Electronic Integrated Disease Surveillance System And Pathogen . - SciELO
Page 1 of 5ProceedingElectronic Integrated Disease Surveillance System andPathogen Asset Control SystemAuthors:Tom G. Wahl1Aleksey V. Burdakov1Andrey O. Oukharov1Azamat K. Zhilokov1Affiliations:1Black and Veatch, MosAlarkoPlaza One, Moscow, RussiaCorrespondence to:Tom WahlEmail:wahlt@bv.comPostal address:Black and Veatch, MosAlarkoPlaza One, 16 MarksistskayaSt., Moscow 109147, RussiaHow to cite this proceeding:Wahl, T.G., Burdakov, A.V.,Oukharov, A.O. & Zhilokov,A.K., 2012, ‘ElectronicIntegrated DiseaseSurveillance System andPathogen Asset ControlSystem’, OnderstepoortJournal of VeterinaryResearch 79(2), Art. #455,5 pages. edings of theConference of the SouthernAfrican Centre for InfectiousDisease Surveillance ‘OneHealth’ held at the NationalInstitute for CommunicableDiseases, Johannesburg, July2011.Electronic Integrated Disease Surveillance System (EIDSS) has been used to strengthen andsupport monitoring and prevention of dangerous diseases within One Health concept byintegrating veterinary and human surveillance, passive and active approaches, case-basedrecords including disease-specific clinical data based on standardised case definitions andaggregated data, laboratory data including sample tracking linked to each case and event withtest results and epidemiological investigations. Information was collected and shared in secureway by different means: through the distributed nodes which are continuously synchronisedamongst each other, through the web service, through the handheld devices. ElectronicIntegrated Disease Surveillance System provided near real time information flow that hasbeen then disseminated to the appropriate organisations in a timely manner. It has been usedfor comprehensive analysis and visualisation capabilities including real time mapping of caseevents as these unfold enhancing decision making. Electronic Integrated Disease SurveillanceSystem facilitated countries to comply with the IHR 2005 requirements through a data transfermodule reporting diseases electronically to the World Health Organisation (WHO) datacenter as well as establish authorised data exchange with other electronic system using OpenArchitecture approach.Pathogen Asset Control System (PACS) has been used for accounting, management andcontrol of biological agent stocks. Information on samples and strains of any kind throughouttheir entire lifecycle has been tracked in a comprehensive and flexible solution PACS.Both systems have been used in a combination and individually. Electronic Integrated DiseaseSurveillance System and PACS are currently deployed in the Republics of Kazakhstan,Georgia and Azerbaijan as a part of the Cooperative Biological Engagement Program (CBEP)sponsored by the US Defense Threat Reduction Agency (DTRA).Problem statementInfectious diseases in the twenty-first century continue to cause economic and social disruptionsbecoming more severe due to the emerging diseases often of a zoonotic nature, active travelincreasing potential of regional and international epidemics and pandemics, and potentialbioterrorist threats.To adequately address these growing threats countries have to strengthen and improve theircapability to perform early detection and rapid reporting of infectious disease situation andoutbreaks, to timely and accurately verify presence or absence of high-consequence pathogens,and to comprehensively and rapidly respond to care for infected patients and reduce exposureof the wider population, and the accidental and/or deliberate release of high-consequencepathogens.There have been a number of attempts to improve detection, reporting and respond capabilitieswith the modern information and communications technology. However, most of the advancesin this field tend to either concentrate on isolated vertical segments (e.g. HIV, TB or Malaria),separately address human or veterinary areas, and be isolated from diagnostics (laboratory) andclinical data sources, be disintegrated with the international information systems (World HealthOrganisation [WHO] and World Organisation for Animal Health [OIE]), or be tailored only forcertain environment and disease surveillance priorities without an ability to adjust. 2012. The Authors.Licensee: AOSISOpenJournals. This workis licensed under theCreative CommonsAttribution License.Thus there is a need for a comprehensive information and communications technology solution,which would overcome the challenges of existing solutions and facilitate in early detection, rapidreporting and response. The creation of this comprehensive solution would require significanteffort from the epidemiology and diagnostics experts society as well as investment in developmentand implementation of the .455
