Disease Surveillance in China - Use of Surveillance Data For Control of Disease

Use of Surveillance Data For Control of Disease

Surveillance data have been used to implement and evaluate public health programs.

Monitoring morbidity from infectious disease during heavy flooding in 1991

When six provinces around the Yangtze River were heavily flooded in 1991, the central government expressed serious concern about disease-prevention activities in these provinces. In response, experts were dispatched to the flooded area, and prevention guidelines were developed and distributed to the affected provinces. Simultaneously, a system for collecting daily reports of disease activity was established. Every 3 days, DSP data on infectious disease morbidity were compared with data from previous years to identify potential outbreaks. For example, rates of hepatitis during the flood were compared with rates for the comparable time periods from the preceding 2 years. Data collected from June to October 1991 indicated that infectious diseases had been controlled effectively during the flood.

Forecasting the epidemiologic transition in China

In a study sponsored by the World Bank, data collected in DSPs in the period 1986-1989 have been used to study the epidemiologic transition in China. Mortality from leading causes of death was projected for 2010 and 2030. After risk factors were assessed and the impact of preventive programs on these chronic diseases was estimated, mortality rates were recalculated. These analyses were used to develop recommendations for program planning to the Ministry of Health.

Prediction and control of meningitis

After surveillance data on morbidity from meningitis in China were reviewed by empirical analysis and Boyer's Theorem, it was predicted that morbidity from this disease would peak in 1984 or 1985. Additional analyses suggested that the vaccination program that had been conducted for several years, which provided vaccination only for children <12 months of age, would not be adequate to control the predicted upsurge in disease. Therefore, a new vaccination program was adopted that expanded coverage to all children <5 years of age in areas in which surveillance data (including serum epidemiologic data) identified a high risk of meningitis outbreaks. The results in Henan Province suggested that the intensified vaccination coverage was successful in decreasing rates of meningitis.

Strategy for vaccination for poliomyelitis

After data from 1988 to 1989 on rates of poliomyelitis and vaccination coverage were reviewed, high-risk areas were identified. In these areas, persons received supplementary vaccination in 1989-1990. By 1991, rates of poliomyelitis had begun to fall.