Implementation of IDSR by an African country begins with an assessment of the national surveillance system. Using a protocol developed by WHO AFRO, WHO Headquarters and CDC, a team of national and international members examine the current surveillance, laboratory confirmation, and epidemic preparedness and response activities at all levels of a country's health system. The ministry of health uses these assessment results to guide them in developing a plan of action for creating a fully functional IDSR system. The activities of the plan of action involve changes at the central, provincial, district, and health facility levels of the health system. The first activity is the adaptation of the WHO generic surveillance and response tools to reflect national policies.
| IDSR framework |
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Detect and respond to priority diseases matrix  PDF 671 KB
A framework of the surveillance functions, skills and activities of each level of a health system |
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IDSR Interactions chart PDF 195 KB
A chart showing how each level of a health system interacts in the IDSR strategy |
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| IDSR core indicators |
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The IDSR core indicators are variables that African countries use to monitor and evaluate their progress with surveillance and response to priority infectious diseases. This process of monitoring and evaluation helps to ensure that countries are maintaining effective and functional IDSR systems. Each level of the health system regularly calculates the IDSR core indicators using routine surveillance information. Countries use the indicator results to identify problems in their IDSR system, and to plan interventions to improve the quality of surveillance information and the overall performance of the system. The WHO AFRO task force for IDSR adopted these IDSR core indicators at the 4th annual task force meeting in 2003: |
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1. |
Proportion of health facilities submitting weekly or monthly surveillance reports on time to the district level. |
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2. |
Proportion of districts submitting weekly or monthly surveillance reports on time to the next higher level. |
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3. |
Proportion of cases of diseases targeted for elimination, eradication and any other diseases selected for case-based surveillance which were reported to the district using case-based or line listing forms. |
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4. |
Proportion of suspected outbreaks* of epidemic-prone diseases notified to the next higher level within two days of surpassing the epidemic threshold. |
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5. |
Proportion of districts with current trend analysis (line graphs) for selected diseases. |
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6. |
Proportion of reports of investigated outbreaks that include analyzed case-based data. |
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7. |
Proportion of investigated outbreaks with laboratory results. |
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8. |
Proportion of confirmed outbreaks with a nationally recommended public health response. |
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9. |
Case fatality rates for outbreaks of priority diseases. |
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10. |
Attack rates for outbreaks of epidemic-prone diseases. |
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Proportion of epidemics detected at regional and national levels through analysis of surveillance data from districts and that were missed by the district level. |
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* Prior to confirmation during an outbreak investigation, all reported outbreaks are "suspected outbreaks." Indicator 4 refers to a sub-set of specific diseases in the IDSR strategy: epidemic-prone diseases. These diseases have program-specific thresholds that trigger a series of actions to identify and confirm the pathogen. |
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Guide for the use if Core Integrated Disease Surveillanceand response Indicators in the African Region, July 2005 ( PDF 856 KB)
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Progress with IDSR implementation 2001 - 2005 |
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Number of Countries (% of total)
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| IDSR Activities |
2001 |
2002 |
2003 |
2004 |
2005 |
Sensitized MOH officials and stakeholders on IDSR |
22
(48%) |
35
(76%) |
36
(78%) |
44
(96%) |
44
(96%) |
Assessed the national surveillance and response system, including laboratory |
22
(48%) |
35
(76%) |
36
(78%) |
43
(93%) |
43
(93%) |
Developed an IDSR plan of action |
13
(28%) |
31
(67%) |
|
43
(93%) |
43
(93%) |
Adapted the generic IDSR technical guidelines* |
1
(2%) |
26
(57%) |
35
(76%) |
39
(85%) |
41
(89%) |
Established a national IDSR committee |
6
(13%) |
|
21
(46%) |
32
(70%) |
32
(70%) |
Adapted generic IDSR training materials* |
- |
1
(2%) |
20
(43%) |
35
(76%) |
41
(89%) |
*Materials were developed by WHO AFRO and CDC.
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