scholarly journals Disease Surveillance by Private Health Providers in Nigeria: A Research Proposal

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Olusesan A. Makinde ◽  
Clifford O. Odimegwu
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
International Health ◽  
Healthcare Services ◽  
Health Providers ◽  
Factors Affecting ◽  
Disease Surveillance System ◽  
Surveillance And Response ◽  
The Impact ◽  
Suspicious Case

A large proportion of Nigerians access healthcare services in private health facilities (PHFs) but the compliance of these PHFs to the mandatory disease surveillance and reporting - a means of implementing the international health regulation of 1969 - has not been established. The recent Ebola outbreak spread to Nigeria and revealed challenges in the efficiency of the surveillance system after a suspicious case presented at a PHF. The impact of an inefficient disease surveillance system can be far reaching. Thus, we propose a study to investigate and understand factors affecting compliance of these PHFs to the country disease surveillance and response system.

scholarly journals Infectious Disease Reporting and Outbreak Management Improvement Project

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Donald E. Brannen ◽  
Melissa Branum ◽  
Amy Schmitt
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Reporting System ◽  
Median Number ◽  
Clinical Services ◽  
Disease Reporting ◽  
E Coli ◽  
Disease Surveillance System ◽  
The Impact

ObjectiveImprove disease reporting and outbreak mangement.IntroductionSpecific communicable diseases have to be reported by law withina specific time period. In Ohio, prior to 2001, most of these diseasereports were on paper reports that were reported from providers tolocal health departments. In turn the Communicable Disease Nursemailed the hardcopies to the Ohio Department of Health (ODH).In 2001 the Ohio Disease Reporting System (ODRS) was rolled out toall local public health agencies in Ohio.1ODRS is Ohio’s portion ofthe National Electronic Disease Surveillance System. ODRS shouldnot be confused with syndromic surveillance systems that are fordetecting a disease outbreak before the disease itself is detected.2Chronic disease surveillance system data has been evaluated forlong term trends and potential enhancements.3However, the use ofcommunicable disease reports vary greatly.4 However, the exportdata has not routinely been used for quality improvement purposesof the disease reporting process itself. In December 2014, GreeneCounty Public Health (GCPH) begain a project to improve reportingof communicable diseases and the response to disease outbreaks.MethodsInitial efforts were to understand the current disease reportingprocess: Quantitative management techniques including creating alogic model and process map of the existing process, brainstormingand ranking of issues. The diseases selected to study included:Campylobacteriosis, Cryptosporidiosis, E. coli O157:H7 &shiga toxin-producing E. coli, Giardiasis, Influenza-associatedhospitalization, Legionnaires’ disease, Pertussis, Salmonellosis,and Shigellosis. The next steps included creating a data collectionand analysis plan. An updated process map was created and thepre- and post-process maps were compared to identify areas toimprove. The median number of days were compared before andafter improvements were implemented. Modeling of the impact ofthe process improvements on the median number of days reportedwas conducted. Estimation of the impact in healthy number of daysderived from the reduction in days to report (if any) were calculated.ResultsProcess improvements identified: Ensure all disease reportersuse digital reporting methods preferably starting with electroniclaboratory reporting directly to the online disease reporting system,with other methods such as direct web data entry into system, faxinglab reports, orsecure emailing reports, with no or little hard copy mailing;Centralize incoming email and fax reports (eliminating process steps);Standardize backup staffing procedures for disease reporting staff;Formalize incident command procedures under the authorized personin charge for every incident rather than distribute command betweenenvironmental and clinical services; and place communicable diseasereporting under that single authority rather than clinical services. Thedays to report diseases were reduced from a median of 2 to .5 days(p<.001). All the diseases were improved except for crytosporodiumdue to an outlier report two months late. The estimated societalhealthy days saved were valued at $52,779 in the first eight monthsafter implementation of the improvements.ConclusionsImprovements in disease reporting decreased the reporting timefrom over 2 days to less than 1 day on average. Estimated societalhealthy days saved by this project during the first 9 months was$52,779. Management of early command and control for outbreakresponse was improved.

scholarly journals Institutionalising wastewater surveillance systems to minimise the impact of COVID-19: cases of Indonesia, Japan and Viet Nam

