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REPUBLIC OF UGANDA

MINISTRY OF HEALTH

National Technical Guidelines for

Integrated Disease Surveillance

and Response

Third Edition

September 2021

Table of Contents

LIST OF FIG URES ................................ ................................ ................................ ............................... i

LIST OF TABLES ................................ ................................ ................................ ................................ ii

FOREWORD iii

ACKNOWLEDGMENTS ................................ ................................ ................................ ................... iv

LIST OF ABBREVIATIONS ................................ ................................ ................................ ............. vi

GLOSSARY (DEFI NITION OF KEY TERMS) ................................ ................................ .............. ix

INTRODUCTION SECTION ................................ ................................ ................................ .............. 2

A.0 Introduction ................................ ................................ ................................ ................................ .. 2

A.1 Public Health Surveillance ................................ ................................ ................................ ........... 2

A.1.1 Approache s to public health surveillance ................................ ................................ .............. 2

A.1.2 Event -based surveillance and Indicator -based Surveillance as back -bone to the IDSR

Strategy ................................ ................................ ................................ ................................ ........... 3

A.3 Integrated Disease Surveillance and Response Strategy ................................ .............................. 6

A.3.1 What takes place in an i ntegrated system? ................................ ................................ ............ 6

A.3.2 Objectives of Integrated Disease Surveillance and Response ................................ ............... 7

A.4 IDSR and IHR (2005) ................................ ................................ ................................ .................. 8

A.4.1 IHR (2005) purpose and goal ................................ ................................ ................................ 8

A.4.2 Monitoring and eva luating implementation of IHR (2005) ................................ .................. 9

A.5 One Health and IDSR ................................ ................................ ................................ ................ 10

A.6 IDSR and Disaster Risk Management (DRM) ................................ ................................ ........... 10

A.7 Implementing Cross Border activities in the context of IDSR ................................ ................... 11

A.8 Electronic IDSR (eIDSR) as a platform to enhance real time surveillance ............................... 11

A.9 Core functions of IDSR ................................ ................................ ................................ .............. 11

A.10 The different levels where surveillanc e activities are performed ................................ ............. 12

A.11 How districts can use the IDSR matrix to strengthen surveillance and response .................... 13

Annexes to Intro duction SECTION ................................ ................................ ................................ .. 14

Annex A: IDSR matrix: Core functions and activities by health system leve ls ............................ 15

Annex B: Events of potential inter national health concern requiring reporting to WHO under the

International Health Regulati ons (2005) ................................ ................................ ........................... 22

Annex C: Guide for Establishing Surveillance and Response systems at Points of Entry (PoE) ..... 24

Annex D: Roles and Responsibilities of various actors in IDSR ................................ ...................... 27

SECTION 1: IDENTIFY AND RECORD CAS ES OF PRIORITY DISEASES, COND ITIONS

AND EVENTS 33

1.0 Identify and record cases of priority diseases, conditions and events ................................ ......... 33

1.1 Priority diseases, conditions and events included in the IDSR ................................ ................... 33

1.2 Detection of priority diseases, conditions and events ................................ ................................ . 35

1.3 Use of sta ndard case definitions to detect priority diseases, conditions or events ...................... 36

1.3.1 How to make case definitions available in health facilities and communities ..................... 37

1.4 One Health approach in identification of events ................................ ................................ ......... 37

1.5 Indicator -based Surveillance (IBS) and Event -Based Surveillance (EBS) ........................... 38

1.5.1 Indicator -based surveillance (IBS) ................................ ................................ ....................... 38

1.5.2 Event -Based Surveillance (EBS) ................................ ................................ ......................... 39

1.6 Commun ity Based Surveillance (CBS) ................................ ................................ ....................... 41

1.6.1 Guide for Establishing Community Based Surveillance and Response ............................... 41

1.6.2 Steps for establishing CBS ................................ ................................ ................................ ... 42

1.6.3 Community representatives on CBS team ................................ ................................ ........... 45

1.6.4 Supervision of CBS ................................ ................................ ................................ .............. 46

1.6.5 Linkage be tween facility -based surveillance and CBS ................................ ........................ 47

1.6.6 Conducting an investigation, confirmation and response to a suspected case/public health

event/signal at the community level ................................ ................................ .............................. 47

1.7 Continuous improvements on identification and recording priority DCEs ................................ . 48

1.7.1 Update district procedures for surveillance and response ................................ .................... 48

1.7.2 Update the description of the catchment area ................................ ................................ ...... 48

1.7.3 Update the list of reporting sites and the names of surveillance focal perso ns in the district

................................ ................................ ................................ ................................ ...................... 49

1.7.4 Distribute updated data collection forms, reporting tools, line lists, registers and technical

guidelines ................................ ................................ ................................ ................................ ...... 49

1.8 Role of the laboratory in surveillance and response ................................ ................................ ... 49

1.8.1 Specimen collection, storage and transportation ................................ ................................ .. 49

1.8.2 Estab lishing a district laboratory network ................................ ................................ ............ 51

1.8.3 Update inventory of supplies, reagents and equipment used for disease confirmation ....... 51

1.8.4 Describe laboratory procedures for confirming priority diseases and conditions ................ 51

1.8.5 Establish a laboratory quality assurance program ................................ ................................ 51

Annexes to S ECTION 1 ................................ ................................ ................................ ...................... 53

Annex 1A: Standard case definitions f or reporting suspected priority diseases, conditions and

events from the health facility to the district ................................ ................................ ..................... 54

Annex 1B: Community le vel case definitions using key signs and symptoms ................................ . 82

Annex 1C: Guide for establishing Event -Based Surveillance (EBS) at National, Regional, District

and Health Facility levels ................................ ................................ ................................ .................. 85