Page 2 of 5Methods and approachFor the 10 years the United States Defense Threat ReductionAgency (DTRA) has been actively implementing theCooperative Biological Engagement Program (CBEP), whichgoals closely match infectious disease threats most of thecountries face: combat bioterrorism and prevent the proliferation ofbiological weapons-related technology, pathogens andexpertise enhance host governments’ disease surveillance systemsto detect and report bioterrorism attacks, epidemics andpotential pandemics.To address these goals two information and communicationstechnology solutions were created, (1) Electronic IntegratedDisease Surveillance System (EIDSS) and (2) PathogenAsset Control System (PACS). Electronic Integrated DiseaseSurveillance System facilitates in early detection, rapidreporting and response to disease outbreaks, whilst PACSimproves security of dangerous pathogens stored in thelaboratories.Method 1: Electronic surveillanceusing Electronic Integrated DiseaseSurveillance SystemElectronic Integrated Disease Surveillance System isan electronic system intended to facilitate in collecting,Proceedingnotifying, sharing and analysing surveillance data. It consistsof several modules listed below together with a specificationof tracked data: Human module demographic data disease-specific clinical data based on standard casedefinitions epidemiological investigations sample and laboratory tests tracking linked to a specificcase aggregate cases. Veterinary module avian and livestock cases farm or owner information disease-specific clinical data based on standard casedefinitions epidemiological investigations sample and laboratory tests tracking linked to a specificcase penside tests aggregate cases active surveillance data. Laboratory samples, tests assignment, tests results and batch testsaliquots and derivativestransfer in or out operationslinks to clinical case manVeterinaryDiagnostic- Central Data Repository- District Site- Laboratory- Epidemiological Office- World HealthOrganisation- World Organisation forAnimal Health- Ministry of Health- Ministry of AgricultureDatabasePaper or phonelinkE-linkRegionDistrictFIGURE 1: Typical Electronic Integrated Disease Surveillance System 79i2.455
Page 3 of 5 Analysis customised and predefined reports statistic analysis different ways of data representation: grids, charts,maps.Information can be collected and shared through thesemodules in several ways providing a near real-timeinformation flow that can be then disseminated to theappropriate organisations in a timely manner. Figure 1represents typical EIDSS hierarchy covering differentadministrative levels: district, region, country.The first way to collect information is through a numberof distributed nodes which are continuously synchronisedamongst each other. Let us say a veterinary case is registeredin a district. Once this information is entered to the system,replication starts and transfers the case to the region levelsite, which in turn send it to the Central Data Repository(CDR), then it goes other sites which are supposed to get suchinformation. Bi-directional regular data exchange amongstsites guaranties that all participants get actual and up-todate information. If a node gets off-line it keeps workingin disconnected mode and will be synchronised with othernodes once it gets on-line.The EIDSS Web server is the other way to get informationinto the system (Figure 2). Data entered through the web siteis distributed to other nodes of the system and available forreview and editing according to users’ permissions.Access to EIDSS from handheld devices is the third entrypoint (Figure 2). Web portal designed for handheld devicesprovides simplified interface and support a variety of devices.Any combination of these methods can be used dependingon infrastructure, organisational and other issues. In acombination with using of commercial ‘off-the-shelf’ readilyavailable generic hardware it makes EIDSS suitable forenvironments with different challenges.Methods and featuresFollowing One Health approach EIDSS integrates humanand veterinary surveillance data along with a laboratoryinformation. For example, it is possible to create an outbreakProceedingrecord in the system which ties together several human andveterinary cases. One can also link several veterinary casestogether. Adding a laboratory piece gives the opportunitydiagnose a case with a most recent laboratory data. Forinstance, case entered in the veterinary service is transferredto the laboratory and available through the EIDSS labmodule. As soon as test results are registered for this casein the laboratory they will be transferred to the veterinaryservice site and can be used for further investigations.Flexibility and scalability is one of the fundamentalprinciples of the EIDSS. One example of such flexibility isthat cases can be tracked with different levels of specification:case-based tracking with a specific case definitions andinvestigation information, when every case is registeredas individual record, can be used for especially dangerousdiseases, case-based tracking with just an emergencynotification information can be used for other importantdiseases, aggregate reporting which is supposed to track justsummary data from district or regions for a certain period oftime. Electronic Integrated Disease Surveillance System alsoallows to switch between different approaches depending onthe current situation. Case definitions used in the system alsocan be adjusted according to the specific