2020 ◽  
Author(s):  
T. Takeda ◽  
M. Kitajima ◽  
N. T. T. Huong ◽  
A. S. Setiyawan ◽  
T. Setiadi ◽  
...  
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Current Status ◽  
Viet Nam ◽  
Surveillance Systems ◽  
Rapid Rate ◽  
Disease Surveillance System ◽  
The Impact ◽  
Potential Tool ◽  
Actual Prevalence

Abstract This mini review describes the current status and challenges regarding institutionalisation of wastewater surveillance systems against COVID-19. Monitoring SARS-CoV-2 in wastewater has been proposed to be a potential tool to understand the actual prevalence of COVID-19 in the community, and it could be an effective approach to monitor the trend during the COVID-19 pandemic. However, challenges to institutionalise wastewater surveillance systems are still abundant and unfolding at a rapid rate given that the international understanding regarding the scientific knowledge and socio-political impacts of COVID-19 are in the developing stages. To better understand the existing challenges and bottlenecks, a comparative study between Japan, Viet Nam, and Indonesia was carried out in the present study. Through gaining a better understanding of common issues as well as issues specific to each country, we hope to contribute to building a robust multistakeholder system to monitor SARS-CoV-2 in wastewater as an effective disease surveillance system for COVID-19.

MO487DYSNATRAEMIA AND ASSOCIATED MORTALITY RISK THRESHOLDS ARE MODIFIED BY KIDNEY FUNCTION IN THE IRISH HEALTH SYSTEM: THE NATIONAL KIDNEY DISEASE SURVEILLANCE SYSTEM (NKDSS)

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Conor Walsh ◽  
Leonard Browne ◽  
Austin Stack
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Mortality Risk ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Optimal Range ◽  
Disease Surveillance System ◽  
All Cause Mortality ◽  
The Impact

Abstract Background and Aims Dysnatraemia is associated with increased mortality risk in the general population, but it is unclear to what extent kidney function influences this relationship. We investigated the impact of dysnatraemia on total and cardiovascular (CV) mortality while exploring the concurrent impact of chronic kidney disease. Method We utilised data from the Irish Kidney Disease Surveillance System (NKSS) to explore the association of serum sodium (Na+) (mmol/L) and mortality in a longitudinal cohort study. We identified all adult individuals (age &gt; 18 years) who accessed health care from January 1st, 2007 and December 31st, 2013 in a regional health system with complete data on serum Na+, associated laboratory indicators and vital status up to 31st December 2013 (n = 32, 686). Patients receiving dialysis were excluded. The primary exposure was serum Na+ first recorded during the study period for each patient with a concurrent serum glucose measurement. Chronic kidney disease was defined as eGFR &lt;60ml/min/1.73m² vs greater recorded at index date. The association of serum Na+ with all-cause (ACM) and CV mortality was explored in categories and as a continuous variable using polynomial splines. Multivariable Cox regression with competing risks determined hazard ratios (HR) and 95% confidence intervals with adjustment for baseline health indicators. Results There were 5,118 deaths (15.7%) over a median follow up of 5.5 years. In multivariable adjusted models, the association of serum Na+ with all-cause and CV mortality followed a non-linear, u-shaped pattern. For all-cause mortality, the optimal range for greatest survival was between 139-146 mmol/L [HR 1.02 (1.00-1.03) and HR 1.19 (1.02-1.38) respectively, while for CV mortality, the optimal range was much narrower at 134-143mmol/L [HR 1.16 (1.02-1.23) and HR 1.09 (1.01-1.89) respectively] (Figure 1). The impact of serum Na+ on mortality was modified by baseline kidney function (p value &lt; 0.001 for interaction). In stratified analysis, the impact of serum Na+ on all-cause mortality was greatly attenuated among patients with GFR&lt; 60 ml/min/m², than above. This pattern was replicated in analyses of CV mortality. Conclusion This study supports the view that hypernatraemia and hyponatraemia are better tolerated with poorer kidney function. The risk thresholds for mortality were much narrower for CV death than all-cause death suggesting that these thresholds be taken into account to inform decision making and therapeutic interventions. Funding source Health Research Board (HRB-SDAP-2019-036), Midwest Research and Education Foundation (MKid)

scholarly journals Advancing GHSA: Lessons learned about strengthening HIS and disease surveillance

