Disease Surveillance in China - National Disease Surveillance Points (DSPs)

National Disease Surveillance Points (DSPs)

In the period 1980-1989, the network of DSPs covered 29 provinces, autonomous regions, and municipalities that had a combined population of 10 million persons (<1% of China's population). When the network was proposed in 1978, it was not possible to obtain a population-based random sample. Because participation in the network was voluntary, the data collected were biased, even after attempts were made to adjust the sample to improve national representativeness. Persons covered by the DSPs tended to be from the upper-middle socioeconomic stratum.

In 1989, efforts were begun to select a new sample of surveillance points. We used stratified cluster random sampling to select 145 DSPs in 30 provinces, autonomous regions, and municipalities, which have a combined population structure similar to that shown in the national census. Data on individual births and deaths, as well as on infectious diseases and certain types of behaviors (e.g., tobacco smoking), are recorded. At the household level, information on socioeconomic indicators, health-care conditions, and environmental factors is collected.

Information obtained from the DSPs is compared with data obtained from the National Disease Reporting System to enable policymakers to estimate more accurately the burden of morbidity and mortality associated with infectious disease. More importantly, policy makers can evaluate information from the DSPs in relation to the economic development, cultural background, and health-care-service use by the population covered by this surveillance system.

Data collected at DSPs:

• Household information: includes data on number of members, income, health-care situation, water supply, and toilet facilities.

• Individual information: includes data on occupation, education, births, deaths, episodes of infectious diseases, pregnancy, lactation, feeding, and vaccination status.

Each month, data collected by the township hospitals and village prevention units are submitted to the country, which then conveys the information through the provincial centers to the Chinese Academy of Preventive Medicine. The Academy distributes monthly reports to the Ministry of Public Health, to provincial health authorities, and to all DSPs. An annual report is also published and distributed.