Clinical Surveillance System (CSS)
The clinical surveillance system monitors patients presenting with illness at outpatient and inpatient facilities. This “passive detection” system permits the measurement of impact of interventions on clinical illness and also serves as the basis for pharmacovigilance. The system presently covers dispensaries, health centres and hospitals in Bagamoyo, Kilombero and Ulanga.
Ifakara Health Institute (IHI) relies on its strong partnership with government and non-government district hospitals for the integrated clinical studies platform. Hence provision of routine clinical services and improvement of quality of care is also important aspect of IHI work.
The objectives of clinical surveillance system
a) The main objective of the system is to monitor morbidity and mortality among patients attending health facilities
b) To monitor disease trends in patients attending health facilities.
c) To assess safety and efficacy of different interventions.
Using datasets with variables attached in the ANNEX, from these platforms DAC is required produce yearly reports for inpatient and outpatient. The reports should be mainly capturing the following information by end 2010;
• Composition of inpatient and outpatient cases
• Case management and outcomes
INPATIENT SURVEILLANCE SYSTEM (ISS)
Procedure for collection data in the ISS
a) On admission a clinical officer completes a standardized questionnaire on all children, a simplified version of the information is collected from the outpatients in four health facilities in Ifakara.
b) A capillary blood sample is collected to measure haemoglobin and thick blood films prepared for quantification of malaria parasitaemia
c) A clinical diagnosis of the disease is documented by a clinician at the time of admission and final diagnosis at the time of discharge.
The ISS in Kilombero district started in 1994 and it involves all admission in the paediatric department at Saint Francis Designed District Hospital (SFDDH). The On average over 6,000 admissions are recorded per year. The main aim of the system is to support the clinical intervention trials done in collaboration with IHI, in monitoring the disease episodes (disease under study) and mortality. It also helps to monitor morbidity pattern changes in the area among under five children admitted in the hospital over time.
The ISS is within paediatric ward at Bagamoyo District Hospital (BDH) established in late 2004. The ISS is operated by Bagamoyo Research and Training Centre (BRTC), a branch of the Ifakara Health Institute. The ISS were used as a platform for performing high-quality Phase II and Phase III malaria vaccine and drug trials according to ICH/GCP standards.The main aim of the system is to support the clinical intervention trials done in collaboration with IHI, in monitoring the disease episodes (disease under study) and mortality. It also helps to monitor morbidity pattern changes in the area among under five children admitted in the hospital over time.
OUTPATIENT SURVEILLANCE SYSTEM
The outpatient surveillance system or Passive Case Detection (PCD) was effectively established since 2008 and 2010 in Bagamoyo and Kilombero districts respectively.
The PCD data are collected in the following five health facilities;
a) Bagamoyo district hospital
b) Kiwangwa Dispensary
c) Kongo Dispensary
d) Yombo Dispensary
e) Fukayosi Dispensary
The PCD data are collected in the following four health facilities;
a) Lupiro Health Centre
b) Milola Dispensary
c) Idete Dispensary
d) Mbingu Dispensary