How can surveillance help to detect and control the disease?
As dengue is mosquito-borne infection, transmitted from person to person through the bite of Aedes mosquito, surveillance and control is important.
Using data from surveillance –
1. Preventive measures – We can enforce preventive measures to reduce mosquitoes breed in the environment, to decrease transmission, advise personal protective measures/awareness raising/early signs & symptoms especially in endemic areas.
2. Know the disease burden – to understand the distribution, nature and burden of infection nationally & sub-nationally
3. Monitor trends – we can evaluate the impact of interventions to the spread of infection
4. Detect and respond to outbreaks – early detection and preparedness plans like resource allocation, refresher training to health staff, blood bank alert
Should we conduct active or passive surveillance or both for the disease, why?
I think it depends on situations-
1) During routine period – Passive surveillance is enough.
2) During outbreaks and seasonal peaks – Passive surveillance is primary and combines with active surveillance. Passive surveillance through reports is sustainable and cost-effective. But during sentinel outbreak or peaks, sentinel active surveillance is necessary to make timely interventions and preventive measures. Combination of both approaches is important because most of the infection is mild or even asymptomatic, which can be missed if we rely only on passive surveillance.
Which method should be best to identify cases, why?
1. Cases in medical facilities VS community
Cases in community because most of the infected cases are asymptomatic or mild, not seeking medical care at facility, which can underestimate the disease burden.
2. Sentinel VS population-based surveillance
Sentinel surveillance because dengue is vector-borne disease and usually spread in community through the bites of infected mosquitoes. Population-based surveillance is more time and resources consuming and may compromise the quality of data.
3. Case-based VS aggregated surveillance
Case-based surveillance for contact tracing, mapping and early outbreak detection and intervention.
4. Syndromic VS laboratory-confirmed surveillance
Lab-confirmed surveillance because it mainly presents with fever & rash which are very non-specific and mimic other viral illnesses. (like influenza, zika, etc.)
What dissemination tools will you choose to disseminate monkeypox surveillance information? Why do you choose this/these tools?
Through multi-media to ensure the reach of the information:
Periodic SMS in local language-since most people, including elderly, use mobile phones nowadays. Therefore, I think it ensures everyone gets the health message and alerts.
Facebook– because this is still the most popular online platform in my country.
Television – Dedicated information sessions on TV show and also footnote in popular TV programs.
Electronic dashboard – to disseminate real-time visualization, dissemination an hotspots mapping
By using this combination of approaches, we can ensure that the information is accessible, timely and inclusive.