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Unit 4: Overview of Public Health Surveillance

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Title: Unit 4: Overview of Public Health Surveillance


1
Unit 4 Overview of Public Health Surveillance
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Warm Up Questions Instructions
  • Take five minutes now to try the Unit 4 warm up
    questions in your manual.
  • Please do not compare answers with other
    participants.
  • Your answers will not be collected or graded.
  • We will review your answers at the end of the
    unit.

1-4-2
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What You Will Learn
  • By the end of this unit you should be able to
  • describe the components of a surveillance system
  • define sentinel surveillance, laboratory-based
    surveillance and case definitions
  • define incidence and prevalence

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What is Surveillance?
  • Systematic collection of information on a
    specific disease or other health-related event
  • Must occur on an ongoing basis with sufficient
    accuracy and completeness for data analysis
  • Utilisation of information for disease prevention
    and control

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Information Loops
  • A surveillance system is an information loop or
    cycle that involves
  • healthcare providers
  • public health agencies
  • the public

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Figure 4.1. Flow of Surveillance Data
Collection
Dissemination, Utilisation
Collation
Analysis and Interpretation
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Surveillance Terms
  • Universal case reporting a surveillance system
    in which all cases of a disease are supposed to
    be reported
  • Sentinel surveillance a surveillance system in
    which reports are obtained from certain
    facilities or populations
  • Laboratory-based reporting a surveillance
    system in which the reports of cases come from
    clinical laboratories instead of healthcare
    practitioners or hospitals

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Terms Related to Surveillance, Cont.
  • Case definition the clinical and laboratory
    characteristics that a patient must have to be
    counted as a case for surveillance purposes
  • Prevalence the proportion of persons in a
    population who have a disease or condition at a
    given point in time
  • Incidence the number of persons who newly
    develop a disease or condition within a specified
    period of time

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Terms Related to Surveillance, Cont.
  • Passive surveillance a system in which data
    generated without solicitation, intervention or
    contact by the health agency carrying out the
    surveillance. Other agencies initiate reporting.
  • Active surveillance the organization conducting
    surveillance initiates procedures to obtain
    reports

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Table 4.1. Relationship Between Disease and Case
Definition
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Additional Surveillance Terms
  • Sensitivity the ability of a case definition or
    laboratory test to predict true disease (a/(ac))
  • Specificity the ability of a case definition or
    laboratory test to predict absence of true
    disease (d/(bd))

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Additional Surveillance Terms, Cont.
  • Positive predictive value proportion of persons
    meeting a case definition, having a positive
    test, that have true disease (a/(ab))
  • Negative predictive value proportion of persons
    not meeting a case definition, having a negative
    test, that do not have true disease (d/(cd))

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Past Approaches
  • Duplication of efforts and resources
  • Delays in reporting and identification of
    outbreaks
  • Lack of dissemination and feedback to the local
    level
  • Lack of integration of training and surveillance
    activities

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Common Problems with Past Surveillance Systems,
Cont.
  • Limited evaluation of programmes
  • Inadequate involvement of laboratories
  • Incomplete reporting and lack of supervisory
    support

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Integrated Disease Surveillance (IDS)
  • Integrates priority communicable disease
    surveillance activities at the district level
  • Provides support for training and supervision
  • Full-time district-level staff dedicated to
  • monitoring health events in the community
  • mobilising community action
  • encouraging national assistance
  • accessing regional resources
  • Resources combined to collect information at each
    level

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IDS Goals
  • Strengthen the capacity of countries to conduct
    effective surveillance activities
  • Integrate multiple surveillance systems so that
    forms, personnel and resources can be used more
    efficiently and effectively
  • Improve the use of information for making
    decisions
  • Improve the flow of surveillance information
    between and within levels of the health system

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IDS Goals, Cont.
  • Improve laboratory capacity in identification of
    pathogens and monitoring of drug sensitivity
  • Increase the involvement of clinicians in the
    surveillance system
  • Emphasise community participation in detection of
    and response to public health problems
  • Strengthen the involvement of laboratory
    personnel in epidemiologic surveillance

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Examples of Priority Communicable Diseases for IDS
  • Epidemic-prone diseases
  • Cholera
  • Yellow fever
  • Diseases targeted for eradication and elimination
  • Polio
  • Neonatal tetanus
  • Other diseases of public health importance
  • Malaria
  • STIs

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In Summary
  • Surveillance is the collection of data relevant
    to public health, which can then be analysed to
    guide prevention and treatment programmes.
  • Sentinel surveillance involves the collection of
    more detailed data from a smaller sample of sites
  • Laboratory-based reporting occurs when case
    reports come from laboratories instead of health
    facilities.

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In Summary, Cont.
  • Prevalence is the proportion or number of persons
    in a certain population who have a particular
    disease.
  • Incidence measures new infections during a
    specific time period.

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Warm Up Review
  • Take a few minutes now to look back at your
    answers to the warm up questions at the beginning
    of the unit.
  • Make any changes you want to.
  • We will discuss the questions and answers in a
    few minutes.

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Answers to Warm Up Questions
  • 1. What is the name of the system that integrates
    priority communicable disease activities at the
    district level with support for training,
    supervision and resources?

1-4-22
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Answers to Warm Up Questions
  • 1. What is the name of the system that integrates
    priority communicable disease activities at the
    district level with support for training,
    supervision and resources? Integrated Disease
    Surveillance

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Answers to Warm Up Questions, Cont.
  • 2. Which of the following terms indicates the
    number or proportion of persons in a population
    who have a disease at a given point in time?
  • a. sensitivity
  • b. prevalence
  • c. negative predictive value
  • d. none of the above

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Answers to Warm Up Questions, Cont.
  • 2. Which of the following terms indicates the
    number or proportion of persons in a population
    who have a disease at a given point in time?
  • a. sensitivity
  • b. prevalence
  • c. negative predictive value
  • d. none of the above

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Answers to Warm Up Questions, Cont.
  • 3. True or false? One-time cross-sectional
    surveys are valid methods of HIV/AIDS
    surveillance.

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Answers to Warm Up Questions, Cont.
  • 3. True or false? One-time cross-sectional
    surveys are valid methods of HIV/AIDS
    surveillance. False

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Answers to Warm Up Questions, Cont.
  • 4. Match the following terms with their
    definitions
  •  

1-4-28
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Answers to Warm Up Questions, Cont.
  • 4. Match the following terms with their
    definitions
  •  

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Answers to Warm Up Questions, Cont.
  • 5. Which of the following terms indicates the
    number of persons who newly develop a disease
    within a specified time period?
  • a. specificity
  • b. positive predictive value
  • c. incidence
  • d. none of the above

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Answers to Warm Up Questions, Cont.
  • 5. Which of the following terms indicates the
    number of persons who develop a disease within a
    specified time period?
  • a. specificity
  • b. positive predictive value
  • c. incidence
  • d. none of the above

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Small Group Discussion Instructions
  • Get into small groups to discuss these questions.
  • Choose a speaker for your group who will report
    back to the class.

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Small Group Reports
  • Select one member from your group to present your
    answers.
  • Discuss with the rest of the class.

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Case Study Instructions
  • Try this case study individually.
  • Well discuss the answers in class.

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Case Study Review
  • Follow along as we go over the case study in
    class.
  • Discuss your answers with the rest of the class.

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Questions, Process Check
  • Do you have any questions on the information we
    just covered?
  • Are you happy with how we worked on Unit 4?
  • Do you want to try something different that will
    help the group?

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