Disease Surveillance

As malaria cases continue to decline in Asia, an integrated service delivery approach is ever more urgent to ensure that no malaria and fever cases are missed, and that malaria health workers continue contributing to broader infectious disease control efforts. However, despite its perceived merit, translating integrated surveillance into practice poses several systemic challenges. This article aims to identify what is hindering improved processes for integrating diagnostic and surveillance services for febrile illnesses. Data from peer‐reviewed and grey literature were reviewed using a systems approach based on the World Health Organisation health systems building blocks to fully understand the connections between different elements and system implications of integration. We include snippets from Sri Lanka, Myanmar, Malaysia and Nepal, highlighting expanded diagnostic integration best practices. This review provides a foundation for ‘integration roadmaps’ that can be adapted to diff...

This white paper identifies knowledge gaps and new challenges in healthcare epidemiology research, assesses the progress made toward addressing research priorities, provides the Society for Healthcare Epidemiology of America (SHEA) Research Committee's recommendations for high-priority research topics, and proposes a road map for making progress toward these goals. It updates the 2010 SHEA Research Committee document, “Charting the Course for the Future of Science in Healthcare Epidemiology: Results of a Survey of the Membership of SHEA,” which called for a national approach to healthcare-associated infections (HAIs) and a prioritized research agenda. This paper highlights recent studies that have advanced our understanding of HAIs, the establishment of the SHEA Research Network as a collaborative infrastructure to address research questions, prevention initiatives at state and national levels, changes in reporting and payment requirements, and new patterns in antimicrobial resi...

Infectious marine diseases can decimate populations and are increasing among some taxa due to global change and our increasing reliance on marine environments. Marine diseases become emergencies when significant ecological, economic or social impacts occur. We can prepare for and manage these emergencies through improved surveillance, and the development and iterative refinement of approaches to mitigate disease and its impacts. Improving surveillance requires fast, accurate diagnoses, forecasting disease risk and real-time monitoring of disease-promoting environmental conditions. Diversifying impact mitigation involves increasing host resilience to disease, reducing pathogen abundance and managing environmental factors that facilitate disease. Disease surveillance and mitigation can be adaptive if informed by research advances and catalysed by communication among observers, researchers and decision-makers using information-sharing platforms. Recent increases in the awareness of the...

Background: The threat of high profile diseases causing outbreaks has drawn attention to public health surveillance systems, much needed for the timely detection of outbreaks. A disease characterized by weakness of the lower limbs in Luatembo rural health facility was reported to the province in 2013. Through the Acute Flaccid Paralysis surveillance (AFP) program the Western Province in Zambia recorded an increase in the numbers of people affected with spastic paraparesis. The disease affected clusters of families, especially women and children. The disease was found to be in specific geographic areas, with the initial cases being identified in Mongu district followed by Luampa and Senanga districts. Surveillance for a particular disease condition may sometimes lead to detection of a related or unrelated condition. This study aims to assess the sensitivity of the Acute Flaccid Paralysis surveillance program surveillance program to detect other diseases of public health importance us...

Introduction As part of efforts to rapidly identify and care for individuals with COVID-19, trace and quarantine contacts, and monitor disease trends over time, most African countries implemented interventions to strengthen their existing disease surveillance systems. This research describes the strengths, weaknesses and lessons learnt from the COVID-19 surveillance strategies implemented in four African countries to inform the enhancement of surveillance systems for future epidemics on the continent. Methods The four countries namely the Democratic Republic of Congo (DRC), Nigeria, Senegal, and Uganda, were selected based on their variability in COVID-19 response and representation of Francophone and Anglophone countries. A mixed-methods observational study was conducted including desk review and key informant interviews, to document best practices, gaps, and innovations in surveillance at the national, sub-national, health facilities, and community levels, and these learnings were...

Outbreaks of highly contagious animal diseases severely affect the global economy, seriously disrupting domestic economies and the international trade of livestock and animal commodities. Italy has a series of contingency plans for the management of outbreaks of all major animal diseases. Disease control measures are mainly based on a traditional approach and eradication policies range from culling and stamping-out to movement restrictions of animals and commodities. Given the marked terrain differences in Italy, the uneven distribution of farms and animal population, the presence of potential disease hotspots constituted by high-density clusters of farms and animals, etc., maps have always been a common working tool for the Italian veterinary services to identify location of premises, define the perimeter of the infected and control zones, etc. The Italian Ministry of Health has requested an integrated system for the management of veterinary emergencies. One of the main features of...

The World Health Organization (WHO) recently completed the first phase of a RSV surveillance pilot study in fourteen countries (two to three in each WHO region) building on the Global Influenza Surveillance and Response System (GISRS). This active surveillance strategy had several objectives including understanding RSV‐related health burden in a variety of settings. A range of approaches can be used to estimate disease burden; most approaches could not be applied by participating countries in the WHO surveillance pilot. This article provides the recommendations made by WHO for strengthening and expanding the scope of the RSV surveillance in the next phase to enable burden estimation.

