Medical Surveillance

Agus Widjaja , dr., MHA

 Deffinitions
Epidemic surveillance :
The ongoing systematic
• Collection
• Analysis
• Interpretation,
of health data essential to the planning,
implementation and evaluation of public health
practice ,
(as well as the timely dissemination of the data to
those need to know)
 Definitions
• An important element definition of
surveillance:
Providing decision makers guidance for
developing and implementing the best
strategies for disease prevention and control
programs.

Key words:
Guidance – strategies –prevention and control.
 Passive surveillance
• Available data on reportable diseases are used
• Or, reporting is mandated or requested
• The completeness and quality of the data
reported thus largely depend on the individual
and his or her staff who often take on this role
without additional funds or resources.
• Risk/disadvantages:
– underreporting
– lack of completeness
– simple and brief instrument is needed
– Local outbreak may be missed
 Active surveillance
• Periodic field fisits to health care facilities are
conducted to identify new cases of disease or diseases
or deaths from the disease that occurred (case fincing)
• Involved :
– Interviewing patient
– Interviewing physicians
– reviewing medical records
– Surveying villages to detect cases either on a routine basis
or after an index case has been eported
• Reporting is generally more accurate than those the
passive surveillance
Some constraints/problems for active
surveillance
• Geographic and demographics
• Communication from areas to the central
authorities
• Inappropriate definition for disease used
• Lack of laboratory
• Other sophisticated resources may needed
• Risk: be an underreporting of observed cases
 Surveillance great value
• Shows trends in incidence in some cases
• It may be carried out to access change in level
of environmental risk factors for disease
• Surveillance for change either in disease rate s
or in lavel of environmental risk factors may
serve as a measure of the severity of accident
and point to possible directions for reducing
such hazards in the future.
 Surveillance bias
• Misclassification
• Nondiferential misclassification

• There are also some types and source of

information bias:
• Bias in abstracting records
• Bias in interviewing
• Bias from surrogate interviews
• Recal bias
• Reporting bias
Jelly fish attacts