Download notifiable disease

BY:
Dr. Olagoke A. Ewedairo
OUTLINE
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Introduction
Definitions
Reasons for disease notification
Factors that determine diseases which require
reporting
• Disease surveillance
• Integrated Disease Surveillance and Response
• Chain of notification
INTRODUCTION
• Disease surveillance and notification (DSN) is
part of the Health Management Information
System (HMIS) which comprises databases,
personnel, and materials that are organized to
collect data which are utilized for informed
decision making.
• Formal reporting of notifiable infectious diseases is a
requirement placed upon health care providers by
many regional and national governments, and upon
national governments by the World Health
Organization.
• Since 1969, WHO international health regulation
(IHR) has required that all cases of the following
diseases be reported to the organization:
• Cholera, plague, yellow fever, small pox, relapsing
fever and typhus. In 2005, the list was extended polio and
SARS.
• Regional and national governments typically monitor a
larger set of communicable diseases (around 80 in the
U.S.) that can potentially threaten the general
population.
• A disease might be added to the list as a new pathogen
emerges, or a disease might be deleted as its incidence
declines.
• Many governments (including Nigeria) have now
enacted regulations for reporting of both human and
animal (generally livestock) diseases.
• This protects the public's health by ensuring the
proper identification and follow-up of cases,
appropriate treatment; trace contacts who need
vaccines, treatment, quarantine, or education;
investigate and halt outbreaks; eliminate
environmental hazards; and close premises where
spread has occurred.
DEFINITIONS
• Disease notification is a process of reporting
the occurrence of disease or other healthrelated conditions to appropriate and
designated authorities.
• A notifiable disease is any disease that is
required by law to be reported to government
authorities.
• A notifiable disease is one for which regular,
frequent, and timely information regarding
individual cases is considered necessary for
the prevention and control of the disease.
• Physicians are required by law to report cases
of certain infectious diseases. Unfortunately,
many do not.
• Family physicians as gate keepers have a major
role to play in disease notification.
• A study by Bawa SB et al. in Yobe state showed
that only 38.2% of the respondents were
aware of the national disease surveillance
system
REASONS FOR SURVEILLANCE
• Evaluate the effectiveness of control and
preventative health measures
• Monitor changes in infectious agents e.g. trends in
development of antimicrobial resistance
• Support health planning and the allocation of
appropriate resources within the healthcare system.
• Identify high risk populations or areas to target
interventions
• Provide a valuable archive of disease activity for
future reference.
Factors that determine which diseases to be
reported
• Its interest to national or international regulations or
prevention programmes
• Its national incidence
• Its severity (potential for rapid mortality)
• Its communicability/ Its potential to cause outbreaks
• Significant risk of international spread
• The socio-economic costs of its cases
• Its preventability
• Evidence that its pattern is changing
DISEASE SURVEILLANCE
• Disease surveillance is the ongoing systematic
collection, analysis and interpretation of data for use
in planning, implementation and evaluation of public
health practice
• The main role of disease surveillance and notification
is to predict, observe, and minimize the harm caused
by outbreak and pandemic situations.
• Surveillance of notifiable conditions helps public
health authorities monitor the effect of notifiable
conditions, measure disease trends, assess the
effectiveness of control and prevention measures,
identify populations or geographic areas at high risk,
allocate
resources
appropriately,
formulate
prevention strategies, and develop public health
policies.
• A key part of modern disease surveillance is the
practice of disease case reporting.
• All the reportable diseases have case definition to
help the health care provider clearly define the cases
to be reported.
• For examples of some case definition click the link
below:
• http://www.who.int/ihr/Case_Definitions.pdf
Case definition for notification of SARS under
the IHR (2005)
A notifiable case of SARS is defined as an individual
with laboratory confirmation of infection with SARS
coronavirus (SARS-CoV) who either fulfills the clinical
case definition of SARS or has worked in a laboratory
working with live SARS-CoV or storing clinical
specimens infected with SARS-CoV.
Clinical case definition of SARS
1. A history of fever, or documented fever
AND
2. One or more symptoms of lower respiratory tract illness
(cough, difficulty breathing, shortness of breath)
AND
3. Radiographic evidence of lung infiltrates consistent with
pneumonia or acute respiratory distress syndrome (ARDS)
or autopsy findings consistent with the pathology of
pneumonia or ARDS without an identifiable cause
AND
4. No alternative diagnosis can fully explain the illness
Integrated Disease Surveillance and Response
To strengthen surveillance in Africa, the WHO regional
office in Africa established the integrated disease
surveillance and response (IDSR) in September 1998
when the 48th World Health Organization Regional
Committee for Africa met in Harare, Zimbabwe.
Member States adopted resolution AFR/RC48/R2 for
improving the availability and use of data for public
health action at all levels of national systems
GOALS OF IDSR
The WHO goal of IDSR is to ensure that each Member
State has the capacity to define, detect and respond to
communicable public health threats. It aims to provide:
• Timely, complete, regular and high quality
information
• Early detection and prediction of epidemics
• Objective assessment of interventions during
epidemics; and
• Efficient monitoring of intervention programmes.
