Hospital based surveillance of Acute Febrile Illness in India

[Ronan Kelly]

[FONT=&quot]AFI Surveillance[/FONT]

[FONT=&quot][FONT=&quot]Ever since its inception, Manipal Centre for Virus Research (MCVR) has been a stalwart in its endeavours to contribute to better public health. In the year 2013, in a bid to further the same, MCVR collaborated with Centers for Disease Control and Prevention (CDC), Atlanta and respective State Health Departments, initiating the Hospital Based Acute Febrile Illness (AFI) Surveillance in India, under the Global Health Security Agenda (GHSA).

Using the AFI Surveillance platform, MCVR began to contribute to the disease surveillance in the country by providing case based real time surveillance data. Acute Febrile Illness (AFI) is caused by a variety of infectious agents, including viruses, bacteria, and parasites some of which are amenable to therapeutic and/or preventative interventions. Advances in laboratory diagnostics have greatly enhanced understanding of the infectious aetiologies of Acute Febrile Illness (AFI).

However, significant gaps remain in the knowledge and understanding of burden, etiologic spectrum, and risk factors associated with AFI happening in India. The project was launched with an objective of bridging this gap and generating evidence for public health action.

Implemented first in the district of Shimoga, Karnataka in June 2014, the project has grown enormously with over 27 Sentinel hospitals currently under its wing. With its presence in over ten states of India including Karnataka, Kerala, Assam, Goa, Gujarat, Maharashtra, Jharkhand, Tripura, Tamil Nadu and Odisha, MCVR,MU continues to maintain close coordination and collaboration with the respective state health services.

This study aims to characterize the infectious causes of Acute Febrile Illness (AFI) among patients in District / Sub-District Hospitals / PHCs in India. It focuses on identifying pathogens including parasite (limited to malaria), bacterial, viral and other unknown causes of AFI. Using serology and modern molecular diagnostic assays, clinical samples are tested for unknown pathogens also by PCR- sequence based pathogen discovery techniques.

Apart from the project’s innate ability to detect various pathogens, its systematic yet highly efficient logistic system is also its highlight. Clinical samples are transported to MCVR on a daily basis under cold chain system. The results are communicated within 48 hours to the treating doctor under intimation to the State and District Health officials. This eliminates wastage of time in the diagnosis chain assisting speedy detection thereby helping with faster recovery.

AFI surveillance project has recruited over 12,000 cases and continues to generate valuable epidemiological data on infectious diseases in the country. This helps in taking evidence based public health action and generates evidence based health policy for the prevention and control of infectious diseases. It also aims to strengthen the public health laboratories by providing necessary equipment and protocols to enable onsite diagnosis of common diseases.

Further, it will help the public health infrastructure of the country in identifying emerging disease trends early which will, in turn, result in detection of outbreaks in the early stages and implementing effective control measures.

For more updates and latest developments please engage with us @MCVRMU

For the questionnaires (Case Report Forms) please click the following language link:
Karnataka - Kannada CRF
Kerala - Malayalam CRF
Goa - Konkani CRF
Assam - Assamese CRF
Maharashtra - Marathi CRF
Gujarat - Gujarati CRF
Jharkhand - Hindi CRF
Tripura - Bengali CRF
Tamil Nadu - Tamil CRF
Odisha - Odia CRF

Follow the link given below to find Standard Operating Procedures (SOPs) on:
Case Recruitment
Informed Consent procedure
Specimen Collection
Sample storage, packaging and transport

Download the Annual Report Nov 2016[/FONT][/FONT]








http://manipal.edu/dvr/about-dvr/AFIstudy.html

 

[Ronan Kelly]

The cold facts: on tracking influenza outbreak
OCTOBER 04, 2017 00:02 IST
UPDATED: OCTOBER 03, 2017 23:38 IST

It?s vital that India scales up surveillance to track various influenza viruses

Ever since the influenza virus known as H1N1 landed on Indian shores during the 2009 pandemic, outbreaks have been an annual occurrence. The worst was in 2015, when 2,990 people succumbed to it. This year the virus has been particularly active; mortality, at 1,873 by the last week of September, is quickly catching up with the 2015 toll. In comparison, official figures show 2016 to be a relatively benign year, with an H1N1 death toll of 265. The problem with these official figures, however, is that they only capture H1N1 numbers, a practice that has been adopted in response to the severity of the 2009 pandemic. But influenza was present in India even before 2009 in the form of H3N2 and Influenza B virus types. Out of these, H3N2 is capable of causing outbreaks as big as H1N1, and yet India does not track H3N2 cases as extensively as it does H1N1. This means that seemingly benign years such as 2016 may probably not be benign at all. Data from outside government surveillance systems are making this fact apparent. For example, a surveillance project for acute febrile illnesses, anchored at the Manipal Centre for Virus Research in Karnataka, has found that influenza accounts for nearly 20% of fevers across rural areas in 10 Indian States ? fevers that are often undiagnosed and classified as ?mystery fevers?. During the years when the H1N1 burden is low in these regions, H3N2 and Influenza B circulation tends to spike.
...
http://www.thehindu.com/opinion/editorial/the-cold-facts/article19791906.ece