Thailand VPD surveillance system (2014) (National VPD surveillance targets…
Thailand VPD surveillance system (2014)
National VPD surveillance targets 2015
Hep B carrier rate in <5 pop <0.25%
NT <1 per 1000 LB
AFP <2 /100 000
JE: <0.15/100 000
Measles <3.5/100 000
Diphtheria <0.015/100 000)
Part of the Southeast Asian Nation Economic Community (ASEAN) in 2015
Dieases: Sustained polio eradication since 1997, eliminated Neonatal Tetanus,
High performing programme
Strong government support at all levels
Immunization as a basic helath service
Essential building blocks of the health system in place to deliver and finance vaccines
Capable staff at all level to deliver EPI as part of comprehensive MCH
Community demand high
Proven ability to detect and respond to VPD outbreak.
Surveillance rapid resonse teams (SRRTs), routine surveillance for communicable diseases achieves >80% completeness and timeliness of reporting + Events based Surveillance Network
Functional NRA + domestic vaccine production + capacity for R&D
endemic VPDs and missed pop in remote (hill tribe, migrants, uran slum residents) or border locations: diphteheria cases on the border with Lao PDR, measles on the border with Myammar
Limited availability and quality of VPD surveillance and EPI programme data
Epidemiology, laboratory, support and immunization program are in separate units.
AFP rate was 1.95/100000 pop <15 years (<2) and stool collection rate 70% (<80%). insufficient data on true MR burden.
Surveillance and performance data from the private sector are not included in national data bases.
Public sector data are limited by the deficiencies in the ehatlh information System (43 file system). HIS is consolidating the Disease Surveillance (506 system)
borad programmatic and technical knowledge requirements for multiple VPDs
health workers lack confidence intheir knolwedge of technical immunization issues, especially on data analysis.
Provincial EPI team has expanding role under the decentralization of health system
Decision making by Advisory Committee on Immunization Practices (ACIP)
Economic analysis is separtely consdiered by the National Health Security Office
Government Pharmaceutical Oragnization is both procurer and provider of vaccines
Moderate vaccine supply requirements and a single year budgeting process.
Eliminate measles by 2020
data to identify current gaps and anticipate future demands is insufficient
Mekong Basin Disease Surveillance
(MBDS): border sentinel site surveillance including adjacent districts in Myammar (4), Cambodia (2), Lao (3), including 5 EPI related VPDs.
Surveillance for temporary shelters
at the Thai-Myammar Border: modification of the 506 and EBS szstems
Event-based surveillance (EBS)
: based on reports from villange health volunteers,(VHV) and sub-district HF covering 6 syndromes (including fever and rash, suspected AFP)
Vaccine preventable Infections Surviellance
(VPIS) - lab based sentinel surveillance sys. from 25 hospitals tracking 6 VPDs (diphtheria, pertussis, pneumococcal disase, sever Hib, meningitis, and group A Strep
like illness and Sever Acute respiratory illness (SARI): facility based surveillance, indludes lab characterization
Measles Elimination Database (ME)
: case-based szstem for MR supported by 13 national M/R lab.
: included in R506, but requires laboratory confirmation and vaccination status
Comprehensive health facility based
(43 file system): based on reporting by ICD from district and provincial health facilityies
: case based surveillance, including all VPDs and AEFI. no laboratory diagnosis or vaccination status included in the report
Is the current VPD surveillance system currently able to detect all VPD outbreaks?
Multiple overlapping surveillance systems covering VPDs,
Bureau of Epidemiology
track VPD incidences based on 506 surveillance system + diseases specific surveillance on AFP and MR + Evidence based surveillance system for outbreak
Strong government support, has capacity to conduct routine report
Use of surveillance data to detect outbreak through network of Surveillance Rapide Response team (SRRTs) at sub national level
Overlapping surveillance systems
Confusion on case defintion
Lack of consistence between lab, epi data and vaccine status
: Surveillance is integrated in different units, but it can often be lower priority comparing to emerging diseases
Bureau of Epidemiology responsible for surveillance
Bureau of General Communicable disease for immunization programme
Department of Medical Science for laboratory
Private sector does not report surveillance data
insufficient working culture based on surveillance data, data quality is an issue
Appoint a task force to review VPD surveillance needs and promot linkage among the epidemiology, EPI programme and relevant laboratory units
Strengthen data collection and analysis