Integrated Disease Surveillance Programme (IDSP) Disease Pattern and its Load on a tertiary level Hospital: A Cross-Sectional Study
Abstract
To strengthen the surveillance system in India, Integrated Disease Surveillance Program (IDSP) was launched in 2004. The frequent occurrence of epidemics even after the launching of the IDSP was an indication toward inadequacy of the system. The aim of the this study was to find out the IDSP disease pattern and load on a tertiary hospital. It was cross-sectional study carried out in hospitals attached to SMS medical College, Jaipur (Rajasthan) India. Weekly report of IDSP in 'P' Form was collected from SMS Medical College, Hospitals. Data related to IDSP diseases were gathered from these reports. These reports were analysed in percentage and proportion. It was observed in this study that among IDSP diseases most common was fever of unknown origin accounting total 93 (23.97%) cases followed by Acute Diarrheal including Ac. Gastroenteritis, Acute Respiratory Infection (ARI) Influenza like illness (ILI), Pneumonia, Malaria, Viral hepatitis etc. Distribution of various IDSP diseases were with significant variation in pediatric and adult population. Among pediatric population ADD was most common whereas in adult population ARIs were most common. Even after launching of more than a decade, a sizable burden of IDSP diseases is there at tertiary level hospital, who could be treated at peripheral health institutes like Sub centre and Primary health centre. So there is a strong need for IDSP disease and its toll free no awareness.
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Introduction
Integrated Disease Surveillance Programme (IDSP) was launched with World Bank assistance in November 2004 to detect and respond to disease outbreaks quickly. The project was extended for 2 years in March 2010 i.e. from April 2010 to March 2012, World Bank funds were available for Central Surveillance Unit (CSU) at NCDC & 9 identified states (Uttarakhand, Rajasthan, Punjab, Maharashtra, Gujarat, Tamil Nadu, Karnataka, Andhra Pradesh and West Bengal) and the rest 26 states/UTs were funded from domestic budget. Programme continues during 12th Plan (2012-17) under NHM. 1
IDSP is a decentralized, state based surveillance program which is intended to detect early warning signals of outbreaks and help to initiate an effective response in a timely manner. It is also expected to monitor progress of on-going disease control programs and help allocate health resources more efficiently. Under this weekly disease surveillance data on epidemic prone disease are being collected from reporting units such as sub centers, primary health centers, community health centers, hospitals including government and private sector hospitals and medical colleges. The data are being collected on ‘S’ syndromic; ‘P’ probable; & ‘L’ laboratory formats using standard case definitions. Presently, more than 90% districts report such weekly data through e-mail/portal (www.idsp.nic.in). The weekly data are analyzed by SSU/DSU for disease trends. Whenever there is rising trend of illnesses, it is investigated by the RRT to diagnose and control the outbreak. States/districts have been asked to notify the outbreaks immediately to the system. On an average, 30-40 outbreaks are reported every week by the States. 553 outbreaks were reported and responded to by states in 2008, 799 outbreaks in 2009, 990 in 2010, 1675 outbreaks in 2011, 1584 outbreaks in 2012, 1964 outbreaks in 2013, 1562 outbreaks in 2014 and 311 outbreaks have been reported till 15th March 2015. District laboratories are being strengthened for diagnosis of epidemic prone diseases. These labs are also being supported by a contractual microbiologist to manage the lab and an annual grant of Rs 2 lakh per annum per lab for reagents and consumables. Till date 29 States (65 labs) have completed the procurement. In addition, a network of 12 laboratories has been developed for Influenza surveillance in the country.1
Conclusion
Most common among IDSP diseases was fever of unknown origin accounting total 93 (23.97%) cases followed by Acute Diarrheal including Ac. Gastroenteritis, Acute Respiratory Infection (ARI) Influenza like illness (ILI), Pneumonia, Malaria, Viral hepatitis etc. Distribution of various IDSP diseases were with significant variation in pediatric and adult population. Among pediatric population ADD was most common whereas in adult population ARIs were most common. It was surprisingly that in a week period 388 cases of IDSP diseases attended at tertiary level hospital, who could be treated at peripheral health institutes like Sub centre and Primary health centre. So there is a strong need for IDSP disease and its toll free 1075 no awareness.