Acknowledgements

Unit 2 Exercises

Warm-up

Take a few minutes now to look back at your answers to the warm-up questions at the beginning of the unit. Make any changes you want.

discussion

Get into small groups by country, region or province to discuss these questions.
1. What is the predominant type of HIV in your country, HIV-1 or HIV-2?

2. What are the risk factors associated with sexual transmission of HIV in your country?

3. What are the most common opportunistic infections in your country?

4. What are the major HIV prevention programmes that are operating in your country? Of those programmes, what proportion of the population do they reach?

Apply what

you’ve learned/

case study

Try this case study. We will discuss the answers in class.

b. Would an STI prevention programme be an important part of the country’s HIV control efforts?

c. Given the HIV incidence in Cariba, what do you think will happen to tuberculosis rates in the next several years, and why?

Unit 3

Overview of Public Health Surveillance

Overview

is about

questions

1. 
   Which of the following terms indicates the number or proportion of persons in a population who have a disease at a given point in time?
   

1. 
   sensitivity
   
2. 
   prevalence
   
3. 
   negative predictive value
   
4. 
   none of the above
   

2. 
   True or false? One-time cross-sectional surveys are valid methods of HIV surveillance.
   

3. 
   Match the following terms with their definitions:
   

4. 
   Which of the following terms indicates the number of persons who develop a disease within a specified time period?
   

1. 
   specificity
   
2. 
   positive predictive value
   
3. 
   incidence
   
4. 
   none of the above
   

Introduction

What you

will learn

By the end of this unit you should be able to:

• 
  describe the components of a surveillance system
  
• 
  define sentinel surveillance, laboratory-based surveillance, and case definitions
  
• 
  define incidence and prevalence.
  

What is

surveillance?

Surveillance is the systematic, regular collection of information on the occurrence, distribution and trends of a specific infection, disease or other health-related event. Surveillance must occur on an ongoing basis, with sufficient accuracy and completeness for data analysis and dissemination that can lead to effective prevention and control of that infection, disease or health-related event.

Public Health Surveillance

Surveillance

events

Surveillance involves the following main components:

• 
  the systematic collection, analysis and evaluation of morbidity and mortality reports and other relevant data
  
• 
  timely and regular distribution of information about the trends and patterns of disease to those who need to know
  
• 
  use of the information for disease prevention and control measures.
  

An important part of the definition is that surveillance systems involve ongoing collection and use of health data. In other words, one-time cross-sectional surveys are not surveillance.

Information

loops

A surveillance system is an information loop or cycle that involves:

• 
  healthcare providers
  
• 
  public health agencies
  
• 
  the public.
  

Information loops, continued

The cycle begins when cases of disease occur. It is complete when information about these cases is made available and used for prevention and control of the disease. The analysed and interpreted data must be communicated to the people and agencies that need to use them. Figure 3.1 shows the information loop.
Figure 3.1. The flow of surveillance data


Discussing

the figure

Refer to Figure 3.1 and think about how HIV surveillance is conducted in your country. (You may also choose a different disease.)
For each block in the loop, write one or two events that might occur. On the next page ‘Reporting’ has been done as an example.
Discussing the figure, continued

Reporting:

1. 
   Laboratory reports laboratory result of Cryptococcus neoformans to treating physician.
   

2. 
   Notification form for patient with cryptococcal meningitis is sent from hospital to health department.
   

Analysis and interpretation:
1.

2.

Dissemination/utilisation

1.

2.

Intervention

1.

2.

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