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Disease surveillance at district level: a model for developing countries

T J John1, R Samuel, V Balraj

  • 1Department of Clinical Virology, Christian Medical College Hospital, Vellore, Tamil Nadu, India.

Lancet (London, England)
|November 4, 1998
PubMed
Summary
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A successful district disease surveillance system significantly reduced vaccine-preventable diseases. This cost-effective model, integrating public and private sectors, is replicable in developing nations for disease control and outbreak detection.

Area of Science:

  • Public Health
  • Epidemiology
  • Infectious Disease Surveillance

Background:

  • A decade-long disease surveillance system was established in a district of 5 million people.
  • The system integrated government and private healthcare sectors, including all hospitals.
  • It focused on prompt reporting of various diseases and laboratory surveillance.

Purpose of the Study:

  • To assess the effectiveness and sustainability of a district-level disease surveillance model.
  • To evaluate the impact of the surveillance system on disease incidence and control measures.
  • To determine the replicability of the model in developing countries.

Main Methods:

  • Implemented a system for prompt reporting of childhood vaccine-preventable diseases, encephalitis, meningitis, hepatitis, and rabies.

Related Experiment Videos

  • Conducted sentinel laboratory surveillance for cholera, typhoid fever, malaria, HIV infection, and antimicrobial resistance.
  • Utilized daily computer scanning for case clustering and initiated interventions like immunisation and health education.

    • Main Results:

    • Marked decline in all vaccine-preventable diseases.
    • Steady increase in malaria and HIV infections.
    • Annual system expense was less than one US cent per capita.

    Conclusions:

    • The district-level disease surveillance model demonstrated success and sustainability due to its simplicity, low cost, and integrated approach.
    • The model is highly replicable in developing countries for various public health initiatives, including polio eradication and immunisation program monitoring.
    • Effective disease surveillance is crucial for timely interventions and control of both old and new infectious diseases.