Technical Guidelines for Integrated Disease Surveillance ... - PHRplus

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Public health action Case finding and contact tracing Treatment of cases and chemoprophylaxis of contacts Individual treatment of cases and contacts Mass treatmentTotal mass treatment (TMT) for prevalence of active yaws above 10% in anarea, all persons living there receive treatment (Hyper-endemic zone).Juvenile mass treatment (JMT) for prevalence of active yaws between 5 and10% in an area all persons ages 1-15 years as well as contacts receivetreatment (Mesoendemic).Selective mass treatment (SMT) for prevalence active yaws less than 5% in anarea, members of households and other obvious contacts of infectiouscases (e.g. classmates) receive treatment. Community health education on personal hygieneAnalyse and interpretdataTime:Place:Graph number of cases monthly.Plot location of affected households, communities and districts.Person:Count monthly cases. Calculate the proportion of persons affected in aparticular community. Analyse age distribution.ReferenceGuidelines for the management and control of yaws, Disease Control Unit, Ghana HealthService, October 2000.Yellow feverBackground Viral hemorrhagic disease caused by a flavivirus transmitted human-to-human viaAedes mosquitos (urban epidemics) or via forest mosquito species and forest primatereservoirs (jungle cycle). Large-scale outbreaks every 3 to 10 years in villages or cities. Sporadic cases canoccur regularly in endemic areas. Resurgence of disease in Africa since mid-1980s.True incidence far exceeds reported cases. Incubation period 3 to 6 days after the bite from an infected mosquito (aedes aegypti). While only the minority of cases are severe, case fatality rate may be 25% to 50%among patients with syndrome of hemorrhage, jaundice and renal disease. Risk factor: sporadic cases often linked to occupation or village location near woods orwhere monkeys are numerous. Also non-vaccinated persons. International reporting to WHO required within 24 hours.VHF and other infections causing haemorrhage may mimic yellow fever.Surveillance goalCase definitionDetect haemorrhagic fever cases and outbreaks promptly, and seek laboratory verificationof the etiology of all cases of suspected yellow fever. (Other viral haemorrhagic fevers,dengue, anthrax, leptosspirosis, rickettsial diseases, malaria, and other infectious agentsand toxic exposures may cause similar epidemics.)Suspected case:A person with acute onset of fever followed by jaundice within two weeks of onset of firstsymptoms. Haemorrhagic manifestations and renal failure may occur.Confirmed case:A suspected case with laboratory confirmation (positive IgM antibody or viral isolation) orepidemiologic link to confirmed cases or outbreaks.Respond to alertthresholdIf a single case is suspected: Report case-based information immediately to the next level. Treat and manage the patient with supportive care administered under a bednet (ORSfor dehydration, paracetamol for fever) and strict isolation procedures.114Technical Guidelines for Integrated Disease Surveillance and Response in Ghana
Respond to epidemicthresholdCollect specimen for laboratory confirmation.Investigate the case to determine how transmission occured.Plan for an immunization activity.If a single case is confirmed: Mobilise community early to enable rapid case detection and treatment. Conduct a mass campaign in appropriate age group in the area (ages 6 months andolder) and in areas with low vaccine coverage. Identify high-risk population groups and take steps to reduce exposure to mosquitos. Improve routine and mass vaccination campaigns to include yellow fever in high-riskareas.Analyse and interpretdataTime:Place:Graph cases and deaths monthly. During an outbreak, graph cases anddeaths daily. Construct an epidemic curve during outbreaks.Plot location of case households and occupation with precise mapping.Person:Report immediate case-based information for cases and deaths. Reportsummary totals monthly. During outbreak, count cases and deaths weekly.Analyse by age. Assess risk factors to improve prevention of sporadicoutbreaks.Reference District guidelines for yellow fever surveillance. WHO 1998Section 9: Summary Guidelines for Specific Priority Diseases and Conditions115
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Technical Guidelines forIntegrated
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3.3.1 Review the updated charts, ta
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7.1.2 Monitor timeliness and comple
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List of TablesTable 1: Surveillance
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AcronymsAFROAFPAIDSCBSCBSWCDCDHMTE-
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An ill person presents to medical a
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How are surveillance functions desc
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4.0 Investigate** 5.0 Respond 6.0 P
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National4.0 Investigate** 5.0 Respo
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In general, the health of Ghanaians
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How does Ghana’s MOH/GHS support
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1.0 Identify Cases of Priority Dise
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1.2 Improve district procedures for
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Section 2Report Priority Diseases a
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Name of diseaseRoutine summary repo
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Identify and train CBS volunteers o
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Clinicians, ward nurses or other re
