Conference abstract

Early warning system in Tunisia: evolution, challenges and role of laboratory, biosecurity, environment and modeling of infectious diseases

Pan African Medical Journal - Conference Proceedings. 2017:4(3).08 Nov 2017.
doi: 10.11604/pamj-cp.2017.4.3.461
Archived on: 08 Nov 2017
Contact the corresponding author
Keywords: Tunisia, early Warning System, surveillance, infectious diseases
Abstract

Early warning system in Tunisia: evolution, challenges and role of laboratory, biosecurity, environment and modeling of infectious diseases

Nissaf Bouafif Ben Alaya1, Hédia Bellali2, Matthias Nachtnebel3, Lilian Hollenweger4, Dilan Kücükali5, Riadh Allani6,&

1General Director of National Observatory for New and Emerging Diseases of the Ministry of Health, Tunisia, 2Director of Directorate for Primary Health Care of the Ministry of Health, Tunisia, 3Project Manager of the German Partnership Program for Excellence in Biological and Health Security at Robert Koch Institute (RKI), Germany, 4Project Coordinator of the German Partnership Program for Excellence in Biological and Health Security at Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), Germany, 5Project Manager of the German Partnership Program for Excellence in Biological and Health Security at Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), Germany, 6Public Health Associate Professor, Faculty of Medicine of Tunis, Tunisia

&Corresponding author
Riadh Allani, Public Health Associate Professor, Faculty of Medicine of Tunis, Tunisia

Abstract

Introduction: the Tunisian National Public Health Surveillance System for Infectious Diseases (IDs) has two main objectives. The first objective consists of the continuous monitoring of the burden of infectious diseases, including the monitoring of morbidity and mortality. Ultimately, these surveillance activities create evidence for policy making, effectively guide interventions, control programs and allow for appropriate allocation of resources. The second objective is the detection of any kind of public health event requiring rapid investigation – as early as possible - and find the appropriate response to avert and minimize negative consequences for the health of affected populations.

Methods: systemic review of the “National Public Health Surveillance System for Infectious Disease” program.

Results: in Tunisia, but also on the international level, it has been recognized that achieving these objectives, particularly objective two, requires the implementation of an early warning and response system (EWAR) in addition to the already existing indicator-based surveillance (IBS); the latter mostly serving objective one. Here, we aim to share the Tunisian experience with the implementation of EWAR, identify relevant challenges and outline the way forward. Currently, there are two main institutions responsible for public health surveillance and early warning, both of which are under the supervision of the Ministry of Health: the National Observatory for New and Emerging Diseases (ONMNE), created in 2008 to improve response to health and environmental threats, and the Directorate for Primary Health Care (DSSB), which serves as the National IHR (International Health Regulations) focal point, and is in charge of IBS. Thus, EWAR succeeded by combining a new event-based surveillance (EBS), an epidemiological teleconference platform (EpiTec) with the routine IBS. The EBS draws on alternative sources of reporting channels and provides a more informal and quicker way of information sharing. The EpiTec brings together most relevant stakeholders in surveillance at regular intervals and thus improves communication and information flow. Integration with IBS takes place during 2016 in close collaboration with other partners. In addition, EWAR draws on a large number of actors from various disciplines, such as environmental and entomological data, mathematical modeling of IDs, or sentinel surveillance at emergency rooms, general practitioners and laboratory networks.

Conclusion: challenges were especially related to data integration, sharing and transmission by using electronic web tools. Next steps foreseen are a simulation exercise, training activities and final evaluation and validation of the process.