BackgroundAntimicrobial resistance (AMR) is a major global public health concern and its surveillance is a fundamental tool for monitoring the development of AMR. In 1998, the Nepalese Ministry of Health (MOH) launched an Infectious Disease (ID) programme. The key components of the programme were to establish a surveillance programme for AMR and to develop awareness among physicians regarding AMR and rational drug usage in Nepal.MethodsAn AMR surveillance programme was established and implemented by the Nepalese MOH in partnership with the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B) from 1998 to 2003. From 2004 to 2012, the programme was integrated and maintained as a core activity of the National Public Health Laboratory (NPHL) and resulted in an increased number of participating laboratories and pathogens brought under surveillance. The main strategies were to build national capacity on isolation, identification and AMR testing of bacterial pathogen...

Disease surveillance is indispensable for monitoring and responding to public health threats, particularly in resourceconstrained regions like Sierra Leone. This study evaluates the Integrated Disease Surveillance and Response (IDSR) system in Sierra Leone, focusing on district-level disease surveillance activities. Through a mixed-methods approach combining quantitative analysis and qualitative interviews, significant gaps in data analysis, interpretation, and utilization were identified. Challenges such as inadequate training, lack of motivation, and limited understanding of data importance were highlighted. However, stakeholders expressed a willingness to enhance skills and utilize surveillance data for decision-making. Recommendations include targeted capacity-building initiatives for district personnel, promotion of data-driven decision-making, integration of electronic early warning systems, and collaboration and investment from multiple stakeholders to strengthen disease surveillance systems in Sierra Leone. Addressing these challenges is critical for enhancing public health outcomes and mitigating the impact of infectious diseases in Sierra Leone and similar settings globally.

ObjectiveTo evaluate the difference in sensitivity between passive and active diarrheal and malnutrition disease surveillance system post-drought period in SwazilandIntroductionOver the past decade Swaziland has experienced recurring drought episodes. In 2016 the country experienced challenges regarding water supplies in both urban and rural areas due to the drought impact. A rapid health and Nutrition Assessment was conducted in 2016 revealed an increase in number of cases of acute watery diarrhea of all age groups. While there is a high demand for epidemiological data in the country a passive system through Health Management Information System (HMIS) and Immediate Disease Notification System (IDNS) has been used to monitor acute watery diarrhea and a set of priority notifiable diseases in the country.MethodsAn active sentinel surveillance system was set up in four regional hospitals for monitoring of all diarrheal cases of the under-fives. A data abstraction form was developed and...

ObjectiveTo enable coordination of Swaziland Ministry of Health units forpublic health surveillance (PHS).IntroductionIn the Kingdom of Swaziland, a baseline assessment found thatmultiple functional units within the Ministry of Health (MoH) performPHS activities. There is limited data sharing and coordination betweenunits; roles and responsibilities are unclear. The Epidemiology andDisease Control Unit (EDCU) is mandated to coordinate efforts andstrengthen PHS through implementing Integrated Disease Surveillanceand Response (IDSR) to fulfill requirements of International HealthRegulations (2005) (IHR[2005]), and the Global Health SecurityAgenda (GHSA).MethodsA baseline assessment that included key informant interviewsof unit representatives was conducted. Data flows were developed.Results were disseminated at a facilitated stakeholder workshop withunit representatives. A database was then built containing all distinctactivities found within the IDSR Technical Guidelines (2010), IHR[...

ObjectiveTo assess essential support functions for Integrated DiseaseSurveillance and Response(IDSR) in the Kingdom of Swaziland andmake recommendations for a national IDSR Roadmap.IntroductionImplementation of the IDSR framework for fulfillment of theInternational Health Regulations (2005) ([IHR 2005]) has beenchallenging in Swaziland due to distribution of IDSR functions acrossunits within the Strategic Information Department (SID) and otherexternal departments within the Ministry of Health. We conducted aqualitative assessment and a Strength, Weaknesses, Opportunities andThreats (SWOT) analysis of current public health surveillance (PHS)support structures to inform implementation of IDSR.MethodsKey informant interviews, focus group discussions, and a deskreview were performed. Participants were personnel at essential units,departments and programs at the national level as well as at healthfacilities and clinics at regional and local levels. Transcripts werecoded into SWOT matrice...

When real-time disease surveillance is practiced in neighboring states within a region, public health users may benefit from easily sharing their concerns and findings regarding potential health threats. To better understand the need for this capability, an event communications component (ECC) was added to the National Capital Region Disease Surveillance System, an operational biosurveillance system employed in the District of Columbia and in surrounding Maryland and Virginia counties. Through usage analysis and user survey methods, we assessed the value of the enhanced system in daily operational use and during two simulated exercises. Results suggest that the system has utility for regular users of the system as well as suggesting several refinements for future implementations.

An outbreak of a chronic liver disease of unidentified cause, known as "Unidentified Liver Disease (ULD)" by local communities was first observed in a rural village in Tigray, northern-Ethiopia in 2001. Little was known about the geographical extent, trend, and epidemiology of the disease. The Ethiopian Public Health Institute (EPHI) by then Ethiopian Health and Nutrition Research Institute (EHNRI), Centers for Disease Control and Prevention, World Health Organization, and Tigray Regional Health Bureaue established the ULD surveillance system in 2009 to characterize and monitor trends for this emerging disease and to identify cases for treatment and follow up. A large-scale official training was provided to the surveillance staff on case identification, management and reporting. In absence of a confirmatory test, the system used simple case definitions that could be applied by frontline staff with varying clinical training. To maximize resources, health extension workers a...