Surveillance

Surveillance
• Definition: the continuous scrutiny of all aspects of
occurrence and spread of disease that are pertinent to
effective control

• “The continuous scrutiny of the factors that determine

the occurrence and distribution of disease and other
condition of ill health.”

• Prerequisite to the rational design and evaluation of any

disease control programme.

• The ultimate objective of surveillance is prevention.

 Monitoring
• “performance and analysis of routine measurements
aimed at detecting changes in the environment or
health status of population.”

• It also refers to on going measurement of performance

of a health service or a health professional, or of the
extent to with or adhere to advice from health
professionals
• Surveillance goes beyond the passive reporting of
cases.

• It includes laboratory confirmation of presumptive diagnosis

• Finding out the source of infection, routes of transmission

• Identification of all cases and susceptible contacts

• Serological surveillance identifies patterns of current and

past infection.
 Objectives
• To provide information about new and changing
trends in the health status in the population

• To provide feedback which may be expect to modify

the policy and system itself and leads to redefinition
of objectives

• To provide timely warning of public health disasters

so that intervention can be mobilized
• Describing trends and the natural (secular) history of health
problems

• Detecting epidemics

• Providing details about patterns of disease

• Monitoring changes in disease agents through laboratory testing

• Planning and setting health program priorities

• Evaluating the effects of prevention and control measures

• Detecting critical changes in health practices

 Types of Surveillance
• Individual surveillance: This is surveillance of infected
persons until they are no longer a significant risk to
other individuals

• Local population surveillance : e.g., surveillance of

malaria

• National population surveillance: e.g., surveillance of

smallpox after the disease has been eradicated.

• International surveillance : influenza, malaria, poilo

Components of Surveillance Activity
• Collection of data

• Complication of data

• Analysis and interpretation

• Follow up action

• Feed back
Prerequisite of the effective surveillance
• Use of standard case definition

• Ensure regularity of reports and

• The action on reports

Surveillance methods for data collection
• Community level • Surveys and special studies
surveillance
• Case and outbreak
• Routine reporting system investigations

• Active surveillance and • Verbal autopsy

passive surveillance for
malaria
• Laboratory surveillance

• Sentinel surveillance
• Entomological surveillance
 Passive Surveillance
• Gathers disease data from all potential reporting health
care workers
• Do not stimulate reporting
• No reminder or feedback
• Most common in humanitarian emergencies
• Most surveillance for communicable diseases is passive
• Training to health workers in how to complete the
surveillance forms
• The data requested of each health worker is minimal
• Passive surveillance is often incomplete because there are
few incentives for health workers to report.
 Active Surveillance
• Provides stimulus to health care workers in the form of
individual feedback or other incentives
• Reporting frequency by individual health workers is
monitored
• Provided specific feedback and incentives for complete
reporting
• Requires more time and resources
• Often more complete than passive surveillance
• Used if an outbreak has begun or is suspected to keep close
track of the number of cases
• Community health workers may be asked to do active case
finding
 Sentinel Surveillance
• Routine notification system may not identify all cases
of infection or disease

• Method of identifying the missing cases

• Reporting biases can be minimized

• Feed-back information to the providers is simplified

 Sentinel Surveillance
• A sentinel surveillance system selects, either randomly or
intentionally, a small group of health workers from whom to
gather data.

• Requires more time and resources

• Produce more detailed data on cases of illness because the

health care workers have agreed to participate and may
receive incentives

• May be the best type of surveillance if more intensive

investigation of each case is necessary to collect the
necessary
Summary &

Surveillance is a lively line of communication that

works
both ways

A surveillance system counts the same events,

consistently, every day

Surveillance directs decision-making

15
Remember &

Surveillance
is
Information for action

16
THANK YOU