Improved timeliness for reporting of acute diarrhoeal disease under surveillance overtime: Evaluation of integrated disease surveillance programme in North 24 Parganas, West Bengal, India, 2015

Abstract

IntroductionIndia’s Integrated Disease Surveillance Programme (IDSP) in North 24 Parganas District of West Bengal reported outbreaks of acute diarrhoeal diseases (ADD) during 2010-2014 without laboratory confirmation. Hence, we described the surveillance system and evaluated in terms of selected surveillance attributes: simplicity, acceptability, timeliness of reporting of ADD/outbreaks, representativeness, positive predictive value, usefulness. MethodsWe described the surveillance through review of documents, manuals, records and interview of surveillance staff. For evaluation of the surveillance system, cross sectional study was conducted among 95 sampled Auxiliary Nurse Midwives (ANMs), 22 Block Medical Officers (BMOHs) of the District and also abstracted data from records. We developed indicators for surveillance attributes and computed proportions for the same. We computed descriptive statistics for timeliness of reporting. ResultsSeventeen percent (n=15) of first ANMs and six of nineteen medical officers had correct knowledge on ADD case definition. One-fourth of the ANMs reported lack of communication, training, supervision and lack of feedback in preceding six months. Median time taken to intimate district rapid response team (RRT) and to collect specimen from the date of first case reporting was the same day of reporting of index case (Range: 0–2days vs. 0–3 days) during ADD outbreaks in 2014. Of the five reported ADD outbreaks in 2014, one was laboratory confirmed. ConclusionsKnowledge regarding case definition was poor at all level of health workers. Existing supervision and feedback mechanism needs to be improved. Timeliness of reporting to district RRT and specimen collection during outbreak had improved overtime.