14. Surveillance: New Approaches “ Integrated” approach (co-ordination, synergy, between surveillance activities) “ Syndromic” approach (avoid laboratory delay, report what you see, avoid stigma, fill surveillance gaps, stable definition) e.g. AFP instead of polio, urethral discharge instead of gonorrhoea, “ Internet-based” surveillance (national or international networks; Web reporting; Web as a source of data/information) Geographic Information Systems (GIS)
19. Public Health Approach Problem Response Intervention Evaluation: What works? Implementation: How do you do it? Surveillance: What is the problem? Risk Factor Identification: What is the cause?
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26. Exposed Clinical specimen Disease Pos. specimen Infected Seek medical care Report Surveillance: “ you see what you look at” Laboratory-based surveillance Clinically-based surveillance Community-based surveillance Serological survey
27. Burden of illness pyramid (CDC, 1999) Illness in the general population Culture-confirmed case Lab tests for organism Specimen obtained Person seeks care Person becomes ill Reported Active Surveillance Physician Survey Laboratory Survey Population Survey
28. HIV/AIDS Surveillance in Thailand Behavioral surveillance 1983 AIDS cases HIV infections Risk behaviors 1995 1989 Mother to child HIV incidence 2001 2004 Reporting HIV Sentinel Sero-surveillance
29. Reported Cases of Leptospirosis per 100,000 Population, Thailand,1995-2004 Detect epidemic Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
30. Reported Cases of Mushroom Poisoning by Month, Thailand, 2000-2004 Outbreak prediction Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
31. Reported Cases of Dengue Hemorrhagic Fever, Thailand, 1967-2004 Outbreak prediction Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
32. Reported Cases of Food Poisoning per 100,000 Population, by Region, Thailand, 2000-2004 Determine the geographic distribution of illness Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
33. Number of Poliomyelitis cases, Thailand, 1981-1993. Number AFP surveillance Oral vaccine Evaluate control measure Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
34. Reported Cases of Malaria per 100,000 Population, by Year, Thailand, 2000-2004 Monitor trends in endemic disease Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
35. Reported Cases of Melioidosis per 100,000 Population, Thailand, 1995-2004 Detect changes in health/medical practices Source: Bureau of Epidemiology, Ministry of Public Health, Thailand
Dr. Narumol Sawanpanyalert Applied epidemiology synthesizes and applies the results of etiologic studies to set priorities for intervention; it evaluates public health interventions and policies; it measures the quality and outcome of medical care; and it effectively communicates epidemiologic findings to health professionals and the public. Outbreak and cluster investigations, public health surveillance and community screening programs represent key areas of public health practice in which systematic application of epidemiologic methods have a large and positive impact.