Surveillance Flashcards

1
Q

What is surveillance?

A

Systematic ongoing data collection

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2
Q

Give 5 reasons why surveillance may be carried out

A

Determine the impact of disease
Detect changes in disease patterns and gather timely feedback
Monitor effectiveness of preventative/control measures
Identify outbreaks
Detect new disease
Monitoring and evaluation
Gives aetiological clues

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3
Q

Give 4 examples where surveillance would be essential

A

Identifying the effects of a mass vaccination programmes
Effect of introducing sanitation/clean water supplies on diarrhoea
Controlling an epidemic by withdrawing contaminated food
Monitoring Legionnaries after a law on maintenance of cooling towers

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4
Q

Why can surveillance not be solely relied on?

A

It only gives a proxy measure of disease
If it covers a large area/population it is likely to miss small changes
Rarely able to measure disease incidence

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5
Q

What is passive surveillance and when is it used?

A

Routine data collection from lab tests

Most commonly used -for diseases with background rates

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6
Q

What is sentinel surveillance and when is it used?

A

Use of reporting sources at different sites across an area

Works best for common diseases

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7
Q

What is enhanced surveillance and when is it used?

A

Certain regions are selected to report on a certain disease within a certain time period - quite specific and suitable for common infections (TB, meningitis, influenza etc.)

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8
Q

What is active surveillance and when is it used?

A

When active completeness of reporting is required - involved reporting known cases and also reported number of no cases

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9
Q

What are the main stages of a surveillance programme?

A
  1. Data collection - needs a case definition and known sources of data and method of collection
  2. Data analysis-use epidemiologist to show stats
  3. Interpretation - look for true trends, risk factors and decide on if something is an outbreak
  4. Response - preventative and control measures to limit spread of disease
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10
Q

What could be the reason for changes in surveillance data?

A

A true change in incidence of a disease (due to an outbreak or seasonal variation)
Artefactual - incorrect recording of data
Change in diagnostic metod
Change in observer/data collecter
Random variation

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11
Q

Name 5 diseases that may require international surveillance

A
Legionnaires
E.coli
Salmonella
Cholera
SARS
hep A
Meningococcal infection
AIDS/HIV
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12
Q

What about a disease may surveillance be reporting?

A

Morbidity
Mortality
Lab results - incidence
Outbreak

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13
Q

What are a vaccine may surveillance be reporting?

A

Utilisation
Efficacy
Side-effects

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14
Q

What factors of a disease must be considered in surveillance implementation?

A

Biological functions of the disease
Biological changes in an agent of disease
Reservoirs of the infection
Vectors of the infection
Environmental/occupational factors affecting the disease
Social disease determinants/lifestyle

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15
Q

What are the advantages and disadvantages of passive surveillance?

A

Advantages - relatively cheap, enables constant monitoring and data collection
Disadvantages - incompleteness, inaccuracy and timeliness (units not reporting on time)
If reporting behaviour changes this can change incidence rates which don’t reflect a true change in incidence

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16
Q

What are the advantages and disadvantages of sentinel surveillance?

A

Usually sentinel general practices have an incentive so may be more reliable in reporting
Works well for viral GE, chickenpox, influenza (common)

Works less well for rare diseases

17
Q

Give 5 situations where active surveillance is likely to be useful

A

Rare conditions
Serious/highly contagious disease - SARS, Ebola
Monitoring vaccine failure eg: Hib
If the goal is disease eradication eg: Polio in Nigeria
If public health interventions are required eg: meningococcal disease in the UK

18
Q

Why is influenza not notifiable?

A

Difficult to clinically diagnose
Could overwhelm surveillance systems during epidemics/pandemics
No urgent action that can be taken

19
Q

What type of surveillance is influenza likely to be under and why?

A

international - due to risk of pandemics

20
Q

What type of surveillance is used for STIs?

A

Sentinel - use of GUM clinics

21
Q

What type of surveillance is necessary for HCAIs?

A

Continuing passive - mandatory to report organisms causing HCAIs