27
Measles Outbreak Surveillance: Data collection and management District Measles Surveillance Workshop Courtesy: Ms S Durrani; Dr A S Bose

A8. Forms and Data

Embed Size (px)

Citation preview

Page 1: A8. Forms and Data

Measles Outbreak Surveillance:

Data collection and management

District Measles Surveillance Workshop

Courtesy: Ms S Durrani; Dr A S Bose

Page 2: A8. Forms and Data

Forms: When and How

Page 3: A8. Forms and Data

Weekly routine reports – to trigger investigation

Outbreak investigation reports – to direct immunization

activities and prevent deaths

Page 4: A8. Forms and Data

Weekly routine reports – to trigger investigation

Page 5: A8. Forms and Data

Form Number and Purpose

(VPD-XXXX)

FROM TO Frequency

H002: clinical measles and AFP case reporting

RU NP DIO Weekly

H003: ACS by RU Nodal person (RU-NP) for record

RU NP RU NP Weekly

D001: District report for clinical measles and AFP (include measles cases reported to IDSP etc.)

DIO SEPIO Weekly

S001: State report for clinical measles and AFP (SEPIO shares with IDSP)

SEPIO GOI / NPSU

Weekly

OB-003: Measles cases Line list (filled up during HTH search by ANM)*

PHC/ BPHC

DIO / SMO

With detailed OB-Inv

OB-004: Summary of outbreak investigation

DIO SEPIO / NPSP

Prelim & detailed OB-Inv

OB-002: Community Survey - used occasionally*

PHC/ BPHC

DIO / SMO

With detailed OB-Inv

Measles Outbreak Line list SMO NPSU Weekly for all flagged OB

*Also Lab Request forms; OB = Outbreak

Page 6: A8. Forms and Data

Weekly routine reports• Routine measles forms merged with AFP

forms

• Data flow: Reporting Units Districts (VPD-H002)

Districts State (VPD-D001)

State GoI/NPSU (VPD-S001)

Mondays

Tuesdays

Wednesdays

Page 7: A8. Forms and Data

Form VPD-H002Name Weekly hospital report

Purpose Transmits hospital surveillance findings to the RCHO

Prepared by Nodal person of the hospital

Sent to RCHO

Report day Monday

Page 8: A8. Forms and Data
Page 9: A8. Forms and Data

Fill up information on all Measles cases below:

Patient's name and

Father's name

Age in months

Sex

Received measles vaccine (Y/N/U)*

Village name and landmark

PHC name Block name District nameOutcome:

Died? (Y/N/U)*

VPD-H002

Page 10: A8. Forms and Data

Form VPD-D003

Name Active case search form

Purpose To assure each reporting unit is actively searched for AFP

cases and Measles cases Prepared by Person conducting active case search

Sent to State

Page 11: A8. Forms and Data
Page 12: A8. Forms and Data

Outbreak investigation reports:

to direct immunization activities and prevent

deaths

Page 13: A8. Forms and Data

Actions following Outbreak Flag

• Allot outbreak identification numberMOB-state code-district code-year-outbreak number

• Preliminary Investigation & Summary Report [VPD-OB004]• Desk review• Field Visit

• Detailed Investigation [VPD-OB 002 and 003]• HTH search and Line list measles cases [OB003]• Sometimes: Community Survey (cases and non-

cases) [OB002]• Allot identification number to cases for which

blood sample is collected• Summary Reports: VPD-OB004

Page 14: A8. Forms and Data

Form Number and Purpose

(VPD-XXXX)

FROM TO Frequency

H002: clinical measles and AFP case reporting

RU NP DIO Weekly

H003: ACS by RU Nodal person (RU-NP) for record

RU NP RU NP Weekly

D001: District report for clinical measles and AFP (include measles cases reported to IDSP etc.)