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Pia D. MacDonald ◽  
Niamh Darcy ◽  
Rita Sembajwe ◽  
Eileen Reynolds ◽  
Henry Chidawanyika ◽  
...  
Keyword(s):  
Information System ◽  
Health Information ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Health Information System ◽  
Lessons Learned ◽  
Surveillance Systems ◽  
Disease Surveillance System ◽  
Surveillance And Response ◽  
Roll Out

ObjectiveThe objective is to discuss two decades of international experiencein health information and disease surveillance systems strengtheningand synthesize lessons learned as applicable to implementation of theGlobal Health Security Agenda (GHSA).IntroductionRTI International has worked on enhancing health informationand disease surveillance systems in many countries, includingThe Democratic Republic of the Congo (DRC), Guinea, Indonesia,Kenya, Nepal, Philippines, Tanzania, Zambia, and Zimbabwe.Strengthening these systems is critical for all three of the Prevent,Detect and Respond domains within the Global Health SecurityAgenda.We have deep experience in this area, ranging from implementingDistrict Health Information Software (DHIS), electronic medicalrecords, health facility registries, eHealth national strategies,electronic Integrated Disease Surveillance and Response system(eIDSR), mobile real-time malaria surveillance and response, nationalweekly disease surveillance, patient referral system, and communitybased surveillance. These experiences and lessons learned can informwork being done to advance the GHSA.We will discuss several examples, including activities in Zimbabweand Tanzania. RTI has been working in Zimbabwe for over six yearsto strengthen the national health information system. This workhas included the configuration and roll-out of DHIS 2, the nationalelectronic health information system. In doing so, RTI examinedand revitalized the weekly disease surveillance system, improvingdisease reporting timeliness and completeness from 40% to 90%.Additionally, RTI has integrated mobile technology to help morerapidly communicate laboratory test results, a laboratory informationmanagement systems to manage and guide test sample processing,and various other patient level systems in support of health servicedelivery at the local level. This work has involved capacity buildingwithin the ministry of health to allow for sustainable support of healthinformation systems practices and technology and improvements todata dissemination and use practices.Similarly, RTI has worked for more than five years to helpstrengthening the National HIS in Tanzania. These activities haveincluded stakeholder coordination, developing national eHealthstrategy and enterprise architecture, harmonizing indicators,redesigning routine reporting instruments, national DHIS 2 roll-out,information technology infrastructure management and user helpdesk support, reducing the number of parallel information systems,data dissemination and use, development of district health profiles,development of the national health facility registry, and supportingroll-out of the electronic integrated disease surveillance system.MethodsWe will profile selected projects and synthesize critical lessonslearned that pertain to implementation of the GHSA in resourceconstrained countries.ResultsWe will summarize our experience and lessons learned withhealth information and disease surveillance systems strengthening.Topics such as those that relate to advancing the GHSA RealTime Surveillance and Reporting Action Package areas will bediscussed, including: indicator and event based surveillance systems;interoperable, interconnected, electronic real-time reporting system;analysis of surveillance data; syndromic surveillance systems;systems for efficient reporting to WHO, FAO and OIE; and reportingnetwork and protocols in country.ConclusionsOur experience working over the past 14 years in 9 countrieson different HIS and disease surveillance system strengtheningprojects has led to a deep understanding of the challenges aroundimplementation of these systems in limited resource settings. Theseexperiences and lessons learned can inform initiatives and programsto advance the GHSA.

scholarly journals Streamlining Disease Surveillance System implementation in Tanzania: Lessons Learnt

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Green Sadru
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Polio Eradication ◽  
Surveillance Systems ◽  
Health Security ◽  
Disease Surveillance System ◽  
Surveillance And Response ◽  
Different Levels ◽  
Disease Specific ◽  
Global Health Security Agenda

