Public Health Surveillance

Public health surveillance is the systematic on-going collection, collation and analysis of data and the timely dissemination of information to those who need to know so that action to be taken (WHO). Public health surveillance differ from research surveys as many of the individuals may get confused. The research surveys mojar at hypothesis-testing, it is one time and involves specific health use. On the other hand public health surveillance involves hypothesis generating, on-going process and looks at a broader context of disease in terms of trends and patterns across health issues. Public health survelliance is considered as a repetetive process due to the activities that are involved. Data is first collected, analysed then interpreted. The interpreted information is then disseminated for appropriate action or intervention to be taken. The process is repeated everal times for appropriate identification and control of problems associated with non-communicable diseases(NCDs).

There are many ways of structuring a given surveillance system. The collection of data for surveillance system have 2 approaches i.e. active and passive data collection systems. A good surveillance sytsem should have the following properties:

• Simple in terms of structure and operation
• Flexible in that it accommodate new issues, technology and reporting requests
• Acceptable to the individuals so that most people develop willingness to participate
• Sensitive to capture all cases and monitor trends of diseases in a population
• Representative of the whole population by avoiding sellection bias
• Reliable through stable provision of accurate information when in need
• Collaborative through partnering with other sectors
• Coordinated through agreements

However the priority data sources for NCDs surveillance involves: vital registries, disease registries, on-going periodical health surveys, administrative data and sentinel surveillance. The general surveillance system can be categorised boadly as follows:

This mode of surveillance system requires the use of attention to the methodology such as the use of standard protocols, supervision of interviewers, comparable sampling strategy and use of standardised questionnaires. It arises from repetitive use of population-based surveys. It requires a proper definition of the target population from which the results can be careully be obtained. An example of this type of surveillance system is in the case of tobacco use that has direct link to the lung cancer causal among populations smoking cigarrete. This is done through surveys conducted in different countries for a long period of time.

Sentinel surveillance system involves a prearranged sample of reporting sources reporting all cases of defined conditions, which might indicate trends in entire target population (Birkhead and Maylahn 2000). It enables prompt and flexible monitoring and investigating suspected public health problems if properly implemented. However, it might pose problems in identification if the selected sites are the representative of a larger population. It might be sometimes be expensive and requires much of resources. It is advantagious since it ensures collection of more information on risk factors of particular diseases. An example of a disease that can be monitored through sentinel surveillance is diabetes where individuals having conditions that are associated by diabetes are identified recorded and introduced to the right interventions.

Laboratory tests are the goldstandards for measuring the nature of disease development in population. The laboratory-based surveillance involves looking into different tests for different non-communicable diseases. Those conditions passing the threshold limit recommended for certain conditions are considered as threats and the right action is taken against them. An example of laboratory-based surveillance is checking on the level of pressure, measuring body weight and blood sugar level to determine the development of diabetes and hypertension. This type of surveillance involves microbiological diagnosis done routinely on the samples of patients hence requires resources, facilities and training.

According to WHO 2000, non-communicable diseases caused approximately 60 percent of the deaths in the wold and 43 percent of the global burden of disease. WHO also predicted that the burden of disease from NCD for developing and newly industrialised countries will have increased more than 60 percent by 2020 (Murray & Lopez 1996). Therefore this prompted to the actions being taken against the increasing cases of NCDs. To ensure that best disease surveillance is done Word Health Organisation has improved on the data collection that is done inconsistently from different countries to monitor the progress of NCDs among the individuals. The most global concerns on non-communicable diseases include hypertension, elevated blood sugar, tobacco use, excessive alcohol consumption, obesity and cancer of different organs. Henceforth, the major functions of the public health surveillance on the NCDs include:

This occurs from a series of events whereby it involves detecting changes in disease and risk factor occurrence and distribution. The data on the change variation can be obtained from health facility data or conducting screening program. The change in the risk factor can be increased alcohol usage, reduced physical activity or tobacco use that might expose individuals to NCDs. The information obtained is through stimulation of public health research on the particular diseases through evaluation of their cause, outcome, prevention and control so that to promote quality of life.

Through carrying out surveillance programmes institutions, organizations or countries are able to plan for their future activities. This can be done through considering resource allocation to suite best the eradication of the diseases. Through surveillance the countries are also able to plan on setting up health facilities that might help in tertiary disease prevention of these diseases. Public health surveillance provide scientific data essential to informed decision making and sound public health actions by guiding the interventions administered.

All in all surveillance is the best method that helps in the accurate monitor of diseases thereby reducing their impacts to populations. However, there are some obstacles that limit this from taking place effectively. The problems facing the surveillance systems include lack of resources and infrastructure which has impact on data collection and transmission mechanism, lack of training capacity and limited availability of needed technology. Other obstacles on surveillance are low priority on NCD due to low political will to address the situation and unenthusiastic system participants. However, this obstacles can be minimised through proper planning and developing positive attitude towards surveillance at it helps in disease control.

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