Wet Market Surveillance




Disease Surveillance Systems of Bangladesh

Surveillance activities


Hospital Based Rotavirus & Intussusception Surveillance (HBRIS)
IEDCR in collaboration with icddr,b has started hospital based Rotavirus & Intussusception surveillance in three selected hospitals across the country from July 2012. The objectives of this surveillance are to estimate the proportion of diarrhea hospitalization among children less than 5 years of age, which are attributable to rotavirus, to describe the predominant strain of rotavirus throughout Bangladesh, to determine the age, region and seasonal distribution of hospitalizations associated with rotavirus in the population under surveillance and to estimate the frequency of hospitalization associated with intussusception among children less than 2 years of age in surveillance hospitals. According to case definition data and samples are collected from the hospitals and sent to central level for analysis and laboratory test on a periodic basis. The results will be shared with all the study collaborators and stakeholders.

Priority communicable disease surveillance (PCDS)
Surveillance of priority communicable diseases started with a view to build up an early warning system. The diseases selected for reporting under this surveillance are: (1) Diarrhoeal diseases (Acute watery diarrhoea and Bloody dysentery), (2) Malaria, (3) Kala-azar, (4) Tuberculosis, (5) Leprosy, (6) Encephalitis and (7) Unknown diseases. These diseases were selected for reporting from all levels to the national head quarter on a weekly basis, but on a daily basis during an outbreak situation. Upazila Health and Family Planning Officer (UH&FPO) and Civil Surgeons (CS) are responsible for conducting this surveillance locally.

Institutional disease surveillance (IDS)
It was started with the objective of developing disease profiles for each institution for future planning of distribution of logistics and manpower. It covers all the medical college hospitals and specialized institutes in Bangladesh. The diseases selected for reporting were both communicable and non-communicable diseases. Besides the above mentioned seven priority communicable diseases, all the diseases reported at outpatient department (OPD) and inpatient department (IPD) were selected for reporting. Priority communicable diseases were scheduled for reporting on a weekly basis and the other disease profiles on a monthly basis. Directors and Superintendants of the hospitals and institutes are responsible for conducting this surveillance locally.

Sentinel surveillance (SS)
It was started with the objective of covering maximum population from a selected community, focusing on people visiting the health care facilities for treatment as well as people who do not seek health care at any health care facilities. Initially, IEDCR started the surveillance in eight selected unions form one of the upazilas of eight selected districts. The diseases selected for reporting under this surveillance system are: (1) Diarrhoeal diseases (Acute watery diarrhoea and Bloody dysentery), (2) Malaria, (3) Kala-azar, (4) Tuberculosis, (5) Diphtheria, (6) Filaria, (7) Hepatitis, (8) Measles, (9) Meningitis, (10) Pneumonia, (11) Polio, (12) Sexually transmitted diseases (STDs), (13) Tetanus, (14) Typhoid, (15) Upper respiratory tract infections (URTIs) and (16) Whooping cough. These diseases were selected for bi-weekly reporting by the concerned UH&FPO and CS.

Surveillance through emergency outbreak investigations
Outbreak investigation is one of the key components of the activities of IEDCR. IEDCR responds to any unusual health events or diseases reported directly or indirectly to the Director, IEDCR on an emergency basis. National Rapid Response Team (NRRT), which is formed by the experts from IEDCR, conducts the outbreak investigations with the help of District Rapid Response Team (DRRT) and Upazila Rapid Response Team (URRT). Concerned UH&FPO, CS, Directors and Superintendants of the hospitals are responsible for reporting of any kind of outbreak situations. URRT and DRRT respond to any such kind of outbreak initially and send a preliminary report to the Director, IEDCR. NRRT responds according to the requirement and situation of the specific outbreak. IEDCR is responsible for preparing the outbreak investigation report, disseminating to the concerned authority and take initiatives to contain the outbreak immediately.

