INTRODUCTION Electronic Disease Early Warning System - PowerPoint Presentation

1. INTRODUCTION Electronic Disease Early Warning SystemStake Holders11/25/20121

2. Disease Early Warning System (DEWS)Disease Early Warning System:This is a system for collection, compilation and analysis of healthcare data to detect outbreaks at an early stage and take necessary response measures to prevent or limit its occurrence.Goal: To minimize morbidity & mortality due to Communicable and epidemic prone diseasesObjective: To detect the occurrence of an epidemic in its earliest possible stageSurveillance system adapted in emergency situations and as a routine Focus on Epidemic prone diseasesSimple, sensitive and timely surveillance system11/25/20122

3. Delayed ResponseDAYCASESOpportunity for controlLate DetectionFirst CaseOutbreak Detection and Response – Early Detection

4. Outbreak Detection and Response – Early DetectionRapid ResponseDAYCASESEarly DetectionPotential Cases PreventedFirst Case

5. Electronic DEWS - IntroductionThe use of electronic devices for collection, compilation and analysis of healthcare data to detect outbreaks at an early stage and take necessary response measures to prevent or limit its occurrence.Countries adopted electronic disease surveillance system:United States, Australia, Europe, Africa and Asian countries.11/25/20125

6. Why eDEWSIdentification of national public health threats more promptlyMore timely and accurate disease reportingMay provide platform to facilitate integration of disparate reporting system11/25/20126

7. HOW eDEWS IDEA WORKSGIS MappingDistrict Response TeamProvincial and National ReportsStake HoldersDistrict Validation/Verification ToolsHF (GPRS)Validation sms to HFEpi-AnalysisGovernorate Validation11/25/20127

8. FLOW OF REPORTING11/25/20128

9. REPORTING FLOWElectronic DEWS (Weekly flow)OPDSun-SatMondayHealth FacilityDistrictGHOeDEWS ServerNational levelSaturdayMondayMondayMonday11/25/20129

