Surveilans EPid-2020
Surveilans EPid-2020
Systematic, ongoing
• Collection
• Analysis
• Interpretation
• Dissemination
• Link to public health
practice
Purposes of Public Health
Surveillance
• Assess public health status
• Define public health
priorities
• Evaluate programs
• Stimulate research
Surveillance
•
Purposes of Public Health
Surveillance
• Assess public health status
• Define public health
priorities
• Evaluate programs
• Stimulate research
Uses of Public Health Surveillance
• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning
Uses of Public Health
Surveillance
• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning
15 Shigellosis
United States, 1968-1998
Reported Cases per 100,000
10
Population
0
1968 1973 1978 1983 1988 1993 1998
Year
Source: CDC. Summary of notifiable diseases. 1998.
Uses of Public Health
Surveillance
• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning
Rate of Hepatitis A
United States, 1998
NYC
DC
PR
NA VI
GUAM
NA AM SAMOA
NA CNMI
160
National Center for Infectious Diseases (NCID) data*
140
Reported Cases
100
80
60
40
20
0
Year (Quarter)
1984 1986 1988 1990 1992 1994 1996
1998
1983 1985 1987 1989 1991 1993 1995 1997
Uses of Public Health
Surveillance
• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning
Botulism (Foodborne)
United States, 1978-1998
110 Outbreak Outbreak caused Laboratory-
caused by by sautéed confirmed cases*
100
potato onions, IL caused NETSS data
90 Outbreak
salad, NM
by fermented Outbreak caused by
Reported Cases
80
fish/sea products, baked potatoes, TX
70 AK
60
50
40
30
20
10
0
1978 1983 1988 1993 1998
Year
Source: CDC. Summary of notifiable diseases. 1998.
Uses of Public Health
Surveillance
• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning
MEASLES (Rubeola)
United States, 1963-1998
Reported Cases (Thousands)
Vaccine MEASLES — by year, United
500 licensed States, 1983–1998
450
400
30
Reported Cases
25
350
(Thousands)
20 20
300
15
250 10 10
200 5
0
150
1983 1988 1993 1998
100
Year
50
0
1963 1968 1973 1978 1983 1988 1993 1998
Year
Pertussis (Whooping Cough)
2,400 United States, 1998
2,100
1,800
Reported
1,500
Cases
1,200
900
600
300
0
<1 1–4 5–9 10–14 15–19 20–29 30–39 40–49 50–59 >60
Age Group (Years)
Uses of Public Health
Surveillance
• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning
Poliomyelitis (Paralytic)
60 United States, 1968-1998
55
Rate/100,000 Population
Inactivated Vaccine
50 1000
100
45 Oral Vaccine
10
Reported Cases
40 1
0.1
35
0.01
30 0.001
25 19511956 19611966 19711976 19811986 1991 1996
20 Year
15
10
5
0
1968 1973 1978 1983 1988 1993 1998
Year
Source: CDC. Summary of notifiable diseases. 1998.
Uses of Public Health
Surveillance
• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning
Trends in Plasmid-Mediated Resistance to
Penicillin and Tetracycline
United States, 1988-1997
12
PPNG
Percent
10 TRNG
PPNG & TRNG
8
6 Source:
Gonococcal
4 Isolate
Surveillance
2 Project (GISP)
0
1988 1989 1990 1991 1992 1993 1994 1995 1996 1997
Year
Uses of Public Health
Surveillance
• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning
Breast Cancer Screening
Uses of Public Health
Surveillance
• Estimate magnitude of the problem
• Determine geographic distribution of illness
• Portray the natural history of a disease
• Detect epidemics/define a problem
• Generate hypotheses, stimulate research
• Evaluate control measures
• Monitor changes in infectious agents
• Detect changes in health practices
• Facilitate planning
Tuberculosis
United States, 1986-1998
(U.S.- and foreign-born persons)
20,000
U.S.-born
Foreign-
born
16,000
Reported Cases
12,000
8,000
4,000
Year
0
1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998
Obesity
United States,
1987-1998
Not available
< 10 %
……
…….
…….
10%-15%
>15%
Physical Activity
Georgia 1998
PER CENT
Responses
YES NO
Less than 15,000- 25,000- 35,000-
$50,000>
15,000$ 24,999$ 34,999$ 49,999$
Source: BRFSS 1998
5. SOURCES OF
SURVEILLANCE DATA
Sumber data surveilans
• WHO mencatat sumber – Report of epidemic
kunci data surveilans investigations
adalah: – Special surveys (e.g.
– Mortality reports hospital admissions,
– Morbidity reports diseses register, and
– Epidemic reports serologic surveys)
– Report of laboratory – Information on animal
utilization reservoirs and vectors
– Report of individual – Demograohic data
case investigations – Environmental data
6. CONDUCTING SURVEILLANCE
KEGIATAN SURVEILANS
Pengumpulan data
Pengolahan data
Penyajian data dan
Analisa data
PENGUMPULAN DATA SURVEILANS
A. Pencatatan:
• Data hasil kunjungan berobat pasien. Dicatat
dalam buku register.
• Data hasil kunjungan diluar gedung:
imunisiasi, penyuluhan, poyandu, UKS,
invesiutigasi KLB, dsb. (Formulir program
oleh petugas yang melakukan kegiatan)
• Khusus data kesakitan/kematian pada KLB
dicatat dalam form investigasi, harus pula
dicatat dalam LB3.
PENGUMPULAN DATA SURVEILANS
B. Pelaporan
Untuk membuat laporan, petugas puskesmas
merekap data dari Register harian kegiatan
dalam dan dalam gedung puskesmas.
