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Sandeep Kumar Panigrahi: Infectious disease surveillance in India

8 Nov, 13 | by BMJ

sandeep_kumar_panigrahiOn the occasion of its Golden Jubilee, the Indian Academy of Paediatrics launched Project “Uday” (meaning Rising), which aims to develop an early warning system for paediatric diseases in India that can be prevented by vaccines. The project, which consists of a reporting system, also aims to generate data on the burden of vaccine preventable diseases and the severe adverse effects following immunisation (AEFI) in India. Diseases covered include diarrhoea, pneumonia, typhoid, tuberculosis, pertussis, dengue, meningitis, and malaria. This project will benefit paediatricians from both public and private practices, as well as volunteer general practitioners, and has already been successfully implemented in the State of Gujurat. The project is planned to expand to other parts of India, including some of the districts in Odisha.

The reporting system allows practitioners to report cases and is made available in three different modes. The first mode of reporting is through the internet where practitioners are able to register and log in at the IDServ website. The webpage gives more information of case definitions, codes for the diseases, immunisation status, and definitions of each disease. Reports are also made available in the form of trend analysis, mapping, and the number of cases reported from the district for various diseases. The second mode of reporting is made available through short messaging services (SMS), which will enable reporting from remote areas without internet access. The final option is through mobile based internet through a mobile webpage.

There are many benefits to this project, which could lead to the collection of unreported data from private practitioners. The first advantage will be that serious adverse effects after immunisation could be tracked early and measures then be taken to prevent that immunisation programme from being hampered anywhere across India [ELSEWHERE IN INDIA?]. Secondly, surveillance will lead to earlier responses.
However, some issues have been observed with the reporting system, which include:

  • Malaria, which is an important infectious disease and at present does not have any vaccine, has been included in the training, but the code for the disease has been left out,
  • Existing ICD-10 codes could have been included, but new codes have been developed,
  • No dropdown menu or option tools are available, which means that a lot of data have to be entered manually, which takes a lot of time,
  • Dependence on memory is required as case definitions and codes do not pop up during entry of surveillance data,
  • When making a report via SMS, any mistyped data can lead to a reporting error leading to data validation becoming an issue,
  • Duplication of data from the same patient can be made by different practitioners submitting a report at different times.

Acknowledgement: I acknowledge Indian Academy of Pediatrics for giving me an opportunity to be a part of the workshop.

Sandeep Kumar Panigrahi is a programme coordinator in community based child health as a deputee of UNICEF.

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