requirements.Electronic Integrated Disease Surveillance System supportsdifferent types of surveillance: passive surveillance (casebased and aggregate) is available for human and veterinarydiseases, active surveillance is supported for veterinarydisease, vector surveillance is planned to be released in thenext version.Comprehensive analysis modules give users variouscapabilities to investigate and present collected data. Usingeither predefined reports which duplicates officiallyapproved paper forms or customisable reports where onecan build a report as needed, users are able to get access toany variables in the database and explore human, veterinaryand lab. The GIS component of the system allows attachinggeo-coordinates to cases and map data in addition to chartsand grid representations (Figure 2).FIGURE 2: Web and/or handheld access to Electronic Integrated Disease Surveillance System: data .455
Page 4 of 5ProceedingComputerised Information System for Infectious Diseases(CISID) assisting in International Health Regulations (IHR)compliance, open architecture approach supported byEIDSS allows to establish communications with existinglocal electronic systems. Regional cooperation betweenneighbouring countries is also possible on the base of EIDSS.Full localisation of the system which includes electronicforms, reports and manuals, unified design and staff trainingmake it easy to operate for non-experienced users. Turn-keydeployment and support contribute to the sustainability ofthe solution.FIGURE 3: Pathogen Asset Control System conceptual schema.ResultsElectronic Integrated Disease Surveillance System isbeing developed since 2005 in collaboration with differentinstitutions including the Centers for Disease Control andPrevention (CDC), US, the Walter Reed Army Institute forResearch (WRAIR), US, Ministries of Health and VeterinaryDepartments of Kazakhstan, Uzbekistan, Azerbaijan andGeorgia, Ukraine and Armenia and numerous internationalmedical and veterinary experts. Following iterative approachEIDSS went through the number of expertise (more than75 000 hours) and revisions.Currently version 3 is deployed in Azerbaijan (90installations), Kazakhstan (more than 150 installations) andGeorgia (more than 120 installations). The initial phase ofdeployment in Armenia and Ukraine. Electronic IntegratedDisease Surveillance System has been officially recognised inAzerbaijan in 2010 and recently in Kazakhstan and Georgia.FIGURE 4: Repository inventory audit.Electronic Integrated Disease Surveillance System is asolution that improves the capacity to detect, diagnose andreport bioterrorism attacks and potential pandemics, andsupports bioresearch. It strengthens both regional and globaldisease surveillance with plans for expansion into Africanand Asian regions and globally.Method 2: Biological pathogenstracking using Pathogen AssetControl SystemPathogen Asset Control System helps to track and controlpathogens that are collected, investigated and stored inbiological laboratories. It allows monitoring of the wholelife-cycle of the pathogens with necessary levels of detail andappropriate security.FIGURE 5: Material classification.Electronic Integrated Disease Surveillance System providesmeans for integration with other local or internationalsystems: the WHO module can transfer approved reports tohttp://www.ojvr.orgPathogen Asset Control System can be implementedwithin different facilities, from small repositories with onecentralised storage area to big multi-discipline institutionswith distributed structure and numerous laboratories. Serverclient architecture allows immediate access to all necessaryinformation for every user who has appropriate rights,which includes principal investigators, facility management,IT administrators and other laboratory personnel.doi:10.4102/ojvr.v79i2.455
Page 5 of 5ProceedingPathogen Asset Control System utilises Barcode technologyand Radio-frequency Identification (RFID) to uniquely trackall individual vials with highly pathogenic materials andallows error-free fast data input and retrieval.ResultsFIGURE 6: Freezer content report.FIGURE 6: Freezer content report.Handling dangerous biological materials and processinginformation about them requires certain level of safety andsecurity, and PACS provides invaluable assistance in thisarea. Separated access control to data, detailed audit trails,inventory audit function and other security features of theapplication help the owner to comply with international andlocal regulations in Biosafety and Biosecurity.Considering that different organisations might havedifferent requirements on what information must betracked on biological materials and how, PACS allowsseveral options for system customisation and adoption tolocal requirements. That includes designing barcode labels,managing repository configuration, creating different dataentry forms depending on material type customise data entryforms and output reports. Being flexible and adoptable to theowner’s requirements PACS employs all common operationswith biological materials, such as registration, transfer,destruction, splitting and reculturing. All operations aresupplied