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The Pakistan Field Epidemiology and Laboratory Training Program
Background| Enhancing Surveillance and Outbreak Response Capacity in Pakistan (Fourth Quarter 2008) This ebrief article mentions Pakistan's surveillance and outbreak response capacity. |
In April 2005, following a 2003 Government of Pakistan (GOP) request for CDC assistance to establish a Field Epidemiology and Laboratory Training Program (FELTP), the USAID Mission in Pakistan agreed to fund a proposal for CDC to establish an FELTP within the Pakistan Ministry of Health (MOH).
The Pakistan FELTP is a two-year, applied epidemiology program offered by the Division of Global Public Health Capacity Development (DGPHCD) to help the MOH develop, set up, and implement dynamic, public health strategies to improve and strengthen the Pakistani public health system and infrastructure. The FELTP program was started in 1980 by the CDC and is modeled after the CDC’s Epidemic Intelligence Service.
The Pakistan FELTP was launched by Federal Health Minister, Mr. M. Nasir Khan on 16th September, 2006 and works within the overall context of the National Plan of Action for surveillance. The program’s focus is on identified priority diseases and using developed case definitions, surveillance and reporting methods. FELTP supports the Pakistan MOH´s National Strategic Framework on Disease Surveillance, 2005- 2015.
Program Components
Pakistan Field Epidemiology and Laboratory Training Program (FELTP)
The Pakistan Field Epidemiology and Laboratory Training Program (FELTP) is a two year (Accredited as MSc in Field Epidemiology), in-service training program in field epidemiology. FELTP also organizes different short courses to increase the surveillance and outbreak skills of public health officials in Pakistan
Legal Framework for Surveillance
CDC through WHO Geneva and MOH is initiating a process to strengthen the legal framework for disease surveillance in Pakistan in light of the revised International Health Regulations (IHR)
National laboratory network
National laboratory will be networked with two provincial laboratories as a pilot project and laboratory quality and standards will be assured.
Sentinel Surveillance for Viral Hepatitis
Viral hepatitis is a priority disease in Pakistan. The FELTP is working with National Program for Prevention and Control of Hepatitis on a protocol for the establishment of hospital-based sentinel surveillance in three pilot sites in Islamabad, Peshawar, and Lahore.
Influenza Surveillance
In response to poultry outbreaks of Influenza A (H5N1) in Pakistan (2006), and in order to build respiratory disease surveillance, the project plans to measure disease burden of influenza through sentinel site surveillance.
Laboratory Quality Systems
In response to an identified need established in the surveillance assessment conducted in 2004, a laboratory coordination cell at NIH has been established. This unit is headed by a senior Laboratory Quality Manager, and will oversee expansion of a public health laboratory network through training, assessment, and coordination. The pilot sites for this project are located in Peshawar and Lahore.
Informatics
CDC is working to develop and deploy an electronic disease surveillance system at 3 pilot sites, building on the hepatitis and influenza activities. This informatics system is sufficiently robust for expansion to other diseases and deployment throughout the country.
- The FELTP conducted its first four week course for 22 participants nominated by Punjab, NWFP, Sindh, Baluchistan, Northern areas and National programs in February 2007. This course trained health workers in priority disease surveillance and outbreak response. The course included respiratory infections including Avian Influenza, Tuberculosis, Hepatitis and Hemorrhagic Fever. The MOH later advised all provinces to use these officials as lead investigators in any suspected Avian Influenza outbreak.
- To date, FELTP has eight residents enrolled in the first cohort. It is anticipated that approximately eleven individuals will be selected for the second cohort from a pool of 30 participants of a screening course. The participants of these courses represent all of the provinces in Pakistan and the Federally Administered Areas.
- An avian influenza outbreak in Pakistan occurred in December, 2007. Four FELTP fellows were involved in the investigation including authorship of the first MOH internal report. The FELTP provided technical guidance to the MOH.
- In light of the outbreak, the Government of Pakistan (GOP) requested the FELTP to plan a short training course for a select number of district surveillance officers in influenza high risk districts in Pakistan. An avian influenza surveillance course was held for 23 participants in February 2008.
- The FELTP team has contracted with a private company to finalize a BETA version of the surveillance database. Implementation is anticipated by September 2008
- The Pakistan MOH requested a special training course on Quality Assurance and Bio-Safety in Laboratory Medicine including Avian Influenza. This course was conducted from February 11-14, 2008. All of the provincial departments of health and federal programs nominated 19 of their high level laboratory staff to attend this course.
The CDC intends to enter into a cooperative agreement with the Pakistan MOH to expand FELTP activities. Additionally, the FELTP is providing technical assistance to develop provincial health districts that serve as sentinel surveillance sites for priority health disease.
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Page last modified: October 14, 2008
