article concept report

8/14/2019 Article Concept Report

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SLSP is Developing an Epidemiological Network inPakistan

Disease Surveillance and Reporting System Functional through Epidemiological

network at Federal, Provincial and SLSP target District level.

Dr. Muhammad RasheedDisease Reporting [email protected]

1. Introduction

With trade increasing its importance on the economy of each country to exist inglobal village, its necessary to give proof of animal health status based on

credible surveillance and reporting system. The same applies on the control,eradication of any globally important disease or to keep the disease or infectionfree status intact. Pakistan has the same obligations as it has submitted its

application for the recognition of Rinderpest infection free country toInternational Animal Health Organization (OIE).

The effective establishment, and operation of a wide scale animal diseasesurveillance and reporting system is a complex undertaking that involvescapture and reporting of high quality and needed data from a variety of sources.

The functionality of Epidemiological Network needs the accurate entry ofreported data into a computerised Disease Information System, the production

of summary reports, the evaluation of findings and recommendations and thesubmission of these to the decision makers.

Field data relating to the presence of any livestock disease can, and should,come from primary source i.e livestock owner and field veterinarians. The datafrom the lines of investigation should complement each other but need not be

identical. Data from these two sources must be evaluated, confirmed, perhapsinvestigated further and eventually used to prioritise Departmental response

strategies and the allocation of funds. The above tasks can only be competentlyundertaken by a permanently established, and adequately resourced veterinary

epidemiology unit that has qualified and capable staff, who can devotethemselves fulltime to the management of the Federal, provincial and targeted

districts Epidemiological Units. These Epidemiology Units shall work towardsimproving the standards and efficiency of animal disease and reporting systemin the Pakistan by informing International and national agencies, decision-makers through provision of timely, appropriate and required information.

This concept of Epidemiological network making the Disease Surveillance and

reporting System Functional is an essence of consultancy reports of National andInternational consultants worked under FAO and EU projects from time to time.

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mailto:[email protected]:[email protected]


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The responsibility as coordinator for the activities of Result 2 of SLSP is achallenge for me and surely the goal will be achieved with the coordination of

National, Provincial and Target District staff in the best interest of LivestockDepartment and profession.

1.1. Why Functional Disease Surveillance and Reporting System is

needed in Pakistan?

Different consultancy reports indicated the needs of functional diseasesurveillance and reporting system in Pakistan;

To get better animal disease control, this is necessary for increasing the

productivity of the livestock sector and improving the livelihood offarmers, livestock owners at village level.

The functional Disease Surveillance and reporting system will improve

access to external markets for bilateral trade.

To keep update to the national and international agencies for newly

emerging disease for control and eradications planning under food

security concept.

To plan future strategies for prophylactics measures in context with the

vaccine production and campaigns.

1.2. Pakistans deficiencies to establish functional disease

Surveillance and Reporting system

The visiting consultants gathered the deficiencies/ problems through conductingworkshops, meeting with higher-ups of livestock departments and field

veterinarians. They all concluded with the following problems / deficiencies inestablishing the functional disease surveillance and reporting system in Pakistan.

Insufficient Resources to establish Epidemiological network coveringdisease surveillance and reporting up to the international standard wasidentified as a main problem.

Absence of clear policies & strategies for animal health in general and forcontagious disease in special.

Devolution of political authority to district level makes animal healthcontrol difficult in disease reporting and administrative channels do notcoincide in enforcement of departmental policies.

Lack of awareness among Livestock owners to report timely and reliably.

No or Little obligation and incentive for VOs & VAs to report as their jobdescription making many reports inadequate.

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No feed back from provincial or national laboratories/authorities on

submission of samples/reports by the field staff making the wholeexercise of disease reporting unnecessary.

District diagnostic laboratories are often non-functional and performingfaecal testing.

Poor interaction between extension & research wings of the VeterinaryService/ livestock department.

Disease information from private sector, especially from poultry, notincluded in data collection.

No desire from the national authorities for disease surveillance and

reporting with guidance and requirements.

No established Federal Epidemiology Unit to collate & analyze theepidemiological data.

2. Existing components of an Epidemiological Network

Livestock disease surveillance and reporting system under proposed

Epidemiological network is a comprehensive Veterinary Investigation Service(VIS) which has been derived from the consultancy reports of Drs. PeterMoorhouse, Roy Halliwel, Gavin Thomson, Berhanu Bedane, William Taylor andArshad Mahmood. Thats the system which any country needs if it is to develop

an on-going understanding of its livestock diseases, their impact on the national

economy, how they can be controlled and at what cost. The components of anepidemiological Network are;

A passive disease surveillance system

A basic disease diagnostic system

A National diagnostic referral system

The ability to mount active disease surveillance

The ability to undertake national strategic research

A management group integrating the outputs from the various systems

A national decision-taking forum benefiting from the results generated by

the Epidemiological network.