10. Electronic DEWS Software11/25/201210

11. 11/25/201211Disease/ ConditionCase DefinitionAlert ThresholdOutbreak ThresholdAcute Upper Respiratory InfectionAny person with acute onset of cough with mild fever, runny nose, pharyngitis, laryngitis, otitis, tonsillitis, or bronchitis, with normal breathing and without any danger signs.2 times the mean number of cases of the previous 3 weeks for a given location Not specified until infectious agent is identified Acute Lower Respiratory Infection (pneumonia, bronchiolitis, epiglottitis, croup &severe pneumonia)Children < 5 years: Any child presenting with cough or difficulty breathing and any one of the following: fast breathing (Less than 2 months: > 60 breaths/min; 2 months to 12 months: >50 breaths/min; 12 months to 5 years: > 40 breaths/min), or unable to drink or breastfeed, difficulty to awaken, fits / convulsions, cyanosis, lower chest wall in-drawing or stridor in calm child. 5 years or over: Any person presenting with acute onset of cough, fever, and difficulty in breathing or chest pain which increases with breathing.2 times the mean number of cases of the previous 3 weeks for a given locationCluster of cases in a single location above the alert thresholdAcute Diarrhoea (non-cholera)Any person with acute diarrhoea (passage of 3 or more loose stools in the past 24 hours) with or without dehydration, and which is not due to bloody diarrhea or suspected cholera.2 times the mean number of cases of the previous 3 weeks for a given locationCluster of cases in a single location above the alert thresholdAWD / suspected CholeraAny person aged five years or more with severe dehydration or death from acute watery diarrhea. 1 AWD caseOne lab confirmed cholera case, or a cluster of 6 or more AWD in a single locality Bloody DiarrhoeaAny person having acute diarrhoea with visible blood in the stool.3 or more cases in one locationCluster of 6 or more cases in one location.Suspected Dengue Fever (DF)Any person having acute onset of fever (> 380C) for 2-10 days with at least two of the following manifestations: severe headache, retro-orbital pain, myalgia/ arthralgia, positive tourniquet test.3 or more cases in one locationCluster of 6 or more cases in one location + one lab confirmed DF case Viral Haemorrhagic Fever (VHF: either DHF or CCHF/Chicken Guinea)Any person having acute onset of fever (> 380C) for 2-10 days and platelets <100,000 cells/mm3, with at least one of the following: haemorrhagic or purpuric rash, epistaxis, haematemesis, haemoptysis, blood in stools, other haemorrhagic symptoms and no known predisposing host factors for haemorrhagic manifestations. 1 VHF caseOne lab confirmed case, if CCHF. 6 or more cases in one location + one lab confirmed case, if DHF.Acute viral hepatitis (A & E) / acute jaundice syndromeAny person having acute onset of jaundice (yellow coloration of skin and sclera, dark urine) and severe illness (fatigue, nausea, vomiting, and abdominal pain) and absence of any known precipitating factors.3 or more cases in one location Cluster of 6 or more cases in one location.Suspected MalariaAny person having had recent fever (>38 0 C in the last 48 hours) with or without other symptoms (chills, headache, body aches, nausea, vomiting, diarrhoea), in whom other causes of fever have been excluded. NB severe malaria may also include signs and symptoms related to organ failure.2 times the mean number of cases of the previous 3 weeks for a given location In endemic area, slide positivity rate above 50% or falciparum rate above 40%; In non-endemic area, evidence of indigenous transmission of falciparum. Suspected MeaslesAny person with fever and maculopapular rash and one of the following: cough, coryza or conjunctivitis ORAny person in whom a clinician suspects measles infection.1 suspected case Cluster of 3 or more clinical cases in a single location over a 30 day time period with at least one lab confirmed case Disease/ ConditionCase DefinitionAlert ThresholdOutbreak ThresholdSuspected Meningococcal Meningitis/ Neisseria MeningitisAny person having sudden onset of fever (>38°C axillary) and one or more of the following:-Neck stiffness-Altered consciousness-Other meningeal sign or petechial or purpural rash-In infants under one year of age, suspect meningitis when fever is accompanied by bulging fontanelle.3 or more suspected cases in one location or one confirmed cases of N. meningitides 2 or more lab confirmed meningococcal meningitis cases from a single location Cutaneous LeishmaniasisAny person having skin lesions on the face, neck, arms, and legs (exposed body parts), which began as nodules and turned into skin ulcers, eventually healing but leaving a depressed scar.1 case outside endemic area, 3 cases in endemic area. Cluster of 6 or more cases in one location Suspected PertussisAny person with a cough lasting at least 2 weeks with one of the following:Paroxysms of coughing; or Inspiratory "whoop"; or post-tussive vomiting AND without other apparent cause1 suspected case 5 cases in one locality Probable DiphtheriaA probable case is any person with illness characterized by an adherent membrane on the tonsils, pharynx and/or nose and any one of the following: laryngitis, pharyngitis or tonsillitis.One probable caseOne confirmed case who has been laboratory confirmed by culture or linked epidemiologically to a laboratory confirmed caseNeonatal tetanus (NNT)Suspected case:Any neonatal death between 3 and 28 days of age in which the cause of death is unknown or any neonate reported as having suffered from neonatal tetanus between 3 and 28 days of age and not investigated.Confirmed case:Any neonate with normal ability to suck and cry during the first 2 days of life, and who between 3 and 28 days of age cannot suck normally and becomes stiff or has convulsions or both. Hospital-reported cases are considered confirmed.One case requires investigation for safe birth practices and immunization. NA Suspected SchistosomiasisUrinary schistosomiasis: In endemic areas, Visible hematuria or positive reagent strip for hematuria, or with eggs of S. haematobium in urine (confirmed case)Intestinal schistosomiasis: In endemic areas, non-specific abdominal symptoms, blood in stool, hepato(spleno)megaly (suspected case), or presence of eggs in stools (confirmed case).Five casesNot applicableCASE DEFINITIONS, ALERT AND OUTBREAK THRESHOLDS

12. THANKS11/25/201212