Review
Beyond traditional surveillance: applying syndromic surveillance to developing settings – opportunities and challenges
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* Corresponding author: Larissa May larissa.may@gmail.com
1 The George Washington University, Department of Emergency Medicine, 2150 Pennsylvania Avenue, NW Suite 2B, Washington, DC 20037, USA
2 Division of Preventive Medicine, Walter Reed Army Institute of Research, Silver Spring, M.D, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA
3 Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore, M.D, USA
4 Global Emerging Infections System, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand, U.S. Army Medical Component, 315/6 Rajvithi Road, Bangkok 10400, Thailand
BMC Public Health 2009, 9:242 doi:10.1186/1471-2458-9-242
Published: 16 July 2009Abstract
Background
All countries need effective disease surveillance systems for early detection of outbreaks. The revised International Health Regulations [IHR], which entered into force for all 194 World Health Organization member states in 2007, have expanded traditional infectious disease notification to include surveillance for public health events of potential international importance, even if the causative agent is not yet known. However, there are no clearly established guidelines for how countries should conduct this surveillance, which types of emerging disease syndromes should be reported, nor any means for enforcement.
Discussion
The commonly established concept of syndromic surveillance in developed regions encompasses the use of pre-diagnostic information in a near real time fashion for further investigation for public health action. Syndromic surveillance is widely used in North America and Europe, and is typically thought of as a highly complex, technology driven automated tool for early detection of outbreaks. Nonetheless, low technology applications of syndromic surveillance are being used worldwide to augment traditional surveillance.
Summary
In this paper, we review examples of these novel applications in the detection of vector-borne diseases, foodborne illness, and sexually transmitted infections. We hope to demonstrate that syndromic surveillance in its basic version is a feasible and effective tool for surveillance in developing countries and may facilitate compliance with the new IHR guidelines.