Communicable Diseases Surveillance System in Aruba

							    Communicable
 Diseases Surveillance
   System in Aruba
A Multicultural Caribbean United Against HIV/AIDS
       Santo Domingo, Dominican Republic
                  March 5-7, 2004




              drs. Chanin Boekhoudt
         Department of Public Health Aruba
INFORMATION ON ARUBA
INFORMATION ON ARUBA
  area:           193 sq km

  population:     90.506 (Census 2000)

  language:       Dutch and Papiamento
                  (English and Spanish are
                  widely spoken)
  dependency status:

  part of the Kingdom
  of the Netherlands
HEALTH CARE SYSTEM
  General Health Insurance (as of January 2001)
  38 General Practitioners
  60 Specialists (20 specialties)
  1   Hospital
  1   Medical Center
  1   Home nursing organization
  1   national laboratory
      + 3 private
      laboratories
BOTTLENECKS
SURVEILLANCE SYSTEM
1.   Not clear WHERE to notify
2.   FEEDBACK from Public Health to
     Physicians was lacking
3.   Not clear WHAT and WHEN to notify
4.   FORMS not appropriate
5.   Not aware of the IMPORTANCE of
     notifying
6.   NO INCENTIVES to participate
7.   LAWS are outdated
ADDRESSING THE
CHALLENGES
1.   WHERE to notify
2.   FEEDBACK

     2 newsletters
     •   INFORMATION (QUARTERLY)
     •   ALERT


     1 – 2 pages
     sent by fax
     request to notify to:
     the section of Communicable Diseases
Newsletters
ADDRESSING THE
CHALLENGES
3.   WHAT and WHEN to notify

     Communicable Diseases Manual
     •   Dutch and Papiamento
     •   Classification of diseases according to priority in
         notification
            Group A:      immediately
            Group B:      within 24 hours
            Group C:      within a week
Communicable Diseases
Manual
ADDRESSING THE
CHALLENGES
4.   Appropriate FORMS

     Develop new forms
     •   1 for group A+B
     •   1 for group C
Form Group A+B
Form Group C
ADDRESSING THE
CHALLENGES
5.   Awareness on IMPORTANCE OF
     NOTIFICATION
6.   INCENTIVE to Participate

     Workshop for physicians and health care providers
     •  importance of notification for public health
     •  introduction Communicable Diseases Manual
     •  introduction new notification forms

     Continuous Medical Education accreditation
Workshop
ADDRESSING THE
CHALLENGES
7.   Modernizing LAWS

     STILL TO BE ADDRESSED
Surveillance System Aruba
        Physicians

                   Manual
                   Forms



      Section of Contagious
            Diseases
Surveillance System Aruba
        Physicians

                  Feedback
                  on patient



      Section of Contagious
            Diseases
  Surveillance System Aruba
                   Physicians


        Lab.
      requests


                 Section of Contagious
                       Diseases

 National
Laboratory
 of Aruba
  Surveillance System Aruba
                   Physicians


        Lab.
       results


                 Section of Contagious
                       Diseases

 National
                   + Lab.
Laboratory         results
 of Aruba
  Surveillance System Aruba
               Physicians




             Section of Contagious
                   Diseases

 National                              Section of
Laboratory           Submit data     Epidemiology &
 of Aruba                               Research
  Surveillance System Aruba
               Physicians




             Section of Contagious
                   Diseases

 National                              Section of
Laboratory              Health       Epidemiology &
                       analysis
 of Aruba                               Research
  Surveillance System Aruba
               Physicians

                                     PH Feedback
                                 2 newsletters

             Section of Contagious
                   Diseases

 National                                Section of
Laboratory      PH Feedback            Epidemiology &
 of Aruba       2 newsletters             Research
  Surveillance System Aruba
               Physicians




             Section of Contagious
                   Diseases

 National                              Section of
Laboratory                           Epidemiology &
 of Aruba                               Research
OUTCOMES AFTER 1 YEAR

1.   INCREASE IN NOTIFICATION

2.   MORE CAPABLE TO ANTICIPATE
     OUTBREAKS

3.   CARRYING OUT AN OUTBREAK
     INVESTIGATION

4.   MORE CONTACT WITH PHYSICIANS
LESSONS LEARNT
1.   DEVELOP RAPPORT WITH
     STAKEHOLDERS

2.   FEEDBACK

3.   DEVELOP PARTNERSHIPS

4.   EVALUATE SYSTEMS PERIODICALLY

5.   SURVEILLANCE SYSTEM SHOULD
     BE SIMPLE ENOUGH TO MAINTAIN