Infectious diseases are on the rise around the world as recent WHO data show, for example, malaria, tuberculosis, or dengue. To meet this threat, infectious disease control must be effective, and systematic surveillance plays an important role by providing timely information about outbreaks and trends. This paper describes how district public health offices and national control programs in Nepal and Eritrea use sentinel surveillance, for example, to respond to epidemic threats and to monitor treatment failure. An early warning and reporting system in Nepal has been operational in 25 hospital sentinel sites for two years and provides daily and weekly case information about six infectious diseases: malaria, Japanese Encephalitis, Kala Azar, acute flaccid paralysis, measles, and neonatal tetanus. In Eritrea, malaria control program officers at zonal and sub-zonal levels use basic entomological and epidemiological data to implement environmental management interventions and personal control measures that are part of an integrated malaria control program. The Environmental Health Project supports surveillance activities in both countries to meet fundamental challenges in designing and implementing sentinel surveillance, incorporating data from other sectors to relate environmental changes with disease patterns, and to document lessons learned. Although the use of sentinel sites can be cost effective in countries where available resources and skills limit the scope of surveillance systems, important issues need to be recognized to ensure data validity and usefulness. Both countries implement solutions that promote the use of surveillance data at district and national levels to make immediate programmatic decisions and inform field interventions.
Learning Objectives: Recognize the uses and issues of sentinel surveillance.
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