DIO SEPIO Weekly

S001: State report for clinical measles and AFP (SEPIO shares with IDSP)

SEPIO GOI / NPSU

Weekly

OB-003: Measles cases Line list (filled up during HTH search by ANM)*

PHC/ BPHC

DIO / SMO

With detailed OB-Inv

OB-004: Summary of outbreak investigation

DIO SEPIO / NPSP

Prelim & detailed OB-Inv

OB-002: Community Survey - used occasionally*

PHC/ BPHC

DIO / SMO

With detailed OB-Inv

Measles Outbreak Line list SMO NPSU Weekly for all flagged OB

*Also Lab Request forms; OB = Outbreak

Page 15: A8. Forms and Data

Form VPD-OB002

Name Community Survey/Census method

Purpose To get key data from measles and non-measles cases in the outbreak; Calculate attack rates

and VE Prepared by District response team during

house to house search

Sent to District/ State/NPSP

Page 16: A8. Forms and Data

Village / Locality name: ______________________________ Date of search: ________________

Block/ Urban Ward: ___________________________ Search done by:__________________

District:______________________________ Outbreak id_________________________

Fill up information of persons surveyed

Tally Mark Number Tally Mark Number Tally Mark Number

Measles

Non-measles

Death due to measles

Measles

Non-measles

Death due to measles

Measles

Non-measles

Death due to measles

OUTBREAK INVESTIGATION: COMMUNITY SURVEY

1 < 1 year

2 1-4 years

3 5-9 years

Serial Number

CategoryNumber received measles vaccine Unknown measles vaccination status

Age GroupNumber not received measles vaccine

Addl Form B

Page 17: A8. Forms and Data

Form VPD-OB003

Name Linelisting of measles cases

Purpose To get key data of suspectedmeasles cases found in the

outbreak Prepared by District response team during

house to house search

Sent to District/ State/ GoI/ NPSP

Page 18: A8. Forms and Data

Form VPD-OB003

Village / Area: ________________ PHC:_________________ Block:__________________________ District:__________________________ State:___________________

Outbreak ID: _________________________________ Report sent by:_____________________Date Sent: ____________

SexDate of last

measles vaccine

Date of onset of rash

If died, date of death

Date of blood specimen collection

M/F Years Months dd/mm/yyyy dd/mm/yyyy dd/mm/yyyy dd/mm/yyyy

Unknown Unknown

Unknown Unknown

Unknown Unknown

Yes

No

Yes Yes

No No

Yes

Setting: Urban / Rural

No

Age

Yes Yes

No No

Patient's name, father's name and address

Patient number

Received measles vaccine (circle)

MEASLES OUTBREAK INVESTIGATION: DATA ON CASES

Death (circle)

Page 19: A8. Forms and Data

1

2

3

4

5

01 / 08 / 06

01 / 08 / 06

MOBKABLK06001

Page 20: A8. Forms and Data

Form VPD-MLRF1Name Measles lab request form-blood

Purpose To accompany blood specimens collected from measles cases to lab

Prepared by Person collecting blood samples

Sent to - Laboratory- Laboratory to State/ GoI/ NPSU after processing

Page 21: A8. Forms and Data

MOBKABLK06001

MOBKABLK06001-B2

MOBKABLK06001-B4

MOBKABLK06001-B8

MOBKABLK06001-B17

MOBKABLK06001-B18

Page 22: A8. Forms and Data

Form VPD-OB004 (Page 1)

Name Measles outbreak investigation - summary

Purpose To summarize the information and result of the outbreak Prepared by DIO

Sent to State/ GoI/ NPSU

Page 23: A8. Forms and Data

Form VPD-OB004

Outbreak ID: _______________________ Notification

Source of notification: Weekly report / Active case search / Media / Other

Index case reported by:______________ Name of DIO:________________________

Designation:____________________ Name of SMO:_______________________

Date of notification of index case: ______________

Location of the outbreak

Village / Urban ward affected: _______________ Sub-center: ________________________

PHC/UHC: ___________________ Block: _______________________

District:______________________ State: _______________________

Cross notification needed: Yes / No

Desk review: date________________________ findings________________________________________________________

Date/s of preliminary search:__________________________

Number of health facilities searched: ___________________ Number of sub-centers/ urban wards searched: _________

Number of areas* searched:__________________ Total number of clinical measles cases:__________

Date of Epidemic Response Team meeting: ____________________

Whether considered as an outbreak requiring house to house investigation: Yes / No

If No, reason: No clustering of cases Low case count

Others (specify ) ________________________________________________________________

