WELCOMEWELCOME

Surveillance and NotificationSurveillance and NotificationSystem in Sivaganga DistrictSystem in Sivaganga District

Dr. N. Ragupathy,M.D.,Dr. N. Ragupathy,M.D.,Deputy Director of Health Services,Deputy Director of Health Services,

Sivagangai.Sivagangai.

Integrated Disease Surveillance Integrated Disease Surveillance ProjectProject(( IDSP)IDSP)

Integrated Disease Surveillance Project (IDSP) was launched by Hon’ble Union Minister of Health & Family Welfare in November 2004.

It is a decentralized, State based Surveillance Program in the country. It is intended to detect early warning signals of impending outbreaks and help initiate an effective response in a timely manner

METHODOLOGYMETHODOLOGY

Under IDSP , data is collected on a weekly (Monday–Sunday) basis. The information is collected on three specified reporting formats, namely “S” (suspected cases), “P” (presumptive cases) and “L” (Laboratory confirmed cases) filled by the Health Workers, Clinician and Clinical Laboratory staff.

The weekly data gives the time trends. Whenever there is a rising trend of illnesses in any area, it is investigated by the Medical Officers/Rapid Response Teams (RRT) to diagnose and control the outbreak

Types of surveillance in Types of surveillance in IDSPIDSP

TypeType Basis of Basis of diagnosisdiagnosis

Who does itWho does it

SyndromicSyndromic

( FORM – ( FORM – S )S )

Clinical patternClinical pattern Paramedical Paramedical personnel and personnel and members of members of communitycommunity

PresumptivPresumptivee

( FORM – P )( FORM – P )

Typical history Typical history and clinical and clinical examinationexamination

Medical Officer of Medical Officer of PHC/CHCPHC/CHC

ConfirmedConfirmed

( FORM – L )( FORM – L )Clinical Clinical diagnosis by a diagnosis by a medical officer medical officer and positive and positive laboratory laboratory ConfirmationConfirmation

Medical officerMedical officer

Laboratory Laboratory TechnicianTechnician

REPORTINGREPORTING UNITS UNITS

TypeType No of No of Reporting Reporting UnitsUnits

Reported ByReported By

Form “ P ”Form “ P ” 7373PHC – 47PHC – 47

GH -16GH -16

Private Hospitals - 10Private Hospitals - 10

Form “ L ”Form “ L ” 1919Block PHC – 12Block PHC – 12

GH - 7GH - 7

Form “ S ”Form “ S ” 275275 HSC / VHNHSC / VHN

Diseases / Syndromes Under Diseases / Syndromes Under IDSPIDSP

Acute Diarrhoeal Acute Diarrhoeal Disease Disease

Bacillary DysenteryBacillary Dysentery Viral HepatitisViral Hepatitis Enteric FeverEnteric Fever MalariaMalaria Dengue / DHF / DSSDengue / DHF / DSS ChikungunyaChikungunya Acute Encephalitis Acute Encephalitis

SyndromeSyndrome MeningitisMeningitis MeaslesMeasles DiphtheriaDiphtheria PertussisPertussis Chiken PoxChiken Pox

Fever of Unknown Fever of Unknown Origin(PUO)Origin(PUO)

Acute Respiratory Acute Respiratory Infection(ARI) Influenza Infection(ARI) Influenza like Illness (ILI)like Illness (ILI)

PneumoniaPneumonia LeptospirosisLeptospirosis Acute Flaccid ParalysisAcute Flaccid Paralysis Dog BiteDog Bite Snake BiteSnake Bite LeporsyLeporsy HIVHIV TuberculosisTuberculosis Unusal Syndromes Unusal Syndromes

Organizational StructureOrganizational Structure

Central Surveillance UnitCentral Surveillance Unit

State Surveillance UnitState Surveillance Unit

District Surveillance UnitDistrict Surveillance Unit

Organizational Structure Organizational Structure District Surveillance UnitDistrict Surveillance Unit

District Surveillance Officer

Data Manager

Data Entry Operator

RRT TEAMRRT TEAM

1. Epidemiologist2. Clinicians3. Pediatrician4. Microbiologist5. Entomologist6. Animal Health Specialist

RAPID RESPONSE TEAM ( RRT )RAPID RESPONSE TEAM ( RRT )

Epidemiologist

Animal Health Specialist Entomologist

Clinician(Pediatrician/

Physician)Microbiologist

Information FlowInformation Flow

Sub-Centres

P.H.C.s

C.H.C.s

Dist.Hosp.