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3.0 Analyse DataAnalysing trends of
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3. Label all the rows and columns,
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Figure 4: Meningitis cases from Bol
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The first step in analysing data by
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3.2.3.3 Calculate case fatality rat
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Table 6: Alert and epidemic/action
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3.4 Use the analysis results to imp
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4.0 Investigate Reported Outbreaks
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4.4 Prepare to conduct an investiga
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Review laboratory results with the
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Draw a histogram representing the c
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If the shape of the curve suddenly
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5.0 Prepare and Respond to Outbreak
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Periodically review and update othe
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3. Select appropriate communication
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Improve safe disposal of human wast
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Table 7: Daily water needs per pers
Page 78 and 79: Recommendations for improving epide
Page 80 and 81: 6.0 Provide FeedbackData are report
Page 82 and 83: The newsletter can be produced simp
Page 84 and 85: 7.0 Evaluate and Improve Surveillan
Page 86 and 87: Table 8 lists possible indicators t
Page 88 and 89: Priority diseases are recorded in t
Page 90 and 91: Indicators for measuring quality of
Page 93 and 94: Section 8Community-based Surveillan
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Page 97 and 98: Participate in information dissemin
Page 99 and 100: Section 9Summary Guidelines for Spe
Page 101 and 102: Analyse and interpretdataReferenceT
Page 103 and 104: Buruli UlcerBackground Buruli ulce
Page 105 and 106: Cholera may cause severe dehydratio
Page 107 and 108: Respond to epidemicthresholdIf a su
Page 109 and 110: In Ghana, the disease was endemic i
Page 111 and 112: ReferenceA guide to eliminating lep
Page 113 and 114: Promote environmental sanitation: c
Page 115 and 116: Surveillance goal Use a rapid late
Page 117 and 118: OnchocerciasisBackground Filarial
Page 119 and 120: Poliomyelitis (Acute flaccid paraly
Page 122 and 123: Public health action Conduct activ
Page 124 and 125: The global HIV pandemic has been a
Page 126 and 127: Respond toepidemicAnalyse and inter
Page 131 and 132: Annex 1Using Assessment Results to
Page 133: Tally, compile and report summary t
Page 136 and 137: Diseases of special public health f
Page 138 and 139: Pneumonia in childrenless than 5 ye
Page 140 and 141: Other diseases of public health imp
Page 143 and 144: Annex 5Laboratory Tests for Confirm
Page 145 and 146: Suspected disease orconditionCholer
Page 147 and 148: Suspected disease orconditionDiagno
Page 153: Annex 6List of Laboratories for Con
Page 157 and 158: Annex 8Case-based Surveillance Repo
Page 159 and 160: If laboratory specimen collectedFor
Page 161: 16. When the investigation of the c
Page 164 and 165: (For reporting from health facility
Page 166 and 167: 13. For vaccine-preventable disease
Page 169 and 170: Annex 11Total Number of Patients Se
Page 171: Annex 12Year ___________ Quarter __
Page 174 and 175: Analysis, interpretations, comments
Page 176 and 177: C. Location of Lesion(s)19. Upper l
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Annex 15Monthly Registration of Bur
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Classification a Location of Lesion
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Annex 17Managing Public Health Surv
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Annex 19Sample Tables for Person An
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Annex 20Log of Suspected Outbreaks
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Instructions for filling suspected
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INITIAL CLINICAL HISTORYPlease use
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SPECIMEN COLLECTIONDate Sent toDate
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186Technical Guidelines for Integra
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188Technical Guidelines for Integra
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Annex 25Treat Cases During an Outbr
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Also give home-based fluids as foll
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3. Give vitamin A to children with
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Annex 26Preparing Disinfectant Solu
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If the health facility does not kee
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Message:DO YOU PREPARE FOOD SAFELY?
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Reducing exposure to mosquitoesPERS
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Annex 30Estimating Vaccine Supplies
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Annex 31Recommended Immunization Pr
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Lab analysis and results:With text,
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District Epidemic Management Commit
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Annex 35Checklist for Supervising S
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Activity Supervisory Question Answe
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Annex 36Indicators for Monitoring t
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