Surveillance Systems

The outbreak of the Ebola Virus Disease (EVD) in Africa in 2014 presented a major threat and concern across the world, spreading to two other continents (Europe and North America). Though the epidemic is on a downward trend, there is a need to evaluate the performance of the systems in place to detect and control such outbreaks and determine the need for improvement in countries affected.

With its first traceable case reported to have been in Guinea, the outbreak spread to Nigeria through an air traveler from Liberia which led to an outbreak in the country that luckily, was quickly contained. This imported case was initially managed at a private health facility (PHF) eventually leading to 20 cases and eight deaths, four of which were health workers from the initial managing PHF. Despite effort to contact the authorities about the suspected imported case by the PHF, it reportedly took some time before the health authorities could be reached and action at control instituted. This might suggest an inefficiency of the IDSR system which was previously adopted by Nigeria as a means of implementing the International Health Regulation (IHR) of 1969. The IHR is a set of regulations that the World Health Assembly uses to implement its constitutional responsibility to prevent the international spread of diseases.

Hemorrhagic fevers like EVD ought to be reported immediately upon suspicion to the health authorities but the delay despite effort suggests this system is not efficient. This is important as PHFs are noted to attend to over 60% of the Nigerian population. Thus, it is important to carry out an assessment of the IDSR system in PHFs to forestall a repeat episode and limit the impact of outbreak of infectious diseases in future.

Objective

To investigate the compliance of private health facilities to the integrated disease surveillance and response (IDSR) system in Nigeria.

Wholesome food in adequate quantities is essential to human beings for their existence. However, diseases spread due to contaminated food are a common problem throughout the world and an important cause of reduced economic productivity. Food borne illness can, therefore, be considered a major international health problem and a significant cause of economic loss. Approximately 10 to 20% of food-borne disease outbreaks cause due to contamination by the food handlers. In Sri Lanka, information about food hygiene practices in plantation sector is scarce. Therefore, this study was designed as a preliminary study to identify hygiene practices in food processing in the plantation sector for the establishment of a surveillance system in Sri Lanka.

Objective

To develop a food hygiene surveillance system to improve food safety measures within food establishments in the plantation sector of Sri Lanka

Electronic data that could be used for global health surveillance are fragmented across diseases, organizations, and countries. This fragmentation frustrates efforts to analyze data and limits the amount of information available to guide disease control actions. In fields such as biology, semantic or knowledge-based methods are used extensively to integrate a wide range of electronically available data sources, thereby rapidly accelerating the pace of data analysis. Recognizing the potential of these semantic methods for global health surveillance, we have developed the Scalable Data Integration for Disease Surveillance (SDIDS) software platform. SDIDS is a knowledge-based system designed to enable the integration and analysis of data across multiple scales to support global health decision-making. A ‘proof of concept’ version of SDIDS is currently focused on data sources related to malaria surveillance in Uganda.

Objective

To develop a scalable software platform for integrating existing global health surveillance data and to implement the platform for malaria surveillance in Uganda.

Zanzibar is comprised primarily of two large islands with a population of 1.3 million. Indoor Residual Spraying (IRS) campaigns, distribution of long-lasting insecticide treated bed nets (LLINs), and use of Rapid Diagnostic Tests (RDTs) have reduced Malaria prevalence from 39% in 2005 to less than 1% in 2011-2012. As malaria burden decreases, there is an increasing need to track and follow up individual cases to contain transmission that could lead to resurgence. One method being used to achieve these aims is reactive case detection (RACD). RACD is generally understood to be triggered whenever a case is identified by passive case detection. The response involves visiting the household of the newly reported case and screening family members. Depending on program protocol, it may also involve screening neighbors within a defined radius. RACD has been used or tested in Cambodia, China, India, Peru, Senegal, Swaziland, Tanzania, and Zambia. RACD can be resource intensive. Several studies raise questions concerning whether and how RACD can be prioritized and targeted effectively as case numbers continue to decline.

Objective

This presentation will share findings from more than three years of using mobile technology for reactive case detection (RACD) to help eliminate malaria in a well-defined geographic area. It will review the concepts of RACD, the application of mobile technology, lessons learned from more than three years of application, and considerations in applying this technology in other malaria elimination contexts.

