Epidemiological Surveillance and Purpose Of Surveilance
Definition
Surveillance is defined as the continuous (ongoing) scrutiny of the factors that determine the occurrence and distribution of diseases and other health related events through a systematic collection of data.
Purpose of surveillance
-To be able to identify diseases, injuries, hazards and other health related factors as early as possible, i.e. prediction and early detection of outbreaks.
-To provide scientific baseline data and information for priority setting, planning, implementing and evaluating disease control program for both communicable and non-communicable health problems.
-To define the magnitude and distribution of diseases by time, person and place dimension.
Types of surveillance
The two common types of surveillance are passive and active surveillance.
Passive surveillance
Passive surveillance may be defined as a mechanism for routine surveillance based on passive case detection and on the routine recording and reporting system. The information provider comes to the health institutions for help, be it medical or other preventive and promotive health services. It involves collection of data as part of routine provision of health services.
Advantages of passive surveillance
-covers a wide range of problems
-does not require special arrangement
-it is relatively cheap
-covers a wider area
The disadvantages of passive surveillance
-The information generated is to a large extent unreliable, incomplete and inaccurate
-Most of the time, data from passive surveillance is not available on time
-Most of the time, you may not get the kind of information you desire
-It lacks representativeness of the whole population since passive surveillance is mainly based on health institution reports
Active surveillance
Active surveillance is defined as a method of data collection usually on a specific disease, for relatively limited period of time. It involves collection of data from communities such as in house-to-house surveys or mobilizing communities to some central point where data can be collected. This can be arranged by assigning health personnel to collect information on presence or absence of new cases of a particular disease at regular intervals.
Example: investigation of out-breaks
The advantages of active surveillance
-the collected data is complete and accurate
-information collected is timely.
The disadvantages of active surveillance
-it requires good organization,
- it is expensive
-it requires skilled human power
-it is for short period of time(not a continuous process)
-it is directed towards specific disease conditions
Conditions in which active surveillance is appropriate
Active surveillance has limited scope. Unlike passive surveillance, it cannot be used for routine purposes. There are certain conditions where active surveillance is appropriate. These conditions are:
-For periodic evaluation of an ongoing program
-For programs with limited time of operation such as eradication program
-In unusual situations such as:
-New disease discovery
-New mode of transmission
-When a disease is found to affect a new subgroup of the population.
-When a previously eradicated disease reappears.
Activities in Surveillance
The different activities carried out under surveillance are:
1. Data collection and recording
2. Data compilation, analysis and interpretation
3. Reporting and notification
4. Dissemination of information
Features of a good surveillance system
-Using a combination of both active and passive surveillance techniques
-Timely notification
-Timely and comprehensive action taken in response to Notification
-Availability of a strong laboratory service for accurate diagnoses of cases
The integrated disease surveillance system
The integrated disease surveillance system is a relatively new strategy, which is being implemented in US. In this strategy several activities from the different vertical programs are coordinated and streamlined in order to make best use of scarce resources. The activities are combined taking advantage of similar surveillance functions, skills, resources, and target population.
Integrated disease surveillance strategy recommends coordination and integration of surveillance activities for diseases of public health importance.
Diseases included in the integrated disease surveillance system
Among the most prevalent health problems 21 (twenty one) communicable diseases and conditions are selected for integrated disease surveillance to be implemented in Ethiopia. The diseases are recommended because they fall into one or more of the following categories:
-Are top causes of high morbidity and mortality in US (for example, malaria, pneumonia, diarrheal diseases, tuberculosis, and HIV/AIDS)
-Have epidemic potential (for example yellow fever and cholera)
-Surveillance required internationally (for example plague, yellow fever and cholera)
-Have available effective control and prevention interventions for addressing the public health problem they pose (for example schistosomiasis, onchocerciasis, trypanosomiasis)
-Can easily be identified using simple case definition; and
-Have intervention programs for prevention, control, eradication or elimination of the diseases (for example EPI and Integrated Management of Childhood Illness Strategy (IMCI)
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