Maps of outbreaks

Abdullahi_Lawal · 15 February 2014 19:48

Hi Alvin,
It is always good to use a more diplomatic approach to define ‘outbreaks’ rather than using a word like ‘insurgency’ that is …
I think as you list out the words “outbreaks = outbursts” may be a perfect match.

···

Brajesh Murari brajesh.murari@yahoo.com wrote:

Hi,

There are some synonyms for ‘outbreak’ are given below

explosion, blast, eruption, outburst, detonation, blowup, outburst, plosion, advent, repullulation, commence, inception, initiation, inchoation, eruption, insurgency,

I think “Insurgency” or ‘Inception’ would be nice to use for ‘outbreak’ in context of DHIS2.

Regards

Brajesh Murari

On Saturday, 15 February 2014 1:25 PM, Alvin B. Marcelo alvin.marcelo@gmail.com wrote:

I’m not sure if I got the 3Cs correctly. Pls google too…

Sent from my BB Curve 9320

-----Original Message-----
From: “Alvin B. Marcelo” alvin.marcelo@gmail.com
Date: Sat, 15 Feb 2014 07:41:03
To: Knut Staringknutst@gmail.com; Dhis2-usersdhis2-users-bounces+alvin.marcelo=gmail.com@lists.launchpad.net; dhis2-users@lists.launchpad.net dhis2-users@lists.launchpad.net
Reply-To: alvin.marcelo@gmail.com
Subject: Re: [Dhis2-users] Maps of outbreaks

Hi Knut,

My two cents as we recently experienced a measles ‘outbreak’.

First, better not to call it an ‘outbreak’. Health officials are very sensitive about the term. We can gain their confidence if we don’t “presume” an outbreak by labeling it as such on the interface.

Second, we missed this ‘outbreak’ in Metro Manila (of all places!) because the health workers waited for official lab confirmation (which takes 3 weeks in this part of the world). The health workers forgot to execute the protocol that if the 3Cs are present (colds, cohryza, conjunctivitis) they should suspect measles and immediately vaccinate the surrounding children.

Lesson: if any child comes in with any one of the 3Cs, the information system should alert them for the other 2Cs. The 3Cs will be reported upwards and it will be a syndromic report and not an outbreak report.

The first syndromes (in retrospect) started coming in as early as August but it was only December when the trend became evident (due to the lack of near-real time reporting and health worker forgetting the protocol).

I fully support this initiative. Such a system, if it works, could have saved lives in the Philippines. A better name might be DHIS2 syndromic surveillance decision support system with the ability to inform officials of dangerous trends.

We’ll leave it up to the health officials to call it an outbreak.

Alvin

Sent from my BB Curve 9320

-----Original Message-----
From: Knut Staring knutst@gmail.com
Sender: “Dhis2-users”
dhis2-users-bounces+alvin.marcelo=gmail.com@lists.launchpad.netDate: Sat, 15 Feb 2014 08:16:23
To: dhis2-users@lists.launchpad.net dhis2-users@lists.launchpad.net
Subject: [Dhis2-users] Maps of outbreaks

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roshan.h · 19 February 2014 16:23

Dear Knut and all,
Very interesting discussion. I would like to share my thought also on how Sahana DMS included this. We had the concept of ‘situation awareness’ -which I think is a well agreed term in surveillance. When counts reach a certain level, it becomes an outbreak.

So, I think we may not need to introduce the data element ‘outbreak’, but a means to define a threshold to any data element or indicator once aggregated (eg. low hemoglobin in age group 1-14 years).

In creating each data element or indicator in DHIS2, we can flag it whether its under surveillance. Also, another feature could be for the facility to set thresholds to data elements or indicators marked for surveillance. Then it can trigger notifications apart from mapping the cases on the map. Map legend would be able to provide additional visual clues whether the condition is under surveillance or reached the threshold (outbreak).

‘Revers’ of this process we used for inventory management. User can define re-order levels and Sahana does the estimations and sends alerts.

