WELCOME

Surveillance and Notification System in Sivaganga District Dr. N. Ragupathy,M.D., Deputy Director of Health Services, Sivagangai.

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

METHODOLOGY 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 IDSP Type Type Basis of diagnosis Who does it Who does it Syndromic Syndromic ( FORM – S ) ( FORM – S ) Clinical pattern Paramedical personnel and members of community Presumptive ( FORM – P ) Typical history and clinical examination Medical Officer of PHC/CHC Confirmed ( FORM – L ) Clinical diagnosis by a medical officer and positive laboratory Confirmation Medical officer Laboratory Technician

REPORTING UNITS Type No of Reporting Units Reported By Form “ P ” 73 PHC – 47 GH -16 Private Hospitals - 10 Form “ L ” 19 Block PHC – 12 GH - 7 Form “ S ” 275 HSC / VHN

Diseases / Syndromes Under IDSP Acute Diarrhoeal Disease Acute Diarrhoeal Disease Bacillary Dysentery Bacillary Dysentery Viral Hepatitis Viral Hepatitis Enteric Fever Enteric Fever Malaria Malaria Dengue / DHF / DSS Dengue / DHF / DSS Chikungunya Chikungunya Acute Encephalitis Syndrome Acute Encephalitis Syndrome Meningitis Meningitis Measles Measles Diphtheria Diphtheria Pertussis Pertussis Chiken Pox Chiken Pox Fever of Unknown Origin(PUO) Fever of Unknown Origin(PUO) Acute Respiratory Infection(ARI) Influenza like Illness (ILI) Acute Respiratory Infection(ARI) Influenza like Illness (ILI) Pneumonia Pneumonia Leptospirosis Leptospirosis Acute Flaccid Paralysis Acute Flaccid Paralysis Dog Bite Dog Bite Snake Bite Snake Bite Leporsy Leporsy HIV HIV Tuberculosis Tuberculosis Unusal Syndromes Unusal Syndromes

Organizational Structure Central Surveillance Unit State Surveillance Unit District Surveillance Unit

Organizational Structure District Surveillance Unit District Surveillance Officer Data Manager Data Entry Operator RRT TEAM RRT TEAM 1.Epidemiologist 2.Clinicians 3.Pediatrician 4.Microbiologist 5.Entomologist 6.Animal Health Specialist

RAPID RESPONSE TEAM ( RRT ) Epidemiologist Animal Health Specialist Entomologist Clinician (Pediatrician/ Physician) Microbiologist

Information Flow Sub-Centres P.H.C.s C.H.C.s Dist.Hosp. Programme Officers 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 Hospitals Private Labs. Corporate Hospitals

LINKAGES BETWEEN ORGANISATION Sub- Centre Village DSU /DDHS PHC /CHC ASHA/ Volunteers Health Workers BMO/MO BHS / HI DSO / DDHS/ DMO  Data Analysis  Outbreak Investigation  Outbreak Response  Training & IEC  OPD Surveillance  Report to DSO  Outbreak Response  Training & IEC  Evaluation &Monitoring Compile Data Collect samples Report to PHC Early Response Collect Data Recording Report to SC Awareness

Data Analysis

Person Place Time Cases Evaluate information Pathogen? Source? Transmission?

Triggers

Triggers Response levels for the diseases under surveillance Response levels for the diseases under surveillance Predetermined surveillance related action at different trigger levels Predetermined surveillance related action at different trigger levels Trigger levels depend on Trigger levels depend on type of disease type of disease Case fatality Case fatality number of evolving cases number of evolving cases Region specific -- depending on incidence of disease and previous reporting trends Region specific -- depending on incidence of disease and previous reporting trends

Levels of Response to different triggers Trigger Significance Levels of Response Level-1 Suspected / limited outbreak Local response by HW/MO Local response by HW/MO Level-2Outbreak Local and district response by DSO and RRT Local and district response by DSO and RRT Level-3 Confirmed outbreak Local, district and state outbreak Local, district and state outbreak Level-4 Wide spread epidemic State level response to an epidemic State level response to an epidemic Level-5 Disaster response Local, district, state and centre Local, district, state and centre

Alerting / Notification System The PHCs having rising trends in reported cases are alerted through Phone, SMS, Alert Reports. The PHCs having rising trends in reported cases are alerted through Phone, SMS, Alert Reports. Based on the Data received, Rapid Response Team investigates the area which is considered as having impending outbreak. Based on the Data received, Rapid Response Team investigates the area which is considered as having impending outbreak. PHCs,Blocks, Health Unit Districts nearer to affected area alerted by sending EWS ( Early Warning Signals ) report. PHCs,Blocks, Health Unit Districts nearer to affected area alerted by sending EWS ( Early Warning Signals ) report.

SURVEILLANCE SYSTEM OTHER THAN IDSP MEASLES & AFP SURVEILLANCE MEASLES & AFP SURVEILLANCE FEVER SURVEILLANCE FEVER SURVEILLANCE ROUTINE SURVEILLANCE ROUTINE SURVEILLANCE

THANK YOU