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Assessment of the infectious diseases surveillance system of the
Republic of Armenia: an example of surveillance in the Republics of the
former Soviet Union.
BMC Public Health 2002;2:3.
Wuhib T, Chorba TL, Davidiants V, MacKenzie WR, McNabb SJN.
Abstract
BACKGROUND: Before 1991, the infectious diseases surveillance systems (IDSS)
of the former Soviet Union (FSU) were centrally planned in Moscow. The dissolution
of the FSU resulted in economic stresses on public health infrastructure.
At the request of seven FSU Ministries of Health, we performed assessments
of the IDSS designed to guide reform. The assessment of the Armenian infectious
diseases surveillance system (AIDSS) is presented here as a prototype. DISCUSSION:
We performed qualitative assessments using the Centers for Disease Control
and Prevention (CDC) guidelines for evaluating surveillance systems. Until
1996, the AIDSS collected aggregate and case-based data on 64 infectious
diseases. It collected information on diseases of low pathogenicity (e.g.,
pediculosis) and those with no public health intervention (e.g., infectious
mononucleosis). The specificity was poor because of the lack of case definitions.
Most cases were investigated using a lengthy, non-disease-specific case-report
form Armenian public health officials analyzed data descriptively and reported
data upward from the local to national level, with little feedback. Information
was not shared across vertical programs. Reform should focus on enhancing
usefulness, efficiency, and effectiveness by reducing the quantity of data
collected and revising reporting procedures and information types; improving
the quality, analyses, and use of data at different levels; reducing system
operations costs; and improving communications to reporting sources. These
recommendations are generalizable to other FSU republics. SUMMARY: The AIDSS
was complex and sensitive, yet costly and inefficient. The flexibility, representativeness,
and timeliness were good because of a comprehensive health-care system and
compulsory reporting. Some data were questionable and some had no utility.