Types of Surveillance

By:

Wubareg Seifu (MPH, Asst Professor)

Department of Epidemiology

School of Public Health

Jigjiga University

April, 2023

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 Presentation Content

• Infectious Disease Surveillance

• Syndromic Surveillance

• Nutritional Surveillance

• Occupational Health Surveillance

• Non communicable Disease surveillance

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 Infectious Disease Surveillance
• Infectious disease surveillance is an important
epidemiological tool to monitor the health of a
population.
• The goals of infectious disease surveillance are
threefold:
– (1) to describe the current burden and epidemiology of
disease,
– (2) to monitor trends, and
– (3) to identify outbreaks and new pathogens.
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 1. To describe the current burden and
epidemiology of disease

• Describing the burden and epidemiology (including

seasonality, age distribution, age groups, etc.) of
disease is critical for demonstrating the need and
advocating for interventions, such as vaccination and
mass drug administration.

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• Is also used to detect antimicrobial resistance in
certain pathogens (for example, fluoroquinolone
resistance in gonorrhea) and the circulating strains of
disease, which helps target vaccine interventions (for
example, annual influenza vaccine composition).

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 2. To monitor disease trends
• It assess the impact of interventions like vaccination.
• Disease trends do not only mean the number of cases,
but also the etiology of cases.
• Information garnered from vaccine effectiveness
studies can be coupled with burden and cost
information to describe the cost-effectiveness of
interventions.

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 Individual Reflection

• Describe the following stage of

disease occurrence
–Effective control
–Elimination
–Eradication
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 3. Monitors the control, elimination, and
eradication of diseases.
• Effective disease control:
– refers to reducing the incidence of disease to a desired
level (which will vary depending on the disease)

• Disease elimination:
– is defined as zero disease in a defined geographic area as
a result of control measures.
– progress toward disease elimination requires control
measures to stay in effect
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• Disease eradication:
– is defined as zero disease globally as a result of control
measures, which are no longer required.
– Smallpox is the only human disease and rinderpest is the
only animal disease that have been eradicated from the
world,
– but efforts are underway to eradicate polio and
dracunculiasis.
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 4. Detecting, responding and preventing
outbreaks
• Ongoing surveillance for an outbreak- and epidemic-prone
disease can facilitate early detection of an outbreak, allowing a
more rapid response and therefore mitigation of the outbreak.
• Epidemic meningococcal disease in the meningitis belt in Africa
requires ongoing surveillance to identify outbreaks in the region.
• Cholera surveillance is maintained globally to detect outbreaks
and requires mandatory reporting to the WHO.
• Emerging and reemerging diseases also pose a big risk to public
health.
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 Syndromic Surveillance (SS)
• Is the collection and analysis of health-related data that
indicate symptoms of patients before a diagnosis is
confirmed.
• It aims to detect and monitor health events early and to
mobilize a rapid response.
• Using both clinical and alternative data sources such as
care-seeking rates, insurance claims, laboratory ordering
volume, school and work absenteeism, over-the-counter
drug sales, and internet-based health searches.
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 Application of Syndromic Surveillance

• SS may be a realistic alternative option where lab

diagnosis is not readily available or cost effective.
• Some countries are using health indicators like changes in
weather patterns to predict disease epidemics.
• In countries challenged by inadequate infrastructure,
syndromic surveillance may be used to enhance existing
surveillance and outbreak detection infrastructure.
• Can be undertaken with relatively minimal technology.
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 Nutritional Surveillance
• To watch over nutritional status, in order to make decisions
that lead to improvements in nutrition in populations.

• Has three objectives, primarily in relation to problems of

malnutrition in developing countries:
– to aid long-term planning in health and development

– to provide input for programme management and evaluation;

– to give timely warning of the need for intervention to prevent

critical deteriorations in food consumption.

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• Data come from two main types of source:

– administrative (e.g., clinics and schools) and

– household sample surveys.

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 Occupational Health Surveillance
• Is a system of ongoing health checks among employees.

• These health checks may be required by law for

employees who are exposed to noise or vibration,
ionising radiation, solvents, fumes, dusts, biological
agents and other substances hazardous to health, or work
in compressed air.

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 Objective of Occupational Health
Surveillance
• (a) for the assessment of the health of workers in
relation to risks caused by exposure to chemicals.

• (b) for the early diagnosis of work-related diseases and

injuries caused by exposure to hazardous chemicals.

• (c) for the assessment of the workers' ability to wear or

use required respiratory or other personal protective
equipment.
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 Criteria for conducting occupational health
surveillance includes when

• an individual being exposed to a hazardous substance

that is linked to an identifiable disease of adverse health
effect
• there is reasonable chance that the disease or adverse
health effect may occur under the conditions of work
• there are valid techniques of detecting the disease or
adverse health effect

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Type of occupational health survey

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Analyzing the level of occupation risk

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Healthcare worker assessment during COVID-19 Pandemic

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Worker subject to occupational
surveillance have;

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 Non communicable disease surveillance
• is the ongoing systematic collection and analysis of data to
provide appropriate information regarding
– non communicable disease burden

– the population groups at risk

– risk factors and determinants

– Health system response

• coupled with the ability to track health outcomes and

risk factor trends over time.
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WHO NCDs STEPS

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Rationale for Surveillance of Chronic Disease
Risk Factors

• they have the greatest impact on chronic disease mortality

and morbidity,

• modification is possible through effective prevention,

• measurement of risk factors has been proven to be valid,

• measurements can be obtained using appropriate ethical

standards

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 Modifiable Risk Factors

• There are eight major behavioural and

biological risk factors are included in STEPS
chronic disease risk factor surveillance.

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Major behavioural risk factors:
– Tobacco use

– Harmful alcohol consumption

– Unhealthy diet (low fruit and vegetable

consumption)

– Physical inactivity

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 Major Biological risk factors:

– Overweight and obesity

– Raised blood pressure

– Raised blood glucose

– Abnormal blood lipids and its subset 'raised total

cholesterol

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• The WHO STEPwise approach to surveillance
(STEPS) is the WHO recommended surveillance tool
for:

• chronic disease risk factors and

• chronic disease-specific morbidity and mortality.

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• STEPS is a sequential process.

• It starts with gathering key information on

risks factors with a questionnaire,

• then moves to simple physical measurements and

• then to more complex collection of blood samples for

biochemical analysis.

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STEPwise approach for CNCDs Surveillance

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STEPS Instrument

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Core, expanded and optional items

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