• Three IDSR forms are used for reporting disease
conditions IDSR 001, IDSR 002, and IDSR 003
• A study by Nnebue CC et al. in Enugu state reported
only 33.3, 31.1, and 33.7% of respondents knew the
specific uses of forms IDSR 001, IDSR 002, and IDSR
003 respectively.
• IDSR form 001: For immediate/case based reporting
of diseases.
• Immediate reporting allows for timely action to be
taken to prevent the re-emergence or rapid
transmission of epidemic prone diseases or events,
especially diseases due to highly pathogenic and
lethal infectious.
• Make the initial report by the fastest means possible
(telephone, text message, facsimile, e-mail,
radiophone).
• Follow up the initial verbal report with a written
report of the case-based report form.
• IDSR 001A when the case is suspected and IDSR 001B
when there is laboratory confirmation.
• Below is a list of diseases/events requiring immediate
reporting.
Diseases/Events reported with form IDSR 001
• Acute Flaccid Paralysis •
(AFP)
• Acute hemorrhagic •
fever syndrome
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(Ebola, Marburg, Lassa
Fever, RVF,
•
Crimean-Congo)
•
• Adverse event
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following
immunization
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(AEFI)
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• Anthrax
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• Chikungunya
• Cholera
•
• Cluster of SARI
•
Diarrhoea with blood
(Shigella)
Dracunculiasis
Influenza due to new
subtype
Maternal death
Measles
Meningococcal
meningitis
Neonatal tetanus
Plague
Rabies (confirmed
cases)
SARS
Smallpox
• Typhoid fever
• Yellow fever
• Any public health
event of international
concern (infectious,
zoonotic, food borne,
chemical, radio nuclear or
due to an
unknown condition)
• IDSR form 002: For weekly reporting of new cases of
epidemic/pandemic prone diseases.
• IDSR form 003: For routine monthly notification of
other diseases of public health importance.
Diseases that require monthly reporting
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Acute viral hepatitis •
AIDS (New Cases) •
Buruli ulcer
•
Diabetes mellitus •
Diarrhoea with
severe dehydration
in children under 5 •
years of age
HIV (new
•
detections)
•
Hypertension
•
Influenza-like illness
Injuries (Road
Traffic Accidents)
Leprosy (quarterly)
Lymphatic Filariasis
Malaria
Malnutrition in
children under 5
years
Mental health
(Epilepsy)
Noma
Onchocerciasis
Severe pneumonia
in children under
5years of age
• Sexually
transmitted
diseases (STIs)
• Trachoma
• Trypanosomiasis
• Tuberculosis
(quarterly)
• Underweight
Newborns (less
than 2500 g)
CHAIN OF REPORTING
HCP
WHO/CDC
DNO
FMOH
LG MOH
SMOH
Key:
HCP: Health care providers
DNO: Disease notification officer
LG MOH: Local Government Medical Officer of Health
SMOH: State Ministry of Health
FMOH: Federal Ministry of Health
Analysis of data. Questions to ask
Have any priority diseases or other public health events
of concern been detected during the reporting period
(this week, for example)? Is an epidemic or unusual
public health event suspected?
• Of the cases, deaths or events detected, how many
were confirmed?
• Where did they occur?
• How does the observed situation compare to
previous observation periods of time this year? For
example, when compared to the start of the reporting
period, is the problem increasing?
• Are the trends stable, improving or worsening?
• Is the reported surveillance information
representative enough of the reporting site’s catchment
area? Out of all the sites that should report, what
proportion has actually
reported?
• How timely were the data received from the
reporting sites?
REASONS FOR NOT REPORTING
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Do not know reporting is required
Do not know how to report
Do not have reporting materials
Do not know numbers to call
Assume someone else will report it
Do not think reporting is of any use
No time to report/forgot to report
Case study
• Let Someone describe the case definition for Ebola
Virus Disease and describe the chain of reporting for
the case.
CONCLUSION
• Disease notification and appropriate data collection
for analysis is an important part of health care
provider’s responsibilities.
• It ensures adequate information is available for
effective planning and running of the healthcare
system
• Healthcare providers should therefore be familiar
with notifiable diseases and the appropriate channel
of notification.
References
• Nnebue CC, Onwasigwe CN, Adogu PO, Onyeonoro UU. Awareness and
knowledge of disease surveillance and notification by health-care workers
and availability of facility records in Anambra state, Nigeria. Niger Med J
2012;53:220-5
• Bawa SB1, Olumide EA, Umar US. The knowledge, attitude and practices
of the reporting of notifiable diseases among health workers in Yobe
State, Nigeria. Afr J Med Med Sci. 2003 Mar;32(1):49-53.
• World Health Organization. Integrated disease surveillance programme.
Available at:
http://www.who.int/csr/labepidemiology/projects/surveillance/en/
accessed 26/01/2015
• CDC technical guidelines for IDSR. Available at:
http://www.cdc.gov/globalhealth/dphswd/idsr/pdf/Technical%20Guidelin
es/IDSR%20Technical%20Guidelines%202nd%20Edition_2010_English.pdf
Accessed on 26/01/2015