2.1. The Passive Disease surveillance System

This is a system whereby the incidence of disease is estimated on the basis ofoutbreak reports from the field. Reports originate only because a livestockkeeper has contacted the Livestock Department for assistance and in this

respect they act only as a mirror of events in the field. To be of any significantvalue this system must provide a comprehensive and continuous set of reports.

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The information available under this system does not come from active searchesfor the disease but only what the local VO reflects in his monthly reports.

The passive monitoring system exists at national (MINFAL) level based onmonitoring reports received from the Provinces. It appears to function only tosatisfy the international obligations of an OIE member state to indicate the

annual inventory of livestock diseases in the country or to report the recentoccurrence of a disease of international importance. It does not appear to be

linked to the development of either Provincial or National policies and istherefore generally regarded as having little relevance to the affairs of the

country.

2.2. The Basic Disease Diagnostic System

Within the Livestock Departments of AJK, NAs, NWFP, Punjab, Sindh andBalochistan a series of disease investigation laboratories (DILs) exist. These are

poorly equipped, staffed by officers with limited exposure to the correct training

and under funded to run the routine tests with consumables. They lack facilitiesfor investigating outbreaks. In essence they can function only at a local levelundertaking worm egg counts, haematology and some basic bacteriology. Roy

Halliwells report suggests that the vast majority of the results they produce areof little value and sometimes misleading. Thus they can offer some limitedassistance to the farmer but cannot provide a confirmed diagnosis of thepresence of any major diseases.

There are no linkages between the laboratories of the different Provincial

Livestock Departments or Research Wings (VRIs) and with National Veterinarylaboratories at Islamabad.

2.3. The National Livestock Disease Referral System

With the creation of the National Veterinary Laboratories in Islamabad, a

national livestock diseases referral system is being built. The NVL can provide adiagnostic service for HS, Rinderpest and PPR (but not virus isolation) and a

typing service for FMD. Within a National Veterinary Investigation Service thislaboratory could be a key component of Federal Epidemiological Unit. This wpuld

be a strong unit able to co-ordinate an understanding of the epidemiology ofmajor disease of livestock across the country.2.4. The Disease investigation and Surveillance System

There is no institutionalised livestock disease investigation and surveillance

system in Pakistan. Under their original mandate it appears that VeterinaryResearch Institutes across the country were charged with undertaking vaccine

manufacture, disease diagnosis, disease surveillance and disease investigation.Now Pakistan has submitted its application for Rinderpest infection free status toOIE, so to keep determine freedom from Rinderpest disease and freedom fromRinderpest infection, the Epidemiological network programme had to consist of a

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component i.e a series of searches for evidence of clinical and serologicalinvestigations of Transboundry Animal Disease especially for Rinderpest or

Rinderpest like disease across the villages of the entire country.

In spite of their mandate it was apparent that the Veterinary Research Institutesdid not participate in any national surveillance or disease investigation network.

Therefore they could not be given the task of searching the villages. Thisworkload was taken up by the Livestock Departments under a specially

introduced programme of participatory disease surveillance in last four yearunder FAO/PAK/088-EC and SLSP EU projects.

At the present time then, there is no practical National Disease SurveillanceSystem. A proposal for the development of an Epidemiological Network with adisease surveillance and reporting system will be implemented in year 4 of SLSP.

Work plan is attached as Annex

3. Ownership by Government of Pakistan for future Developments

Before a fully functional Epidemiological Network can be developed by SLSPunder its Result 2 Disease Surveillance and Reporting System Functional and

handover to Government of Pakistan, an agreement (MoU) of ownership for thefurther development of existing components and bringing them together within

the network should be developed between SLSP and Animal HusbandryCommissioner Ministry of Food, Agriculture and Livestock Government ofPakistan..It should be clearly defined from start that, if SLSP is to assist in the

development of a Epidemiological Network and whatever is the shape of theEpidemiological Network to come, it has to be admitted and owned by

Government of Pakistan from the outset, with technical, back-stopping andfinancial assistance followed by transfer from SLSP.

In fact it is essential that the SLSP contributes towards strengthening each ofthe existing components of the proposed Epidemiological Network as well asassisting in the development of more components of proposed Epidemiological

Network.

3. 1. Inputs from the SLSP

With the intention of assisting in the development of an EpidemiologicalNetwork, the areas in which SLSP can be of assistance are discussed below.