Acute meningo-encephalitis surveillance (AMES)
Acute Meningo-Encephalitis Surveillance (AMES) started in Bangladesh with the objectives of expanding the ongoing vaccine-preventable diseases surveillance to include Meningo-encephalitis, strengthening national capacity to detect important causes of Meningo-encephalitis and estimating incidence of vaccine-preventable causes of Meningo-encephalitis to provide vaccination in future. AMES started from October 2007 in collaboration with the partner organizations. Rajshahi, Khulna and Chittagong medical college hospitals were selected initially for the study. The meningo-encephalitis diseases selected for reporting under this surveillance are: (1) Japanese Encephalitis, (2) Nipah, (3) Dengue, (4) Other bacterial causes of encephalitis. The concerned surveillance physicians, Directors and Superintendants of the selected hospitals are responsible for conducting the surveillance locally and sending the reports bi-weekly.


High Risk Group Avian Influenza Surveillance (among cullers)
IEDCR has started the monitoring of follow-up of poultry workers and cullers of the avian influenza (H5) infected poultry farms since January 2008. When there is any report of confirmed H5 outbreak in any poultry farms from any districts, the local health authority immediately initiates the follow-up of those workers involved in that specific poultry. Those workers are given prophylactic anti-virals, tablet Oseltamivir daily for seven days and followed up for 14 days for development of any symptoms of influenza-like-illness (ILI). The concerned UH&FPO and the CS are responsible for sending the specific contact follow-up form daily by fax to the Director, IEDCR. If there is any report of suspected ILI case, IEDCR instructs the concerned local health authority for the necessary measures.

Hospital based Nipah surveillance
IEDCR in collaboration with ICDDR,B has started Nipah surveillance in ten selected hospitals since February 2006. The concerned surveillance physicians, Directors and Superintendants of the hospitals are responsible for sending monthly report according to the case definition of suspected Nipah cases in the prescribed form to the central level. Samples from the sites are collected and tested on a periodic basis. Data from the surveillance are stored and analyzed at the central level.

Hospital Based Influenza Surveillance
IEDCR in collaboration with ICDDR,B has started hospital based influenza surveillance in twelve selected hospitals across the country since May 2007. Six of them are public and six are private hospitals. The objectives were to identify individuals and clusters of people who have life threatening infections with influenza virus and to identify clusters of patients / health care workers / poultry workers with severe acute respiratory illnesses (SARI) and influenza-like-illnesses (ILI). The concerned surveillance physicians, Directors and Superintendants of the hospitals are responsible for sending monthly report according to the case definition of SARI and ILI cases in the prescribed form to the central level. Samples from the sites are collected and tested on a periodic basis. Data from the surveillance are stored and analyzed at the central level.

Event based disease surveillance
It is a process of investigating unofficial reports of disease events to verify the truth. This surveillance aims to decrease the potential for misinformation and misunderstanding and to inform the public and health officials about disease outbreaks, facilitate a rapid response, and promote public health preparedness. IEDCR has started the recording of any unusual health events from the daily newspaper, television, personal sources in addition to the local health authority. Following such kind of reports, IEDCR requests the local health authority to verify the truth immediately and initiate outbreak investigations from central level, if necessary.

High risk group avian influenza surveillance (among live-bird handlers)
The live bird handlers are another high risk group for avian influenza other than the poultry workers and cullers. Considering the importance of follow-up of this high risk group, IEDCR started the wet market surveillance among the live bird handlers, initially confined to Dhaka city only. Two specific fixed markets from each zone of the city corporations are selected for the study. At the first stage, IEDCR started from Dhaka City Corporation. The concerned local NGO/health clinic are responsible for conducting the surveillance locally. The health workers of the NGO/health clinic are collecting data from the live bird handlers from the specific market on a weekly basis. They are sending these data through web-based disease surveillance system. IEDCR is responsible for the coordination of all activities and subsequent report preparation periodically.

Sentinel surveillance for influenza-like-illness (ILI)
IEDCR will start the sentinel surveillance for influenza-like-illness (ILI) in eighteen more district hospitals throughout the country. Data will be collected from outdoor patient departments (OPDs) for suspected ILI cases and samples will also be collected and tested periodically. IEDCR will be responsible for overall coordination and subsequent report preparation periodically.