Download - The Syndromic Surveillance of ArbaeenMass
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The Syndromic Surveillance of Arbaeen Mass
Gathering 2018
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Early detection & Numeration of
syndromes
Early detection of the outbreaks
Rapid response to the detected outbreaks both in Iraq and Iran
The objectives of the surveillance system
Early detection and rapid response to important
outbreaks during Arbaeenmass gathering
Specific Objectives
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Selected syndromes1. Acute watery diarrhoea2. Acute bloody diarrhoea3. Food poisoning4. Influenza like infections5. Sever acute respiratory infections6. Fever and haemorrhage7. Jaundice8. Fever & neurologic symptoms9. Sudden death
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Case Definition:• For each syndrome a case definition was proposed; in this
case the health officers were able to count the number of cases.
• A meeting was held for training the health staff who were involved for the surveillance system .
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Data collection method• Sentinel site data collection method • Two different categories of locations:
1. At the border posts• 3 health posts at the Iraqi borders• 2 heath posts at the Pakistan and Afghanistan borders
2. In a number of red crescent clinics in Iraq • 2 in Karbala• 2 in Najaf• 1 in Kazemeyn
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Data collection method• All patients were screened
for any of the 9 syndromes at the entry of the targeted clinics.
• The necessary data were recorded in a prepared form
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Data collection tool• We used an application installed on mobile phone for data
collection:
• Health officer recorded data on their smart phone
• They sent the collected data once they had accessibility to internet
• Data were analysed in the Iranian CDC & the feed back was prepared on the next morning
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Data collection tool• The target groups of the feed back were:
• Authorities of the Iranian MOH• Surveillance groups inside Iraq• Medical universities across the country
For timeline intervention
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Results of the syndromic surveillance • During a 13 day period a total of 2935 patients were enrolled
with at least one of the proposed syndromes (screened from 111572 attended patients to the 5 red crescent clinics in Iraq)
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Results of the syndromic surveillance Syndromes Female Male Total
Acute bloody diarrhea 24 41 65
Acute watery diarrhea 498 1111 1609
Sever acute respiratory infection 69 128 197
Fever & hemorrhage 0 1 1
Fever & neurologic fever 0 3 3
Jaundice 0 1 1
Influenza like infection 187 283 470
Food poisoning 236 353 589
Total 1014 1921 2935
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Results of the syndromic surveillance
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19-Oct 20-Oct 21-Oct 22-Oct 23-Oct 24-Oct 25-Oct 26-Oct 27-Oct 28-Oct 29-Oct 30-Oct 31-Oct
Trend of reported syndromes
Bloody diarrhea Watery Diarrhea SARI ILI Food posining
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Evidence based interventions• We detected a number of outbreaks
during the pilgrimage and surveillance period:• Inspection of “Mokebs” for food water supply
by environmental health experts who were settled in different places on the roads leading to Karbala (31 persons)
• 3021 inspections during 20 days
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Evidence based interventions• 3404 sampling from suspected foods
• 4119 chlorine measurements
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Evidence based interventions• Training the pilgrims for hand hygiene and
food safety (45430 persons)
• Training the servants of “MOKEBS” for environmental health (13026 servants)
•
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Challenges
During Arbaeen
• We used cholera rapid test for a number of diarrheal patients during the pilgrimage
• We had difficulty for confirmation of positive tests
• It is necessary to implement a microbiologic lab in order to confirm these results.
Challenges
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Thank You
Babak Eshrati
Questions?