ObjectiveTo support streamlining of VPD surveillance into integrated diseases surveillance and response (IDSR) system in TanzaniaIntroductionTanzania adopted IDSR as the platform for all disease surveillance activities. Today, Tanzania’s IDSR guidelines include surveillance and response protocols for 34 diseases and conditions of public health importance, outlining in detail necessary recording and reporting procedures and activities to be taken at all levels. A total of 15 disease-specific programs/sections in the Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC) are linked to the IDSR, though the extent to which each program uses IDSR data varies. Over the years, IDSR procedures and the structures that support them have received significant government and external resources to maintain and strengthen detection, notification, reporting and analysis of surveillance information. However, with the imminent phasing out of programs (such as the Polio eradication program) that have supported IDSR strengthening and maintenance in the past, resources for surveillance will become more limited and the government will need to identify additional resources to sustain the country’s essential surveillance functions.Maternal and Child Survival Program (MCSP), a USAID Funded Program supported MOHCDGEC managing active and passive surveillance systems in improving coordination and strengthen the system taking into consideration declining resources as well as transitioning to polio end game where most of the financial resources were derived from to support vaccine preventable diseases surveillance. The support complements other Global health security agenda (GHSA) on the key thematic areas (Prevent, Detect and Report) support to the MOHCDGEC and working with the newly formed Emergency Operations Center (EOC) to improve response.MethodsBetween February and November 2018, the MOHCDGEC and MCSP undertook activities to generate information for future plans to strengthen Tanzania’s disease surveillance system to address the Global Health Security Agenda (GHSA): 1) desk review of country’s disease surveillance 2) meetings with stakeholders involved in surveillance; 3) workshop where stakeholders discussed and developed strategies for streamlining disease surveillance; 4) asset mapping to identify assets (human, financial, physical 5) stakeholders meeting to further discuss and agree on future strategies, activities.ResultsThe Disease surveillance system review found the functions for surveillance being implemented at different levels (Figure 1). These include identifying cases; reporting suspected cases, conditions, or events; investigating and confirming suspected cases, outbreaks and events. To facilitate decision making at different levels, it was found that analysing and response are done at all levels. A total of 15 disease-specific programs/sections in the MOHCDGEC are linked to the IDSR, though the extent to which each program uses IDSR data varies.Key strengths and opportunitiesThe government’s adoption of the IDSR platform and the fact that the MOHCDGEC has a dedicated department to monitor IDSR performance has been a great achievement of the program. The system is fully adaptable to support all disease surveillance with clear supervisory structures in place at regional and council levels. At the operational level there is presence of full-time, competent and dedicated government employees and exhibiting awareness of their responsibilities, and resourcefulness. The entire surveillance program benefits from government and external funding for disease-specific surveillance-related programs (e.g. funds for polio eradication and malaria program).Despite the achievements, there are notable challenges faced by the program including disease-specific programs often requiring additional information and opting to set up parallel surveillance systems rather than integrating with the IDSR; surveillance activities often not being considered high priority at council level relative to curative service and/or surveillance not being a line item in budgets; electronic data transmission platforms not being able to support transmission of all e-IDSR data with the result that health facility data (including diseases for immediate notification) may not get reported in weekly transmissions; high turnover of surveillance staff and unsystematic orientation of newly-deployed staff; discrepancies in reported HMIS, IDSR, and disease-specific program data indicating data quality issues.Asset mapping: At the time of the review, the number of staff available varied widely between programs, with the national laboratory and the National AIDS Control program (NACP) reporting the highest number at council level and Immunization and Vaccine Development (IVD) having significant number of persons supporting vaccine preventable disease surveillance. At the time of the review, most of the funds were allocated in capacity building through training and supportive supervision compared to core surveillance function.Key inteventions to streamlining and harmonizing of surveillance Supported the roll out of electronic IDSR to ensure real time surveillance through DHIS2Supported proceedures to establishement of surveillance expert working group (EWG);Development of Term of reference for EWG to guide implementation of IDSR activitiesDevelopment of transition plan highlighting key stakeholders and the support they provide to strengthening surveillance in the country;Development of workplan to guide implementation of agreed recommendations which includes;1. Coordinating activities of all stakeholders involved in surveillance,2. Developing or advocating for an interoperable and harmonized reporting system through DHIS2 that will accommodate the needs ofthe various disease- and event-surveillance programs,3. Promoting synergies at national level so that active surveillance is expanded as appropriate to other diseases and supports casebased surveillance,4. Building capacity of RHMTs/CHMTs in leadership and management to manage human and financial resources and prioritizesurveillance;5. Coordinating and strengthening disease and event-surveillance at community level by having at least one trained focal person at thecommunity for all disease surveillance.ConclusionsStreamlining and strengthening of the surveillance system could be achieved by existing coordination structures within MOHCDGEC. Strengthening IDSR by implementing an interoperable of reporting systems including integration of laboratory data will achieve harmonization, consistency in data and appropriate response. At the Regional and council level, priority activities identified include strengthening coordination, orientation and training for financial and human resources management for surveillance aimed at strengthening surveillance and response teams. The IDSR should strengthen active surveillance to adopt case based surveillance as deemed appropriate for more diseases. A proposed plan for implementing key activities to achieve integration and streamlining of disease surveillance has been developed and it is hoped that resources will be made available for immediate implementation. 

