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REFERENC ES 587
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LIST OF FIGURES
Figure 1: Indicator - and event -based surveillance for Early Warning Alert and Response
(EWAR) for IDSR Strategy -------------------------------- -------------------------------- -------------- 4
Figure 2: Levels of Applications and Reporti ng of EBS and IBS in the context of IDSR ----- 5
Figure 3 : Implementing IHR through IDSR -------------------------------- -------------------------- 9
Figure 4: IHR monitoring and evaluation framewo rk -------------------------------- --------------- 9
Figure 5: Functions of EBS at all levels of the health system -------------------------------- -----40
Figure 6: Standard Operating Procedure for EBS implementation ------------------------------- 41
Figure 7: Example of line graph showing Trend Line of Dysentery by Epidemiologic Week,
2018 to 2019, Uganda -------------------------------- -------------------------------- ----------------- 151
Figure 8: Example of Histogram (Epidemic Curve) showing Reported Cholera Cases,
Bududa District, Epidemiologic week 1 - 31, 2020 -------------------------------- ---------------- 152
Figure 9: Cases of Aflatoxicosis by Date of Onset of symptoms, Ankole and Kigez i Sub -
Regions, Uganda, 2016 -------------------------------- -------------------------------- ---------------- 153
Figure 10: Example of District Spot Map Showing Location of Suspected and Confirmed
Cases -------------------------------- -------------------------------- -------------------------------- ----- 154
Figure 11: Example of a Map Drawn Using QGIS Software Showing Concentration of Rift
Valley Fever Cases in Queen Elizabeth National Park in Kasese District --------------------- 155
Figure 12: Example of a bar graph showing Age distribution of Diarrheal Cases During an
Outbreak in Kasese District, 2019 -------------------------------- -------------------------------- --- 159
Figure 13: Steps in outbreak investigation -------------------------------- ------------------------- 171
Figure 14: Types of Epidemic Curves and the manner of spread ------------------------------ 182
Figure 15: An integrated model for risk communication -------------------------------- -------- 279
Figure 16 : Epidemic curve illustrating the importance of proactive communication ------- 287
Figure 17: Attributes/Qualities of a Surveillance System -------------------------------- ------- 310
Figure 18: Information flow and management, eIDSR system in Uganda -------------------- 376
Figure 19: Simplified information flow diagram for eIDSR -------------------------------- ---- 376
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LIST OF TABLES
Table 1: Priority diseases, conditions and events for Integrated Disease Surveillance and
Response -------------------------------- -------------------------------- -------------------------------- ---34
Table 2 : Diseases, conditions or events req uiring immediate reporting ----------------------- 105
Table 3: Diseases and conditions requiring monthly or quarterly reporting ------------------ 110
Table 4: Types of analy sis, objectives, data display tools and methods ----------------------- 147
Table 5: Differences between a histogram a nd bar graph -------------------------------- -------- 153
Table 6: Example: Att ack rate by age group during a Malaria outbreak in 3 sub -counties in
Nwoya District, Uganda, Fe bruary -May 2018 -------------------------------- --------------------- 183
Table 7 : Functions of Public Health Emergency Management Subcommittees -------------- 210
Table 8: Elements/Sections of Emergency Preparedness and Response Plan ---------------- 219
Table 9 : Water Basic quantity needs calculat ions -------------------------------- ----------------- 239
Table 10: Template of a risk communication implementation plan ---------------------------- 284
Table 11: Types of sources of data at various levels -------------------------------- ------------- 307
Table 12 : Summary of other attributes for assessing quality of surveillance system. ------- 310
Table 13: Indicators for community -based disease surveillanc e -------------------------------- 314
Table 14: Roles of stakeholders in eIDSR i mplementation at each level --------------------- 372
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FOREWORD
In 2001, Uganda adapted the Integrated Disease Surveillance and Respons e (IDSR) developed by
World Health Organization (WHO) for member states in African region. The Minis try of Health has
been implementing the IDSR strategy since then with success across the country. This strategy
provides the opportunity for rational use of resources and maximises investments in health
surveillance systems. The 3rd edition IDSR guidelines incorporate s lessons learnt from previous
epidemics, new frameworks like the Global Health Security Agenda (GHSA), One Health, Disaster
Risk Management (DR M), the WHO regional strategy for health security and emergencies , and the
rising non -communicable d iseases , and aims to strengthen implementation of IHR (2005) core
surveillance and response capacities. These guidelines have been adapted to reflect nation al priorities,
policies and public health structures; and shall be used in conjunction with other si milar
guideli nes/strategies or initiatives.
Overall, the 3rd edition technical gu idelines will incorporate the following:
• Strengthening Indicator Based Su rveillance
• Strengthening Event Based Surveillance
• Improving community -based disease surveillance
• Improving Cross Border Surveillance and response
• Scaling up e -IDSR implementation
• Improving reporting and information sharing platforms
• Improved data sharing across sectors
• Tailoring IDSR to Emergency or Disaster contexts
The 3rd edition guidelines are inten ded for use a s:
• A general reference for surveillance activities across all levels
• A set of definitions for thresholds that trigger some action for response
• A stand -alone reference for level -specific guidelines on surveillance and response
• A resource for d eveloping training, supervision and evaluation of surveillance activities
• A guide for improving early detection and preparedness for outbreak response .
Thes e guidelines will be used by; health workers at all levels of public and private settings, IHR
Natio nal Focal Points, health authorities at Points of Entry (PoE), Hospital managers, clinicians,
infection prevention and control officers, national and region al reference laboratories, veterinary and
wildlife officers, environmental health officers, district health teams, health training institutions,
communication officers, community leaders, other health partners including Non -Governmental
Organizations (NGOs ), other line ministries, departments and agencies.
Dr. Henry G. Mwebesa
DIRECTOR GENERAL HEALTH SERVICES
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ACKNOWLEDGMENTS
These technical guidelines on IDSR were adapted by a technical team of Ministry of Health with
support from WHO , US CDC , Africa CDC , Baylor Uganda, IDI , SACIDS, TDDAP, AFENET,
MakSPH and PATH Uganda based on the generic document pr epared by WHO -AFRO. We would
like to acknowledge the following persons that participated in the adapt ation of the 3rd edition IDSR