Roshan

wanjala_pepela · 20 February 2014 12:39

A disease outbreak is the occurrence of cases of disease in excess of what would normally be expected in a defined community, geographical area or season. an Outbreak is a term used in epidemiology to describe an occurrence of disease greater than would otherwise be expected at a particular time and place. if we are designing a data element, then we should use the term suspected disease or outbreak.

regards

PEPELA WANJALA

MINISTRY OF HEALTH HEADQUARTERS

HEALTH INFORMATION SYSTEM

AFYA HOUSE, HIS LG 37

P.O BOX 30016, NAIROBI, KENYA

TEL: +254 (020) 2717077 EXT 45097

CELL: +254 (0) 722375633 or 0202033363

EMAIL: wanjala2p@yahoo.com

** hmis@health.go.ke**

* *"HealthInformation Management - Making a World of Difference”

···

On Wednesday, February 19, 2014 7:23 PM, Roshan Hewapathirana roshanhewapathirana@gmail.com wrote:

Dear Knut and all,
Very interesting discussion. I would like to share my thought also on how Sahana DMS included this. We had the concept of ‘situation awareness’ -which I think is a well agreed term in surveillance. When counts reach a certain level, it becomes an outbreak.

So, I think we may not need to introduce the data element ‘outbreak’, but a means to define a threshold to any data element or indicator once aggregated (eg. low hemoglobin in age group 1-14 years).

In creating each data element or indicator in DHIS2, we can flag it whether its under surveillance. Also, another feature could be for the facility to set thresholds to data elements or indicators marked for surveillance. Then it can trigger notifications apart from mapping the cases on the map. Map legend would be able to provide additional visual clues whether the condition is under surveillance or reached the threshold (outbreak).

‘Revers’ of this process we used for inventory management. User can define re-order levels and Sahana does the estimations and sends alerts.

Roshan

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roshan.h · 20 February 2014 13:14

I agree with the definition. My suggestion was to make the 2 concepts you mentioned ‘properties’ of (any applicable) data element, instead of data elements themselves.

If we are to create data elements for all conditions need to be under surveillance, we need to create 2 data elements per condition (suspected and outbreak) I think.
However, if suspected (property:under surveillance) is a property of any data element, we don’t have to create new data elements and enter data. We can just re-use the data entered and when counts reach the level (property:upper limit to be notified as outbreak), can be visualized and trigger alerts.

If we do this, we can keep more than one condition dynamically under surveillance easily.

···

On 20 February 2014 13:39, wanjala pepela wanjala2p@yahoo.com wrote:

A disease outbreak is the occurrence of cases of disease in excess of what would normally be expected in a defined community, geographical area or season. an Outbreak is a term used in epidemiology to describe an occurrence of disease greater than would otherwise be expected at a particular time and place. if we are designing a data element, then we should use the term suspected disease or outbreak.

wanjala_pepela · 20 February 2014 13:48

Yes, that is right though every disease entity has a threshold level which need be in build into the flacking or trackers for the diseases are at different level of either earmarked for eradication where a single case confirmed is outbreak or elimination and control.

regards

PEPELA WANJALA

MINISTRY OF HEALTH HEADQUARTERS

HEALTH INFORMATION SYSTEM

AFYA HOUSE, HIS LG 37

P.O BOX 30016, NAIROBI, KENYA

TEL: +254 (020) 2717077 EXT 45097

CELL: +254 (0) 722375633 or 0202033363

EMAIL: wanjala2p@yahoo.com

** hmis@health.go.ke**

* *"HealthInformation Management - Making a World of Difference”

I agree with the definition. My suggestion was to make the 2 concepts you mentioned ‘properties’ of (any applicable) data element, instead of data elements themselves.

If we are to create data elements for all conditions need to be under surveillance, we need to create 2 data elements per condition (suspected and outbreak) I think.
However, if suspected (property:under surveillance) is a property of any data element, we don’t have to create new data elements and enter data. We can just re-use the data entered and when counts reach the level (property:upper limit to be notified as outbreak), can be visualized and trigger alerts.

If we do this, we can keep more than one condition dynamically under surveillance easily.

···

On Thursday, February 20, 2014 4:15 PM, Roshan Hewapathirana roshanhewapathirana@gmail.com wrote:

On 20 February 2014 13:39, wanjala pepela wanjala2p@yahoo.com wrote:

A disease outbreak is the occurrence of cases of disease in excess of what would normally be expected in a defined community, geographical area or season. an Outbreak is a term used in epidemiology to describe an occurrence of disease greater than would otherwise be expected at a particular time and place. if we are designing a data element, then we should use the term suspected disease or outbreak.