Transcript 7- Report of Surveillance committee
VPD SURVEILLANCE IN INDIA
Idsurv Way Forward
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Dissemination Consensus on Case Definitions Alert System ? More VPDs Analysis
SURVEILLANCE SYSTEMS IN INDIA
System IDSP
(Integrated Disease Surveillance Project)
Description / Salient features
Nationwide
outbreak
surveillance system. Including Measles, Diphtheria, Pertussis, AFP, Hepatitis and AES.
Remarks
Sustainable system but variable state ownership. Data does not capture age and immunization status. Lab component weak. In transition.
CBHI/SBHI
(Central and State Bureaus of Health Intelligence) Nation-wide
passive
reporting system of suspected cases All VPDs under traditional EPI are reportable. Extremely variable completeness, data quality and reliability. Annual updates.
System Measles: ICMR AES/JE: NVBDCP and ICMR
Surveillance systems in India
Description / Salient features Remarks
Selected practitioners and institutions provide clinical samples to NIV-Pune for measles virus isolation and genotyping.
Facility based surveillance for acute encephalitis syndrome in endemic areas.
ICMR provides lab support.
Laboratory based surveillance by NIV in Gorakhpur Strong lab component. Case definition and case inclusion may not be standardized. Not
population based
. Variable sensitivity Many cases of AES without lab diagnosis
Multicenter Pneumonia and Meningitis surveillance
Established in preparation for Hib vaccine probe study in Chandigarh, Kolkata & Vellore
Sentinel
reporting sites Etiologic diagnosis of pnuemonia and meningitis in children < 2years
PNEUMO SURVEILLANCE IN INDIA
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In India surveillance data is being collected since 1993 as part of Invasive Bacterial Infection Surveillance (IBIS) from 6 centers coordinated through India Clinical Epidemiology Network (IndiaCLEN).
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Since April 2004, the IBIS project was continued in India as part of the South Asian Pneumococcal Alliance (SAPNA) project with additional centers in Nepal and Sri Lanka.
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SAPNA was funded by Global Alliance on Vaccine and Immunization (GAVI) and through the Accelerated Development and Implementation Plan (PneumoADIP) at John's Hopkins School of Public Health.
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From April 2011, Surveillance is being carried out only at one site (Christian Medical College, Vellore) and is being funded by the WHO SEARO .
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India is also part of Asian Network for Surveillance of Resistance System (ANSORP), 2011 - For S pneumonia Antibiotic resistance ongoing at CMC Vellore (Dr MK Lalitha / Dr Dilip Mathai )
ASIP
• Since 2011 , 2 nd year of study ongoing .
• Dr Anand Manoharan - Principal Investigator , CMC Vellore • It is a surveillance of invasive disease caused by
S. pneumoniae
or
H. influenzae
or
N. meningitidis
in children <5 years of age in India.
• Institutional arm – 18 institutes and sentinel arm – 58 doctors representing the whole country
PneumoNET study - Pan Asia Epidemiologic surveillance network to assess the burden of invasive pneumococcal disease (IPD)
• Two -year active, prospective, hospital-based surveillance study of IPD and pneumonia ( Feb 27, 2009 to Feb 26, 2011) • 3 hospitals in Bangalore South Zone, India: Kempegowda Institute of Medical Sciences Hospital, Vani Vilas Hospital, and the Indira Gandhi Institute of Child Health • Children aged 28 days to <60 months
ISSUES IN PNEUMO SURVEILLANCE
• • • • • • • Good Case definition required Robust Diagnostic methods to improve bacteria yield Coordination and regular follow-up needed for long term surveillance Need for Laboratory support with trained personnel Financial support : Cost intensive study Logistics support for timely delivery of samples Sustaining the momentum of recruitment of cases by sites
ROTAVIRUS SURVEILLANCE NETWORK- INDIA
• • • • The Indian Rotavirus Strain Surveillance Network: 4 labs and 10 hospitals in 7 regions.
Children <5 years admitted with acute gastroenteritis and given rehydration for at least 6 h enrolled. A fecal specimen is tested for rotavirus using a commercial enzyme immunoassay, and strains characterized using rtPCR.
Dr Gagandeep Kang – CMC Vellore The Journal of Infectious Diseases : 2009:S147–53
• Disease burden study - Epidemiology of rotavirus in North India Community - study designed to support site preparation and to conduct a disease burden study for the planning and implementation of the phase III trials for the oral rotavirus vaccine 116E. Conducted by
Society for Applied Studies .
• Multicenter prospective Hospital-based surveillance of rotavirus gastroenteritis in children ≤ 59 months of age currently ongoing in India – Supported by
Shantha Biotech
TYPHOID SURVEILLANCE IN INDIA
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NICED
in collaboration with International Vaccine Institute, Seoul, Korea initiated a project titled “Surveillance for typhoid fever and cholera in eastern Kolkata, West Bengal, India” in 2002, in preparation for field trials of vaccines against these two diseases.
• It is basically a healthcare facility-based passive surveillance; nested case-control studies done among urban slum population (60,000) of Kolkata in ward 29 and 30.
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IDSP
( Integrated Disease Surveillance Programme ) also undertakes typhoid surveillance in India
ISSUES IN ROTA & TYPHOID SURVEILLANCE
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