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Surveillance in General; | Centralization of Data: Delay in the Catch of Decision

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Surveillance in General; | Centralization of Data: Delay in the Catch of Decision • Administrative division : 16 regions, 1 Dr DGHOUGHI Nouzha 69 provinces (districts) Dr LAKRANBI Mohammed • Population : 30.695.807 • 646 000 live births per year Epidemiological surveillance is an uninterrupted process of collection, compilation and analysis of data, as well as their broadcasting to the group of those who need to be informed. Obligatory Statement of Diseases List of diseases with obligatory statement Obligatory Statement of Diseases | Diseases subjected to the international health regulations The statement of diseases is a medical treatment which | Diseases that can give rise to one pushed infectious consists in signalling to health authorized authority | appearance or presence of one or of several cases of Other diseases to obligatory statement. certain diseases. She allows so to watch the health state | New diseases returned in obligatory statement of the population and to take the necessary measures. Obligatory Statement of Diseases Obligatory Statement of Diseases 1. Diseases subjected to the international health 2. Diseases that can give rise to infectious increases: regulations Diphtheria, lockjaw, poliomyelitis and PFA | Peste, The measles, whooping cough and tuberculosis, | yellow fever, Malaria, The bilharziose and leprosy, | cholera The AIDS and MST, syphilis firstly - secondary, infections méningococciques Typhoid fever and paratyphoids, TIAC, human rage, trachoma. Obligatory Statement of Diseases Obligatory Statement of Diseases 3. Other diseases with obligatory statement: 4. New diseases returned in obligatory statement: High-pitched articular rheumatism, Illness of Creutzfeldt-Jakob and diseases related, leishmanioses, human coal and brucellose, The severe acute respiratory syndrome (SRAS), viral hepatitises, The haemorrhagic fever of Crimea-Congo, leptospirose, The fever of the Valley of the Rift valley, typhus exanthématique and recurrent fever, The fever of Nile Westerner, gonococcic conjunctivitis of the newborn baby. The hydatidose. Epidemiological surveillance - Morocco | Based on disease reporting: Epidemiological surveillance y Royal Decree: mandatory reporting, y Ministerial note (Arrêtés ministériels) : list of diseases organization to be mandatory reported and procedures, Morocco | Decentralized Surveillance : regional & provincial Units, | Passive or active Surveillance according to the type of the disease | Data aggregate and & case investigation, System existing before 2000 From 2000 | Every program has its own system of surveillance; | passive Surveillance in general; | centralization of data: Delay in the catch of decision. Restructuring of epidemiological | Punctual epidemiological studies. surveillance in Morocco Objectives DECENTRALIZATION | to Ameliorate the quality of the system of surveillance | General Objective: | to Reinforce regional and peripheral competences in epidemiology Decentralize the activities of epidemiology and conflict against | to Implicate the liberal sector diseases at the level of all the regions at the end of plan 2000-2004 | to Reinforce surveillance on borders. | Operational objectives: | Create local databases Discern infectious phenomena, | quick local reaction early and appropriate to epidemics. the training of the regional teams Define working norms | Institute the use of local data for the catch of DECISION Redeploy the personnel of DELM to reinforce regional structures and ACTION at LOCAL AND REGIONAL level Restructure DELM Actions Strategical axles | Systematic working of data and re-rendered at all levels Communication of data by electronic mail | Creation of the Regional Observatories of Epidémiologie | Development of systems of precocious alert and preparation in epidemics (circular ORE / CPE) | to Reinforce surveillance of environment | Restructuring and médicalisation of health services on | to Reinforce surveillance sentry borders Private sector Other diseases: Influenza, trachoma | General implementation of the computer tool at provincial | to Institute a system of monitoring and valuation of the system of and regional level surveillance | Promotion of the research applied in the field of the epidemiology and | Training of the personnel in the surveillance of diseases | Promotion of the education of modules on epidemiological surveillance in faculties and institutes. | Reins production of surveillance. Alert System Required to have simple and practical tools so that the set up system of surveillance is reactive ═► System of epidemiological alert Système d’alerte de la méningite méningococcique, Maroc, années 2006-2007* Date de mise à jour le 26/06/07 ORE: Missions 3,5 2006 2007 3 oTo assure the epidemiological