Jenis laporan surveilans:
• Laporan 24 jam, yi laporan pemberitahuan awal
terjadinya KLB ke unit atasan dan pusat
menggunakan form W1
• Laporan mingguan, yi. Laporan kewaspadaan dini
kemungkinan terjadinya KLB menggunakan W2.
• Laporan bulanan, yi. Lap. Bulanan kesakitan dan
laporan program yg dilaporkan ke unit atasan
menggunakan form LB1, LB2 dan LB3.
PENGUMPULAN DATA SURVEILANS
c. Validitas laporan
Validitas data artinya data yg dimuat didalam laporan tsb data
yang dapat dipertanggung jawabkan kebenaran
pengisiannya oleh petugas pd sumberdata terutama di
puskesmad dan RS.
Misalnya:
Dilaporkan kasus Poliomyelitis 5 kasus dari satu desa.
Kita ketahui bahwa`kasus polio pada sat ini hampir dapat
diketahui tidak ada/ amat jarang. Maka dengan informasi
yg seperti ini petugas surveilans puskesmas harus
melakukan pengecekan terhadap data tersebut sebelum
melaporkannya ke tingkat lebih atas.
PENGUMPULAN DATA SURVEILANS
Tabel
Tabel silang :
Ada judul
Syarat
Kolom variabel
<1
1-4
5-14
15-44
>45
Jumlah
Grafik dan Peta
Data dari tabel diringkas dalam bentuk grafik dan peta, agar mudah dipahami
Angka Statistik
- Kelompok
Angka Statistik
- Tunggal
- Jumlah
- Mean
Angka Tunggal : - mutlak
- Median
- modus
- Rate
- relatif - Ratio
- Propinsi
Gambar 1 Line /garis: Melihat Trend
500
400
300
th1996
sus
200
lK
J a
100
0
J F M A M J Jl A S O N D J F M A M J Jl A S O N D J F M A M J Jl A S O N D J F M A M
Bulan
Gambar 4: Scatter diagram
Hubungan (asosiasi) atau kekuatan hubungan
Gambar 4.
Pengaruh penyemprotan rumah pada % Parasit Rate
di Prov X , per 6 bulan tahun 1960-1965
15
10
PR (%)
PR(% )
0
0 1 2 3 4 5 6 7 8 9 10 11 12
Tahun tiap 6 bulan
AREA MAP
Intervensi:
Lock down
Cruva Epidemik Covid-19 di
Korea Selatan
Intervensi:
Lock down
Massive Rapid test
Kasus DBD dan ABJ di Kota X
tahun 2019
Analisis Data
KHUSUS :
a. Teridentifikasinya adanya ancaman KLB.
b. Terselenggaranya peringatan Kewaspadaan Dini KLB.
c. Terselenggaranya Kesiapsiagaan menghadapi
kemungkinan tjdnya KLB.
d. Terdeteksinya secara dini adanya kondisi rentan KLB
e. Terdeteksinya secara dini adanya KLB
f. Terselenggaranya dugaan KLB
SISTEM KEWASPADAAN DINI-KLB
PENYAKIT MENULAR DAN KERACUNAN
96
Wanmo 97
PEMAHAMAN SKD-KLB
Respon Respon
KLB
KL
B
SKD KLB
Memberikan toleransi untuk terjadi KLB namun jumlah kasus / kematian
dan daerah terserang ditekan seminimal mungkin
Wanmo 101
Wanmo 103
KONSEP SKD:
Deteksi Fak Risiko, Deteksi masalah
kes/Penyakit
• Contoh: SKD KLB Keracunan makanan
KLB
Faktor
Kasus Keracunan
Risiko
-Makanan Diare Makananan
Meningkat Angka Kesakitan
> 4 jam
-Basi kematian meningkat
Penyakit Potensial KLB
VARIABEL
PENYAKIT Kondisi rentan (Faktor Kasus
risiko)
1. PD3I Cak imunisasi desa < 80 Peningkatan atau
% adanya kasus
Suhu lemari es campak, difteri,
polio
2. DIARE -Perilaku hidup sehat - Peningkatan
-Penyediaan air bersih kasus diare
-% jamban keluarga - kematian atau
- prbhn musim kss diare dg
dehidrasi berat
3. DBD Angka bebas jentik Peningkatan kasus
House index DBD
Prbhn musim
Contoh Penyakit akibat bencana
VARIABEL
PENYAKIT Kondisi Rentan (Fak risiko) Kssus
STP/W2/W STP/
1 W2/W1
STP STP/
STP
W2/W1
RS Kemkes
RS
STP=Surveilans Terpadu Penyakit
KONDISI LINGKUNGAN RENTAN KLB
Avian Flu and Response in Indonesia
Gb.3. Cakupan immunisasi Polio 3 perpuskesmas Kab.X
Jan-Juni tahun 2005
60
Target 40,2 %
50
40
30
20
10
0
Pusk-A Pusk-B Pusk_C Pusk-D Pusk-E Pusk-F Pusk-G Pusk-H Kab_X
% Kumulatif 53 50 50 49 45 39 39 33 44
% Bulan Ini 7 17 11 10 13 11 2 10 10
% Bulan lalu 4 4 5 3 4 3 5 0 4
Trend N N N N N N T N N
PWS
Gambar 1. Inde ksi je ntik di De sa A, B dan
C Ke camatan X Triw I dan II , 2005
In d e k s J e n tik (% )
50
40
30 Triw-I
20 Triw-II
Target <10%
10
0
Desa A Desa B Desa C
Reference
• Principle of epidemiology (1992), 2 ed, U.S Department
of Health and Human Services.
• Denise Koo, MD, MPH, Epidemiology Program Office,
Centers for Disease Control and Prevention
• Depkes RI, Pedoman surveilans
• Keputusan Menkes No 1116 tahun 2003 tentang
Pedoman Penyelenggaraan sistem Surveilans
epidemiologi Kesehatan