If Yes, provide details of outbreak investigation below

Details of outbreak investigation

Date of pre outbreak investigation orientation:_______________________

Date of outbreak investigation From:________________ To:_______________

Number of health facilites involved:____________ Number of sub-centers/ urban wards involved: _________

Number of areas* involved:__________ Total population investigated:___________

Total number of measles cases:________ Total number of deaths due to measles:________

Date of onset of first case:________________ Date of onset of most recent case:__________

Laboratory investigation details

Age SexDate of last

measles dose

Date of collection

Date sent to lab

Date received in lab

Result Measles/ Rubella/ Negative/ Equivocal

Date of Result

Note: * Areas are villages, towns, municipalities or corporations.

MEASLES OUTBREAK INVESTIGATION: SUMMARY

Preliminary investigation including desk review

Case ID / EPID number**

** Case ID/ EPID number is the code given to each case from whom a sample of blood or urine is collected. If sample collected is blood, case ID/ EPID number will be outbreak ID-B-patient number or if the sample is urine, case ID/ EPID number will be outbreak ID-U-patient number.

Page 24: A8. Forms and Data

Form VPD-OB004

Outbreak ID: _______________________ Notification

Source of notification: Weekly report / Active case search / Media / Other

Index case reported by:______________ Name of DIO:________________________

Designation:____________________ Name of SMO:_______________________

Date of notification of index case: ______________

MEASLES OUTBREAK INVESTIGATION: SUMMARY

Desk review: date________________________ findings________________________________________________________

Date/s of preliminary search:__________________________

Number of health facilities searched: ___________________ Number of sub-centers/ urban wards searched: _________

Number of areas* searched:__________________ Total number of clinical measles cases:__________

Date of Epidemic Response Team meeting: ____________________

Whether considered as an outbreak requiring house to house investigation: Yes / No

If No, reason: No clustering of cases Low case count

Others (specify ) ________________________________________________________________

If Yes, provide details of outbreak investigation below

Preliminary investigation including desk review

Page 25: A8. Forms and Data

Form VPD-OB004

Outbreak ID: _______________________ Notification

Source of notification: Weekly report / Active case search / Media / Other

Index case reported by:______________ Name of DIO:________________________

Designation:____________________ Name of SMO:_______________________

Date of notification of index case: ______________

Location of the outbreak

Village / Urban ward affected: _______________ Sub-center: ________________________

PHC/UHC: ___________________ Block: _______________________

District:______________________ State: _______________________

Cross notification needed: Yes / No

Desk review: date________________________ findings________________________________________________________

Date/s of preliminary search:__________________________

Number of health facilities searched: ___________________ Number of sub-centers/ urban wards searched: _________

Number of areas* searched:__________________ Total number of clinical measles cases:__________

Date of Epidemic Response Team meeting: ____________________

Whether considered as an outbreak requiring house to house investigation: Yes / No

If No, reason: No clustering of cases Low case count

Others (specify ) ________________________________________________________________

If Yes, provide details of outbreak investigation below

Details of outbreak investigation

Date of pre outbreak investigation orientation:_______________________

Date of outbreak investigation From:________________ To:_______________

Number of health facilites involved:____________ Number of sub-centers/ urban wards involved: _________

Number of areas* involved:__________ Total population investigated:___________

Total number of measles cases:________ Total number of deaths due to measles:________

Date of onset of first case:________________ Date of onset of most recent case:__________

Laboratory investigation details

Age SexDate of last

measles dose

Date of collection

Date sent to lab

Date received in lab

Result Measles/ Rubella/ Negative/ Equivocal

Date of Result

Note: * Areas are villages, towns, municipalities or corporations.

MEASLES OUTBREAK INVESTIGATION: SUMMARY

Preliminary investigation including desk review

Case ID / EPID number**

** Case ID/ EPID number is the code given to each case from whom a sample of blood or urine is collected. If sample collected is blood, case ID/ EPID number will be outbreak ID-B-patient number or if the sample is urine, case ID/ EPID number will be outbreak ID-U-patient number.

Page 26: A8. Forms and Data
Page 27: A8. Forms and Data

THANK YOU