surveillance to the scale of 2,5 the region 2 oTo coordinate the activities of epidemiology oTo create regional data bases 1,5 oTo assure the systematic exploitation of the data, the 1 diffusion / the rétroinformation 0,5 oTo assure the use of the results of the surveillance for the 0 decision and the action to the local level 0 5 4 7 0 6 9 2 2 4 S1 S4 S7 5 S3 S6 S9 S1 S13 S16 S19 S22 S2 S28 S31 S3 S3 S4 S43 S4 S4 S S1 S15 S18 S21 S2 Sem aine s * 2007 : situation à Ratio Limite supérieure Limite inférieure la semaine 24 Distribution of the settings of the ORE/CPE in Surveillance flow chart epidemiology, by regions. Epidemiological National level Surveillance Unit Regional observatory Regional level of epidemiology ORE •Hospitals 2 •Laboratories 3 •Private 4-9 10-19 Provincial level Provincial unit 20-29 CPE of epidemiology 40-49 Primary health Peripheral care units = Data collection = Feed back Weekly cases reporting Data collection & reporting | Software used: Excel – Epi info | Frequency of Reporting : y Immediately notification & investigation: AFP, meningitis y Weekly report: Measles, Pertussis, Diphteria y Monthly report: others (Tetanus, Tuberculosis, Rotavirus…) | Transmission by email: between provincial, regional and national levels. Flue and ARI cases reporting Monthly cases reporting Identification du patient Nom/Prénom :..................................................... Sexe : M /__/ F /__/ Date de naissance : /__/__/ /__/__/ /__/__/__/__/ Age en années :………………………. Préfecture :………………………………………… Commune :………………………………… Circonscription sanitaire :................................... N° du dossier : /__/__/__/ /__/__/ Milieu : Urbain /__/ Rural /__/ Données cliniques et épidémiologiques Data analysis Date du début des symptômes : /__/__/ /__/__/ /__/__/__/__/ Symptomatologie : Eruption maculopapuleuse généralisée : Oui /___/ Non /___/ Température ≥ 38,5 °C : Oui /___/ Non /___/ Toux : Oui /___/ Non /___/ Coryza : Oui /___/ Non /___/ | Systematically done at all levels: Provincial, r (CPE), Conjonctivite : Oui /___/ Non /___/ Vaccination : regional (ORE) and National surveillance Units L’enfant est-il vacciné par la 1ère dose Oui /___/ Non /___/ ère o Si oui, Date de la vaccination par la 1 dose / __/__/ /__/__/ /__/__/__/__/ ème Measles L’enfant est-il vacciné par la 2 dose Oui /___/ Non /___/ ème o Si oui, Date de la vaccination par la 2 dose / __/__/ /__/__/ /__/__/__/__/ | Early warning system: based on the Epidemiological Ratio: Préciser la source de l’information : 1ère dose 2ème dose investigation o Carte vaccinale : /___/ /___/ o Registre : /___/ /___/ Surveillance for Action form o Pas de document : /___/ /___/ Existe-t-il un (des) cas similaire(s) dans l’entourage ? : Oui /___/ Non /___/ Si oui : leur nombre /__/__/ où ? : Famille /___/ Ecole /___/ Voisins /___/ Autre :………………………………. Nombre de cas similaires investigués /___/___/ Données du laboratoire Prélèvement : Non effectué /__/ Pourquoi ?............................................................................................... Effectué /__/ Date /__/__/ /__/__/ /__/__/__/__/ Type de prélèvement : urinaire /__/ sanguin /__/ Rhino-pharyngé /__/ Date d’envoi au laboratoire : /__/__/ /__/__/ /__/__/__/__/ Date de réception du résultat : /__/__/ /__/__/ /__/__/__/__/ Résultat pour la rougeole : Positif /__/ Négatif /__/ Indéterminé /__/ Résultat pour la rubéole : Positif /__/ Négatif /__/ Indéterminé /__/ Evolution (Examen de contrôle 15 jours après la consultation initiale) Guéri /__/ Compliqué /__/ Décédé /__/ perdu de vue /__/ Responsable de l’investigation Nom / Prénom :……………………………………………. Qualité :………………………………………….. Date : /__/__/ /__/__/ /__/__/__/__/ Signature :………………………………. Feed back Feed back | Recommended at all levels (Monthly????): y From the Province to all PHCU : printed reports ROYAUME DU MAROC – MINISTERE DE LA SANTE DIRECTION DE L’EPIDEMIOLOGIE ET DE LUTTE CONTRE LES MALADIES y From the Region to all provinces: by Email Bulletin Epidémiologique y From National to all by: Bilan année 2000 Avril 2001 website: http://www.sante.gov.ma private web: http://Intranet.sante.gov.ma BULLETIN ROYAUME DU MAROC - MINISTERE DE LA SANTE | Quarterly: OBSERVATOIRE REGIONAL D’EPIDEMIOLOGIE REGION SOUSS MASSA DRAA y Regional Epidemiological Bulletin y National Epidemiological Bulletin EPIDEMIOLOGIQUE REGIONAL y “info-rougeole” (Measles) ROYAUME DU MAROC – MINISTERE DE LA SANTE y “info-PFA” (AFP) Préfecture de fès Bulletin Epidémiologique Numéro spécial Avril 2000 Info-PFA, année 2006 Cas Cas Attendus Ratio % Specimens %Fiches Préfectures / Provinces Année 2006 Année 2006 Année 2006 Adéquats Hebdomadaires reçues Oued Ed-Dahab- Laguira 00.390.00 31 Oued Ed-Dahab 0.29 0.00 31 Aousserd 0.09 0.00 Laâyoune-Boujdour-Sakia El Hamra 00.880.00 96 Laâyoune 0.70 0.00 98 Boujdour 0.18 0.00 88 Guelmim- Es-Smara 01.650.00 92 Guelmim 0.55 0.00 96 Tata 0.44
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