scholarly journals Evaluating the sensitivity of a passive diarrheal disease surveillance system during a post-drought

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Nhlanhla Nhlabatsi ◽  
Vusie Lokotfwako ◽  
Phinda Khumalo ◽  
Siphiwe M. Shongwe-Gama ◽  
Maria Dlamini ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Diarrheal Disease ◽  
Watery Diarrhea ◽  
Health Management Information System ◽  
Passive Surveillance ◽  
Disease Surveillance System ◽  
Surveillance And Response ◽  
Acute Watery Diarrhea

ObjectiveTo evaluate the difference in sensitivity between passive and active diarrheal and malnutrition disease surveillance system post-drought period in SwazilandIntroductionOver the past decade Swaziland has experienced recurring drought episodes. In 2016 the country experienced challenges regarding water supplies in both urban and rural areas due to the drought impact. A rapid health and Nutrition Assessment was conducted in 2016 revealed an increase in number of cases of acute watery diarrhea of all age groups. While there is a high demand for epidemiological data in the country a passive system through Health Management Information System (HMIS) and Immediate Disease Notification System (IDNS) has been used to monitor acute watery diarrhea and a set of priority notifiable diseases in the country.MethodsAn active sentinel surveillance system was set up in four regional hospitals for monitoring of all diarrheal cases of the under-fives. A data abstraction form was developed and used to extract data from outpatient registers and inpatient mainly from the children’s ward over a period of 15 weeks. Two surveillance officers trained on Integrated Disease Surveillance and Response (IDSR) collected and analyzed on weekly basis and further compared with data from a passive surveillance system that included the HMIS and IDNS.ResultsWhile acute gastroenteritis was the most prevalent type of diarrheal disease (93%), about 35.5% (1788 in active surveillance vs 1147 passive surveillance) of the cases of diarrheal cases are being underreported in the passive surveillance. Similar observation was made on malnutrition with more than 51% of the cases not reported in passive surveillance (186 cases vs 91 cases).ConclusionsThe process exposed gaps in data collected for passive surveillance and also differing data standards indicating inconsistency and under reporting which may be misleading for public health purposes. Low sensitivity in terms missing cases within the passive surveillance was observed when comparing within the active surveillance sentinel sites. It was also noted that having multiple data sources poses challenges in the country as they provide varying diseases trends and burden estimate.References1. WHO. Integrated Disease Surveillance and Response

scholarly journals Older and Wiser? The Need to Reexamine the Impact of Health Professionals Age and Experience on Competency-Based Practices

2021 ◽  
Vol 7 ◽  
pp. 237796082110290
Author(s):  
Jing Xu ◽  
Kristen Hicks-Roof ◽  
Chloe E. Bailey ◽  
Hanadi Y. Hamadi
Keyword(s):  
Health Professionals ◽  
Online Survey ◽  
Evidence Based Practice ◽  
Core Competencies ◽  
Healthcare Services ◽  
Interdisciplinary Teams ◽  
Evidence Based ◽  
Health Providers ◽  
Cross Sectional ◽  
The Impact

Introduction Delivery of healthcare services makes up a complex system and it requires providers to be competent and to be able to integrate each of the institute of medicine’s (IOM) 5 core competencies into practice. However, healthcare providers are challenged with the task to be able to understand and apply the IOM core competencies into practice. Objective The purpose of the study was to examine the factors that influence health professional’s likelihood of accomplishing the IOM core competencies. Methods A cross-sectional study design was used to administer a validated online survey to health providers. This survey was distributed to physicians, nursing professionals, specialists, and allied healthcare professionals. The final sample included 3,940 participants who completed the survey. Results The study findings show that younger health professionals more consistently practice daily competencies than their older counterparts, especially in the use of evidence-based practice, informatics, and working in interdisciplinary teams. Less experienced health professionals more consistently applied quality improvement methods but less consistently used evidence-based practice compared to their more experienced counterparts. Conclusion There is a need to understand how health professionals’ age and experience impact their engagement with IOM’s core competencies. This study highlights the need for educational resources on the competencies to be tailored to health providers’ age and experience.

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