International Health

The International Health Regulations (IHR) 2005, provides a framework that supports efforts to improve global health security and requires that, member states develop and strengthen systems and capacity for disease surveillance and detection and response to public health threats. To contribute to this global agenda, an international collaborative comprising of personnel from the Health Protection Agency, West Midlands, United Kingdom (HPA); the Indian Institute of Public Health (IIPH), Hyderabad, Andhra Pradesh (AP) state, India and the Department of Community Medicine, Rajarajeswari Medical College and Hospital (RRMCH), Bangalore, Karnataka state, India was established with funding from the HPA Global Health Fund to deliver the objectives stated above.

Objective:

This project aimed to contribute to ongoing efforts to improve the capability and capacity to undertake disease surveillance and Emergency Preparedness and Response (EPR) activities in India. The main outcome measure was to empower a cadre of trainers through the inter-related streams of training & education to enhance knowledge and skills and the development of collaborative networks in the regions.

A liver disease of unknown etiology, called unknown liver disease (ULD) by the community, was first identified in 2002 in Tigray; a rugged, semi-arid, mountainous region that is considered one of the most drought-prone and food insecure regions of Ethiopia. ULD is a chronic condition characterized by epigastric pain, abdominal distention, ascites, emaciation, and hepato/splenomegaly. In 2005, the Ethiopian Health and Nutritional Research Institute was assigned by the Ethiopia Ministry of Health to assist the Tigray Regional Health Bureau and oversee the disease investigation. In 2008, Centers for Disease Control and Prevention (CDC) assisted the Ethiopian team and jointly developed the surveillance tools. The surveillance system was implemented in 2009 with the objectives to determine the magnitude and distribution of the disease; identify disease trends; detect cases to provide them with clinical care; and inform health officials and funding bodies for resource allocation.  After several investigations, a local plant containing a particular type of pyrrolizidine alkaloid (PA) toxin that contaminated local foodstuffs was identified as the etiologic agent, and ULD was renamed PAILD in 2011.

Objective:

To describe the results of the evaluation of the PAILD active surveillance system and lessons learned for similar surveillance efforts in a resource-limited setting.

Each year Ministry of Health and Social welfare of Tanzania under Epidemiology Section has been reporting many suspected cases of Shigella throughout the country. However only fewer laboratories have been reporting the confirmed cases.

Objective:

To determine whether the IDSR system meets its purpose and objectives, to evaluate the system attributes, and provide recommendations to improve the IDSR system, using the example of bacillary dysentery, a priority disease in Tanzania.

 

Cholera causes frequent outbreaks in Nigeria, resulting in mortality. In 2010 and 2011, 41,936 cases (case fatality rate [CFR]-4.1%) and 23,366 cases (CFR-3.2%) were reported (1). Reported cases in Nigeria by week 26, 2012 was 309 (CFR-1.29%) involving 20 Local Government Areas in 6 States. In Nigeria, there are currently eleven (11) States including Niger state at high risk for cholera/bloodless diarrhea outbreaks. In 2011, Niger state had 2472 cholera cases (CFR-2%) and 45,111 other diarrhea diseases cases, recorded in more than half of state Purpose of surveillance system is to ensure early detection of cholera and other diarrheal cases and to monitor trends towards evidencebased decision for management, prevention and control.

Objective:

To determine how the cholera and other diarrheal disease surveillance system in Niger state is meeting its surveillance objectives, to evaluate its performance and attributes and to describe its operation to make recommendations for improvement.

 

Absenteeism has great advantages in promoting the early detection of epidemics1. Since August 2011, an integrated syndromic surveillance project (ISSC) has been implemented in China2. Distribution of the absenteeism generally are asymmetry, zero inflation, truncation and non-independence3. For handling these encumbrances, we should apply the Zero-inflated Mixed Model (ZIMM).

Objective

To describe and explore the spatial and temporal variability via ZIMM for absenteeism surveillance in primary school for early detection of infectious disease outbreak in rural China.

Scarlet fever is a bacterial infection caused by group A streptococcus (GAS). The clinical symptoms are usually mild. Before October, 2007, case-based surveillance of scarlet fever was conducted through notifiable infectious diseases in Taiwan, but was removed later from the list of notifiable disease because of improved medical care capacities. In 2011, Hong Kong had encountered an outbreak of scarlet fever (1,2). In response, Taiwan developed an integrated syndromic surveillance system using multiple data sources since July 2011.

Objective

To develop an integrated syndromic surveillance system for timely monitoring and early detection of unusual situations of scarlet fever in Taiwan, since Hong Kong, being so close geographically to Taiwan, had an outbreak of scarlet fever in June 2011.

 

The international Society for Disease Surveillance has successfully brought together practitioners and researchers to share tools, ideas, and strategies to strengthen health surveillance systems. The Society has evolved from an initial focus on syndromic surveillance to a broader consideration of innovation in health surveillance. More recently, ISDS has also worked to support surveillance research and practice in International resource-constrained settings. Individuals who work in surveillance in developed countries outside the USA, however, have received little direct attention from ISDS. The policy and practice contexts in these countries are often quite different than the USA, so there is a need to support surveillance innovation in these countries in a manner that fits the context. Canadian surveillance practitioners and researchers comprise the largest International group of ISDS members, and these members have expressed an interest in working with ISDS to translate surveillance innovations into practice in Canada, where a national surveillance network and forum is lacking. This Round Table will consider how ISDS can help to support members in countries like Canada and will identify next steps for promoting the science and practice of disease surveillance in the Canadian context.

Objective

1) To explore how ISDS can better support researchers and public health practitioners working in the field of disease surveillance outside the United States;

and

2) To identify current surveillance issues in the Canadian public health system where ISDS can support dialogue and action.

 

International borders present unique challenges for the surveillance of infectious disease. Border communities represent locations with vast differences in cultures and languages, governing institutions, healthcare access, and priorities for the collection and surveillance of disease data. Pathogens and the health and security risks they create do not respect geographical and political boundaries. However, the organizations responsible for the surveillance and control of these agents must function within the borders of their respective governments. One Border One Health is a binational, multidisciplinary initiative aimed at engaging partners in the US and Mexico to identify and implement methods for successful communication and collaboration to enhance health capacity and disease surveillance within the border region. The advancements of international initiatives such as OBOH will help to develop the types of multi-country networks necessary for the effective monitoring of disease patterns and risks.

Objective

The purpose of this demonstration is to describe the cross-border collaborative processes used for the development of a transparent methodology to identify and prioritize zoonotic infectious disease agents in the California-Baja California border region.

In response to the 2009 H1N1 pandemic, the Early Warning Infectious Disease Surveillance Program Office of Binational Border Health in the California Department of Public Health sought to strengthen outpatient ILI surveillance along the CA/BC border by creating the first binational influenza surveillance network in the region. The establishment of this network was crucial for enhancing cross-border situational awareness of influenza activity, especially in a region characterized by high levels of population mobility.

Objective

To enhance cross-border surveillance for Influenza-Like-Illness (ILI) in the California/Baja California (CA/BC) border region through the formation of a border binational surveillance network.

Dengue is a major cause of morbidity in Thailand. Annual outbreaks of varying sizes provide a particular challenge to the public health system because treatment of severe cases requires significant resources. Advanced warning of increases in incidence could help public health authorities allocate resources more effectively and mitigate the impact of epidemics.

Objective

To develop a statistical model for dengue fever surveillance that uses data from across Thailand to give early warning of developing epidemics.