VPD SURVEILLANCE IN INDIA
Idsurv Way Forward
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Dissemination
Consensus on Case Definitions
Alert System
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Analysis
SURVEILLANCE SYSTEMS IN INDIA
System
Description / Salient
features
Remarks
IDSP
(Integrated
Disease
Surveillance
Project)
Nationwide outbreak
surveillance system.
Including Measles,
Diphtheria, Pertussis,
AFP, Hepatitis and AES.
Sustainable system but variable state
ownership.
Data does not capture age and
immunization status.
Lab component weak.
In transition.
CBHI/SBHI
(Central and
State
Bureaus of
Health
Intelligence)
Nation-wide passive
reporting system of
suspected cases
All VPDs under traditional EPI are
reportable.
Extremely variable completeness,
data quality and reliability.
Annual updates.
Surveillance systems in India
System
Description / Salient
features
Remarks
Measles:
ICMR
Selected practitioners and
institutions provide clinical
samples to NIV-Pune for
measles virus isolation and
genotyping.
AES/JE:
NVBDCP
and ICMR
Facility based surveillance for Variable sensitivity
acute encephalitis syndrome Many cases of AES without lab
in endemic areas.
diagnosis
ICMR provides lab support.
Laboratory based
surveillance by NIV in
Gorakhpur
Multicenter
Pneumonia
and
Meningitis
surveillance
Established in preparation for
Hib vaccine probe study in
Chandigarh, Kolkata &
Vellore
Strong lab component. Case definition
and case inclusion may not be
standardized.
Not population based.
Sentinel reporting sites
Etiologic diagnosis of pnuemonia and
meningitis in children < 2years
PNEUMO SURVEILLANCE IN INDIA
•In India surveillance data is being collected since 1993 as part of
Invasive Bacterial Infection Surveillance (IBIS) from 6 centers
coordinated through India Clinical Epidemiology Network
(IndiaCLEN).
•Since April 2004, the IBIS project was continued in India as part
of the South Asian Pneumococcal Alliance (SAPNA) project with
additional centers in Nepal and Sri Lanka.
•SAPNA was funded by Global Alliance on Vaccine and
Immunization (GAVI) and through the Accelerated Development
and Implementation Plan (PneumoADIP) at John's Hopkins School
of Public Health.
•From April 2011, Surveillance is being carried out only at
one site (Christian Medical College, Vellore) and is being
funded by the WHO SEARO.
•India is also part of Asian Network for Surveillance of
Resistance System (ANSORP), 2011 - For S pneumonia
Antibiotic resistance ongoing at CMC Vellore (Dr MK
Lalitha / Dr Dilip Mathai )
ASIP
• Since 2011 , 2nd year of study ongoing .
• Dr Anand Manoharan - Principal Investigator , CMC
Vellore
• It is a surveillance of invasive disease caused by S.
pneumoniae or H. influenzae or N. meningitidis in children
<5 years of age in India.
• Institutional arm – 18 institutes and sentinel arm – 58
doctors representing the whole country
PneumoNET study - Pan Asia Epidemiologic
surveillance network to assess the burden of invasive
pneumococcal disease (IPD)
• Two -year active, prospective, hospital-based
surveillance study of IPD and pneumonia ( Feb 27, 2009
to Feb 26, 2011)
• 3 hospitals in Bangalore South Zone, India:
Kempegowda Institute of Medical Sciences Hospital, Vani
Vilas Hospital, and the Indira Gandhi Institute of Child
Health
• Children aged 28 days to <60 months
ISSUES IN PNEUMO SURVEILLANCE
• Good Case definition required
• Robust Diagnostic methods to improve bacteria yield
• Coordination and regular follow-up needed for long
term surveillance
• Need for Laboratory support with trained personnel
• Financial support : Cost intensive study
• Logistics support for timely delivery of samples
• Sustaining the momentum of recruitment of cases by
sites
ROTAVIRUS SURVEILLANCE
NETWORK- INDIA
• The Indian Rotavirus Strain
Surveillance Network: 4 labs and
10 hospitals in 7 regions.
• Children <5 years admitted with
acute gastroenteritis and given
rehydration for at least 6 h
enrolled.
• A fecal specimen is tested for
rotavirus using a commercial
enzyme immunoassay, and strains
characterized using rtPCR.
• Dr Gagandeep Kang – CMC Vellore
The Journal of Infectious Diseases : 2009:S147–53
• Disease burden study - Epidemiology of rotavirus in
North India Community - study designed to support
site preparation and to conduct a disease burden study
for the planning and implementation of the phase III
trials for the oral rotavirus vaccine 116E. Conducted by
Society for Applied Studies .
• Multicenter prospective Hospital-based surveillance of
rotavirus gastroenteritis in children ≤ 59 months of
age currently ongoing in India – Supported by
Shantha Biotech
TYPHOID SURVEILLANCE IN INDIA
•NICED in collaboration with International Vaccine Institute, Seoul,
Korea initiated a project titled “Surveillance for typhoid fever and
cholera in eastern Kolkata, West Bengal, India” in 2002, in
preparation for field trials of vaccines against these two diseases.
• It is basically a healthcare facility-based passive surveillance;
nested case-control studies done among urban slum population
(60,000) of Kolkata in ward 29 and 30.
•IDSP ( Integrated Disease Surveillance Programme ) also
undertakes typhoid surveillance in India
ISSUES IN ROTA & TYPHOID
SURVEILLANCE
• Need for sustaining surveillance activities
• Poor analysis of available Data