INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP)

1 INTEGRATED DISEASE SURVEILLANCE . PROGRAMME . (IDSP). Dr. Seema Aggarwal State Epidemiologist IDSP. INTEGRATED DISEASE SURVEILLANCE PROGRAMME IDSP is decentralized, state based SURVEILLANCE PROGRAMME in the country. It is intended to detect early warning signals of impending outbreaks and help initiate an effective response in a timely manner. Objectives of the IDSP. To establish a decentralized district based system of SURVEILLANCE for communicable and non- communicable diseases for timely and effective public health actions to be initiated To integrate existing SURVEILLANCE activities to avoid duplication and facilitate sharing of information across all DISEASE control programes and other stake holders. INTEGRATED DISEASE SURVEILLANCE PROGRAMME Launched in Nov.

2 2004 with World Bank Assistance in some states Major Objective: Early detection & response to DISEASE outbreaks Major components: Integration and Decentralization of SURVEILLANCE activities for communicable and non-communicable diseases To establish data base of diseases and ensure community participation Strengthening of Public Health Laboratories Human Resource Development - Training of SSO, DSO, RRT, other medical and paramedical staff Use of Information Technology for collection, compilation, analysis & dissemination of data Introduction to DISEASE SURVEILLANCE What is Public Health SURVEILLANCE ? SURVEILLANCE is defined as . The ongoing systematic collection, collation, analysis and interpretation of data. Dissemination of information to those who need to know in so that action be taken.

3 SURVEILLANCE is monitoring of behavior. Components of SURVEILLANCE Activity Collection of data Compilation of data Analysis and interpretation Follow up action Feed back- IDSP ALERT. Why do we need to do SURVEILLANCE ? Recognize cases or cluster of cases to trigger intervention to prevent transmission or reduce morbidity and mortality Assess the public health impact of health events or determine and measure trends. Demonstrate the need for public health intervention PROGRAMME and resources during public health planning. Monitor effectiveness of prevention and control measures and prevent outbreaks Identify high risk groups or geographical areas to target interventions . COUNTRY RESPONSE TO. STRENGTHEN SURVEILLANCE . 1997-98: National SURVEILLANCE PROGRAMME for Communicable Diseases (NSPCD) initiated Nodal point - NICD.

4 Implementing agencies - States/UTs Main components: Infrastructural strengthening - Laboratories Manpower development Uniform & regular reporting Monitoring & evaluation Weaknesses in DISEASE SURVEILLANCE Lack of integration of Private Sector in SURVEILLANCE activity Poor Laboratory capacity Lack of surv. infrastructure in urban areas Slow & inefficient sharing of SURVEILLANCE information at district level Limited capacity to undertake analysis &. response at district level Non-inclusion of NCDs in Surv. Program Strategy for SURVEILLANCE in IDSP. District level is the basic functional unit for integrating SURVEILLANCE functions. All SURVEILLANCE activities are coordinated and streamlined. Resources are combined to collect information from single focal point at each level.

5 Several activities are combined into one INTEGRATED activity to take advantage of similar SURVEILLANCE functions, skills, resources and target populations. Strategy for SURVEILLANCE in IDSP (Contd.). IDSP integrates both public and private sector by involving private practitioners, Private hospitals, Private labs, NGOs etc and also emphasis on community participation- signing of MOU. Integrates communicable and non communicable diseases. Integrates both rural and urban health system. Integration with medical colleges both Govt & private. Important Information in DISEASE SURVEILLANCE - OUTBREAKS. Who get the DISEASE ? How many get them? Where they get them? When they get them? Why they get them? What needs to be done as public health response?

6 Types of SURVEILLANCE in IDSP. Syndromic: Information of diseases on the basis of clinical pattern by paramedical personnel and members of community. Presumptive: Diagnosis made on typical history, pattern and clinical examination by medical officers Confirmed: Clinical diagnosis by medical officer confirmed by positive laboratory investigation. Reporting units of DISEASE SURVEILLANCE Public health sector Private health sector Rural SHC ,CHCs, PHCs Sentinel private practitioners and sentinel hospitals Urban Distt. Hospitals, Urban Sentinel private hospitals, ESI/ nursing homes, Railway hospitals/ Govt. sentinel hospitals Medical college Hospitals Medical colleges ( Private) and NGOs & pvt. laboratories Reporting units of DISEASE SURVEILLANCE (contd.)