with printable reports and acts.Pathogen Asset Control System provides wide opportunitiesto utilise information entered into the system for biologicalinvestigation support. A variety of different user definedfields and information in them, supplemented with thecapability of creating custom reports provides an opportunityto output data in ways so it can be used for analysis ofdifferent parameters.http://www.ojvr.orgPathogen Asset Control System is an important part of theoverall Biosecurity solution and can be very efficient inevery biological laboratory where implemented. It allowsthe necessary levels of tracking and control over dangerouspathogens and complies with strengthening or enforcingregulations in Biosafety.Being implemented in numerous laboratories in 6 differentcountries PACS proved its reliability and effectiveness.Pathogen Asset Control System is currently undergoingCertification and Accreditation (C&A) process according toUnited States Department of Defense standards and shouldbe offered to many government agencies as a system fortracking biological agents once C&A is completed. PathogenAsset Control System is a robust electronic system thatcompetently helps to solve the important task of managingdangerous materials and will be in demand by biologicallaboratories.AcknowledgementsMr Tom G. Wahl is a project manager for EIDSS and PACSproduct. He prepared the overview of the EIDSS and PACSand introduction. Dr Aleksey V. Burdakov made contributionto all sections of the article, including problem statement. MrAndrey O. Oukharov wrote EIDSS section of the article. MrAzamat K. Zhilokov wrote PACS section.ReferencesBurdakov, A.V., 2005, ‘Implementation of the communications and informationtechnology part of the International Program on Treat Agent Detection andResponse in the Republic of Kazakhstan’, Environment and Population Health 1, 37.Wahl, T. & Burdakov, A.V., 2007, ‘Electronic Integrated Disease Surveillance System(EIDSS)’, Advances in Disease Surveillance 2, 171.doi:10.4102/ojvr.v79i2.455
Electronic Integrated Disease Surveillance System supports different types of surveillance: passive surveillance (case-based and aggregate) is available for human and veterinary diseases, active surveillance is supported for veterinary disease, vector surveillance is planned to be released in the next version.
Philippine Integrated Disease Surveillance and Response The Philippine Integrated Disease Surveillance and Response (PIDSR) is an enhanced surveillance system that monitors notifiable diseases and other health-related events of public health importance utilizing integrated approach (World Health Organization Philippines, 2014a).
1.2. Indicator-Based Surveillance (IBS) and Event-Based Surveillance (EBS) Approaches Used to Detect Diseases, Conditions and Events 52 1.3. Standard Case Definitions 52 1.4 Establish Event-Based Surveillance (EBS) at all levels 57 1.5 Update LGA Procedures for Surveillance and Response 58 1.6 Role of the laboratory in surveillance and response 61
Integrated Disease Surveillance and Response Strategy (IDSR) to monitor, prevent and control priority notifiable infectious diseases in the country. Through this strate gy, activities pertaining to disease surveillance are coordinated and streamlined to take advantage of similar surveillance functions, skills, resources and targeted populations.
Boolean operators. e search terms were Integrated Disease Surveillance and Response, Integrated Disease Surveillance, Health Management Information Systems, District Health Information System and Sub Saharan Africa or individual member country. e search was limited to studies published in the English language between January 1998 and December 2020.
diseases. National disease surveillance The system implemented for communicable disease surveillance at a country or national level. In the WHO Africa Region, this strategy is referred to as 'Integrated Disease Surveillance and Response'. The name will differ from country to country. Magpi Commercially available mobile data collection software.
The main basis of integrated disease surveillance is data collection for action. In this case, CBS is intended for improving public health surveillance and response by linking communities with their local health facilities. The health sector can then leverage community structures for better surveillance, disease prevention and disease control.
countries, most of the studies have been on the integrated diseases surveillance (IDSR) and have been performed shortly after the adoption of the IDSR. Thus it might be too early to make a fair . The need to strengthen disease surveillance and response system is recognized globally (3). A well functioning disease surveillance system provides .
accounting purposes, and are rarely designed to have a voting equity class possessing the power to direct the activities of the entity, they are generally VIEs. The investments or other interests that will absorb portions of a VIE’s expected losses or receive portions of its expected residual returns are called variable interests. In February 2015, the Financial Accounting Standards Board .