Champaign County is one of the largest counties in central Illinois with a population of ~207,000 and is home to the University of Illinois at Urbana-Champaign which currently has 44,500 students. In the fall the university hosts Big Ten football games which have recently been drawing an average attendance of ~45,000 people, many traveling from Chicago or other parts of the Midwest. The twin cities host a number of community events and festivals throughout the Spring and Summer. Typically the community festivals have liquor licenses whereas no alcohol is served in the football stadium. Despite the lack of alcohol availability in the stadium many fans drink during tailgate parties before and after the game.

Objective

The objective for this research project was to see if there are predictable patterns for certain annual events in Champaign County, Illinois. The focus was on how alcohol intoxication effected the population and whether or not its effects were dangerous to the community at an alarming rate.

The Public Health Agency of Canada (PHAC) established the Canadian Chronic Disease Surveillance System (CCDSS) in 2009 to facilitate national estimates of chronic disease prevalence, incidence, and health outcomes. The CCDSS uses population-based linked health administrative databases from all provinces/territories (P/Ts) and a distributed analytic protocol to produce standardized disease estimates.

Objective

To describe the process, benefits, and challenges of implementing a distributed model for chronic disease surveillance across thirteen Canadian jurisdictions.

Stemming from the 2014-6 Ebola virus disease (EVD) outbreak, community event based surveillance (CEBS) was implemented in Sierra Leone using community health workers to generate alerts for trigger events suggestive of EVD transmission. Through September 30, 2015 (last month of active EVD transmission), the majority (86%) of alerts reflected community deaths; this was beneficial as Ebolarelated deaths were detected with delay during the epidemic’s peak. The Government had implemented a policy of mandatory swabbing and testing of all dead bodies. The policy changed on June 30, 2016 wherein only swabbing of deaths deemed to be high-risk for EVD is required. To assess whether this policy change has begun to affect community death reporting, we analyzed trends in death reporting before and after the policy change.

Objective

To assess whether the change in death swabbing policy in Sierra Leon has begun to affect community death reporting, we analyzed trends in death reporting before and after the policy change

Syndromic surveillance systems are large and complex technology projects that increasingly require large investments of financial and political capital to be sustainable. What was once a minor surveillance tool in the mid-2000s has evolved into a program that is regarded as valuable to public health yet is increasingly difficult to maintain and operate for local health departments. The Houston Health Department installed a syndromic surveillance system (SyS) six years before Meaning Use became known to healthcare communities. The system chosen at the time was the Real-time Outbreak Disease Surveillance System (RODS) which, at the time and for its purpose, was a suitable platform for syndromic surveillance. During the past 13 years however, maintaining, operating, and growing a SyS by a local health department has become increasingly difficult. Inclusion in Meaningful Use elevated the importance and profile of syndromic surveillance such that network growth, transparency of operations, ease of data sharing, and cooperation with other state systems in Texas became program imperatives.

Objective

Describe and explain the transition of the syndromic surveillance program at the Houston Health Department (HHD) from being a locally managed and aging system to an ESSENCE system governed by a regional Consortium of public health agencies and stakeholders in the 13-county area of the southeast Texas

Information and Communication Technology (ICT) can enhance public health surveillance (PHS) by facilitating the digital exchange of information. Electronic surveillance (e-Surveillance) is the use of electronic systems to empower the digitization of PHS functions of prevention, detection, and response. E-Surveillance maximizes compliance with the International Health Regulations (2005), enables efficient Integrated Disease Surveillance and Response, and empowers One Health.

In Africa, e-Health is hindered by donor-funded, short-term projects known as “pilotitus.” Proactive national leadership is required to establish a sustainable e-Surveillance program; an assessment and a strategic plan are the first steps.

Therefore, the One Health e-Surveillance Initiative (OHSI) was conceived and piloted by Public Health Practice, LLC (PHP) and the African Field Epidemiology Network (AFENET), with support by the Defense Threat Reduction Agency and the U.S. Centers for Disease Control and Prevention (CDC).

Objective

1) To establish One Health workgroups and conduct an e-Surveillance assessment to inform national strategic planning efforts in pilot countries. 2) To provide evidence for the African Surveillance Informatics Governance Board (ASIGB) to address its mission of establishing e-Surveillance.