7 Sub centre: Health worker/ANM reports all patients on basis of symptoms to PHC including from private clinics, hospitals etc in the rural areas. PHC/CHC: Medical officer reports ,as probable cases of diseases which cannot be confirmed by laboratory test at periphery. Can confirm and report cases like +ve Malaria, Sputum +ve Tuberculosis, typhoid etc. with available facility at PHC,CHC. Sentinel private practitioner, Dist. hospitals, Municipal hospitals, Medical colleges, Sentinel hospitals, NGOs- Medical officers report as probable cases of interest, with confirmation from Laboratories. Data Management Tools & Methods Weekly Data (Monday to Sunday). Form S (Suspect Cases): Health Workers (Sub Centers). Form P (Probable Cases): Doctors (PHC, CHC, Hospitals).

8 Form L (Lab Confirmed Cases): Laboratories SOS reporting for DISEASE outbreaks Early Warning Signal/outbreak reporting format Supplemental Information through IDSP Toll free Number 1075. Media Scanning Data Transmission from states/districts through IT. Network IDSP Portal ( ). Email Data compilation/analysis and response at all levels What is integration? Sharing of SURVEILLANCE information of DISEASE control programmes Developing effective partnership with health and non health sectors in SURVEILLANCE Including communicable and non communicable diseases in the SURVEILLANCE system Working with the private sector and NGOs Bringing academic institutions and medical colleges into DISEASE SURVEILLANCE Organizational structure National SURVEILLANCE Committee Central SURVEILLANCE Unit State SURVEILLANCE Committee State SURVEILLANCE Unit District SURVEILLANCE Committee District SURVEILLANCE Unit Reporting Unit (PRU).

9 Data source (1). S, P & L forms (Weekly Reporting). Form S. (Syndromic Reporting) - Health Workers (Sub Centres). Form P. (Probable Cases which are clinically diagnosed by a medical doctor) - PHC, CHC, Hospitals Form L - Lab Confirmed Cases A probable case that is Laboratory confirmed Data source (2). Weekly & SOS reporting on EWS format and monitoring of outbreaks Supplemental Information: IDSP 24x7 Call Centre Information about outbreaks received on a toll free number 1075 & information shared with SSO/DSO. Media Scanning & Verification Cell Provides information about outbreaks by scanning media; shared with stakeholders Data transmission methods e-mail: S,P,L forms & EWS. IDSP Portal ( ). SMS reporting thru mobiles piloted in Andhra Pradesh Levels Of SURVEILLANCE Activities Activities Periphery District State Detection and notification of +++ ++ - cases Consolidation of data + +++ +++.

10 Analysis and interpretation + +++ +++. Investigation and +++ +++ +. confirmation Feed Back + +++ +++. Dissemination + ++ ++. Action ++ +++ +. DISEASES UNDER SURVEILLANCE . Core Diseases Regular SURVEILLANCE : Vector Borne DISEASE : Malaria, Dengue, JE, Chickengunya etc. Water Borne DISEASE : Acute Diarrhoeal DISEASE (Cholera). Typhoid, Gastro entritis, Hepatitis. Respiratory Diseases : Tuberculosis Vaccine Preventable Diseases : Measles Diseases under eradication : Polio Other International commitments : Plague, Yellow fever Unusual Clinical syndromes : Meningococcal-encephalitis/. (Causing death/hospitalization) respiratory Distress, Hemorrahgic fevers etc. CONTD. Sexually transmitted diseases : HIV/HBV, HCV. Blood Borne Other Conditions : Water Quality : Outdoor Air Quality State Specific Diseases : State Specific Non- communicable diseases like Cardiovascular, Diabetes, strokes, and Flurosis etc.