Integrates data from various ’registries’ to provide real-time information on health surveillance

Uses the latest technologies and digital health initiatives.

From across India for decision-makers to take action. The platform has been implemented in 7 states of the country in pilot mode

Although structurally the same as the IDSP, there are some significant functional changes to achieve the original objectives envisaged for the IDSP

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IHP CONT…

The ANM daily (real-time) feeds syndromic, case-wise (disaggregated) information through tablets (Namely ANMOL tablets) along with the geocoded location of the cases for geographic reference.

Such data is synchronized directly to the server.

System captures real-time disaggregated data (case-based surveillance) and links data from S, P, L & EWS forms to cover 33+ disease conditions

Therefore, the district, state, and central surveillance unit (DSU, SSU, and CSU) will be able to view and analyze the data immediately, & act

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ORGANIZATION STRUCTURE

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SCALING UP & ENHANCING QUALITY

Surveillance activities have developed in an uneven way;

Establishing surveillance in vertical programs allows many activities to be gathered allowing surveillance control function (different methods, terminology, forms, schedules); specialized surveillance

Eradication programs may require very active surveillance

Dropping non-specific & high volume conditions (e.g. AGE except Cholera), data to be driven by the need to use the data

Appropriate feedback from the higher unit to the lower unit

Enhanced ability to analyse & act on information being generated

Adequate supportive supervision for the ANMs/MOs, and the ethical challenges associated with dealing with case-based information, like data confidentiality

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HOW CAN SURVEILLANCE DATA BE USED?

Estimates of a health problem – including changes in trends, patterns

Natural history of disease

Detection of epidemics

Distribution and spread of a health event

Hypothesis testing

Evaluating control and prevention measures

Monitoring change

Detecting changes in health practice

Facilitate planning

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SURVEILLANCE IS OUTCOME ORIENTED

  • Can measure frequency of an illness or injury (e.g., number of cases, incidence, prevalence)
  • Can measure severity of the condition (e.g., hospitalization rate, disability, case fatality)
  • Can measure impact of the condition (e.g., cost)
  • Orient data by person, place, and time

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EVALUATION - SYSTEM ATTRIBUTES

  • Sensitivity
    • Proportion of cases detected by the system. Completeness of reporting. Detect epidemics?
    • Increased awareness, new diagnostic test, change in surveillance method may impact.
  • Predictive Value Positive
    • Proportion of persons identified as having the disease who actually have it.

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SENSITIVITY/SPECIFICITY AND PREDICTIVE VALUE +/- (PVP/PVN)

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IDSP

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STATE/UT WISE P FORM COMPLETENESS % FOR JUNE 2022

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STATE/UT WISE L FORM COMPLETENESS % FOR JUNE 2022

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NO. OF ENTERIC FEVER CASES REPORTED UNDER P & L FORM DURING JUNE 2020 -22

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WEEKLY OUTBREAK REPORT