ProgrammeOfficers

Pvt. Practitioners

D.S.U.

P.H.Lab.

Med.Col.

Other Hospitals: ESI, Municipal Rly., Army etc.

S.S.U.

C.S.U.

Nursing Homes

Private HospitalsPrivate Labs.Corporate Hospitals

LINKAGES BETWEEN ORGANISATIONLINKAGES BETWEEN ORGANISATION

Sub-Centre

VillageDSU /DDHS PHC/CHC

ASHA/Volunteers

HealthWorkers

BMO/MO BHS / HI

DSO / DDHS/ DMO

Data AnalysisOutbreak InvestigationOutbreak ResponseTraining & IEC

OPD SurveillanceReport to DSOOutbreak ResponseTraining & IECEvaluation &Monitoring

Compile DataCollect samplesReport to PHCEarly Response

Collect DataRecordingReport to SCAwareness

Data AnalysisData Analysis

Person

Place

Time

Cases

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9 10

0

200

400

600

800

1000

1200

0-4 '5-14 '15-44 '45-64 '64+

Age Group

Evaluate information

Pathogen? Source? Transmission?

TriggersTriggers

TriggersTriggers Response levels for the diseases under Response levels for the diseases under

surveillancesurveillance Predetermined surveillance related action at Predetermined surveillance related action at

different trigger levelsdifferent trigger levels Trigger levels depend on Trigger levels depend on

type of diseasetype of disease Case fatality Case fatality number of evolving casesnumber of evolving cases Region specific -- depending on incidence of Region specific -- depending on incidence of

disease and previous reporting trendsdisease and previous reporting trends

Levels of Response to Levels of Response to different triggersdifferent triggers

Trigger Trigger SignificanceSignificance

Levels of ResponseLevels of Response

Level-1Level-1 Suspected / Suspected / limited outbreaklimited outbreak

Local response by Local response by HW/MOHW/MO

Level-2Level-2 OutbreakOutbreak Local and district Local and district response by DSO response by DSO and RRTand RRT

Level-3 Level-3 Confirmed Confirmed outbreakoutbreak

Local, district and Local, district and state outbreakstate outbreak

Level-4Level-4 Wide spread Wide spread epidemicepidemic

State level State level response to an response to an epidemicepidemic

Level-5Level-5 Disaster responseDisaster response Local, district, state Local, district, state and centreand centre

Alerting / Notification Alerting / Notification SystemSystem

The PHCs having rising trends in reported The PHCs having rising trends in reported cases are alerted through Phone , SMS, cases are alerted through Phone , SMS, Alert Reports.Alert Reports.

Based on the Data received , Rapid Based on the Data received , Rapid Response Team investigates the area Response Team investigates the area which is considered as having impending which is considered as having impending outbreak.outbreak.

PHCs ,Blocks , Health Unit Districts nearer PHCs ,Blocks , Health Unit Districts nearer to affected area alerted by sending EWS ( to affected area alerted by sending EWS ( Early Warning Signals ) report.Early Warning Signals ) report.

SURVEILLANCE SYSTEM SURVEILLANCE SYSTEM OTHER THAN IDSPOTHER THAN IDSP

MEASLES & AFP MEASLES & AFP SURVEILLANCESURVEILLANCE

FEVER SURVEILLANCE FEVER SURVEILLANCE ROUTINE SURVEILLANCEROUTINE SURVEILLANCE

THANK YOUTHANK YOU