CDC Accomplishments in Integrated Disease Surveillance and Response (IDSR)

• The results of a study modeling the cost-effectiveness of an integrated surveillance system demonstrated a correlation between investments in IDSR and subsequent reductions in mortality, morbidity, and time-to-peak of an outbreak.  The study is unique in that it examined a comprehensive rather than disease specific surveillance system. (Somda et al. 2009)
• In 2010, WHO/AFRO and CDC systematically revised the WHO/AFRO IDSR Technical Guidelines to incorporate emerging and reemerging disease threats (i.e., pandemic influenza), the national core capacity and public health event requirements specified in the IHR (2005), and emergent priorities in the African region for non-communicable diseases and neglected tropical diseases.  The 2010 edition of the IDSR Technical Guidelines was completed in October 2011 with French and Portuguese translations.
• The CDC IDSR Team, and our partners in WHO-AFRO and Africa 2010, designed and conducted a rapid assessment of progress with implementation of the IDSR strategy in African countries.  Results suggested areas of success included adoption of IDSR guidelines by 42 countries.  Nearly half of the countries have a defined laboratory network and a budget line dedicated to support for surveillance activities.  Challenge areas included high turnover of IDSR-trained workforce at all levels.   A report will be available from WHO-AFRO. This example of evidence-based knowledge will be used to inform decisions at country level.

• The CDC IDSR Team, in collaboration with WHO-AFRO, completed a revision of the WHO-AFRO IDSR Training Materials to match the revised Technical Guidelines. Field testing of these materials occurred in May 2011 in Jinja, Uganda. Training materials have been translated into French and Portuguese.  WHO-AFRO has distributed the materials to countries in each of its sub-regions where they are adapted and adopted by national programs.
• To better understand gaps and barriers to effective surveillance and timely response at the district level, the CDC IDSR Team analyzed detection and response data associated with an outbreak prone diseases such as cholera.  Results indicated that among the challenges to timely detection and response were low use of standard case definitions at peripheral levels, inconsistent and unreliable reporting of cases, and low communication between different levels of the healthcare system.  CDC and WHO AFRO continue to examine solutions such as the creation of simple, field-ready job aids and checklists to support adherence to the IDSR framework and thus improve detection and response efforts for priority diseases that afflict African communities.
• IDSR is cross functional and is a leader in leveraging strengths through partnership and coordination in the African region.We have provided technical assistance to and shared materials with several CDC programs, including the Sustainable Management Development Program (SMDP), Field Epidemiology Training Program (FETP), Meningitis and Vaccine Preventable Diseases Branch, and Waterborne Disease Prevention Branch.