3.1.1. Improving the passive disease reporting system

This system can be made to function. The major obstacle at this time appears to

be persuading District Livestock Officers (DLOs) to submit meaningful returns.Nevertheless DLOs remain in contact with the Veterinary Officers of the District

Hospitals who have the information that is needed. If the DLOs and AssistantDisease investigation Officer (ADIO) of target district are mandated to work

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together in district epidemiological network, the performance and informationrelated to disease surveillance and reporting will increase.

However, as a prerequisite, it is imperative to agree at a national level to placecomputers and software at target district level with DLO and ADIO. Alternatively,if it would be more appropriate to move hard copy between the districts and

Provincial Headquarters. In either case it would be necessary to develop a set ofnationally agreed reporting standards for contagious and non-contagious

diseases that allow data entry into whatever software programme is selected fordata compilation.

3.1.2. Improving disease diagnosis skills and capabilities

SLSP can improve the basic disease diagnostic system across the country

through the provision of equipments, and trainings as indicated in the proposedEpidemiological Network programme. Epidemiological Network is the system

which consists of 30 targeted districts, 4 provincial and 1 National laboratories

working within a federally administrative and Co-ordinated network.Pragmatically, this Epidemiological network can be created from existinglaboratories belonging to different Provincial Governments and then at National,

Provincial and targeted district level, working for different Directorates(VRI/CVDLs and Departmental DILs.). Developing a set of MoUs to identify therole and mandates of Epidemiological Units at each level, which allows thedevelopment of these networks/units, will require a major federal initiative by

Animal Husbandry Commissioner and Co-Directors SLSP. It appears that most ofthe required inputs have been identified by SLSP (Roy Haliwell) but their supply

should be contingent on the acceptance of Federal and Provincial coordination.The objective would be to have in place in each of the network labs/ units, the

reagents and trained manpower, able to confirm all the commonly occurringdiseases of Pakistan.

Because of the existing infrastructure, in each province there will be a provincial

lab / Epidemiological Unit and identified number of targeted districts labshowever, all will be participants in the surveillance and reporting network. The

role of Veterinary Research Institute Lahore in the proposed Epidemiologicalnetwork will be defined by the concerned working group, whether or not to

include the VRI, Lahore in the Epidemiological network of Punjab. From theRinderpest experience it seems there is no real interest in diagnostic orsurveillance work on the part of the Veterinary Research Institute Lahore. Theother units in Punjab belonging to the Livestock and Dairy Development (Ext)

are able to contribute in the establishment of Epidemiological network in theprovince.

3.1.3. The National Livestock Disease Surveillance System

This is the most important area to which the SLSP can contribute. DiseaseSurveillance and Reporting system will establish with time and experience but astart-up model can be proposed, based on the successful Rinderpest surveillance

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and reporting system, in which PDS and laboratory services collaborated todeliver the results. Actually this surveillance and reporting system will be

laboratory based and, the laboratories must be part of Epidemiological network.

There will be equal attention to surveillance for the presence of contagiousdisease (HS, PPR, FMD, Bluetongue, Capripox, and BQ) and of disease affecting

the reproductive performance of large ruminants (Brucellosis, BVD, and IBR). Ineach province the existing ELISA equipment would be re-established in the lead

Provincial laboratory within the network. The NVL will be accorded a role asparticipating laboratory and co-ordinating Agency.

Surveillance results from the network must be regularly cross-informed andpublished. The identification of new pathogens identified by the surveillanceprogramme can undertake by the national referral laboratory. Researching the

role of viral diseases in cause of reproductive failure can be jointly examined bythe Federal epidemiology unit.

3.1.4. The National Referral Service National veterinary laboratories

The development of a National Laboratory with the capacity to act as a National

Referral Laboratory is vital to any Disease Information System. The staff of thislaboratory will have a working comprehension of a wide range of livestockdiseases and the techniques for their diagnosis. This referral laboratory (NVL)would be the part of the National / Federal Epidemiological network, equipped

with a wider range of diagnostic reagents than the other participatinglaboratories and provision of staff who have gained wide international exposure

to a variety of conditions and diagnostic tests.

Acting as the National referral Laboratory, the NVL will also set role, mandatesand standards to be adhered by other laboratories in the network. It is alsonecessary that the NVL will take on the role making epidemiological analysesrelating to all livestock diseases throughout the country.

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4. The Proposed Structure

Disease Surveillance and reporting System Functional at National, Provincial and

Targeted Districts level

Upgrading the routine disease surveillance and reporting system, based on early

detection, reporting and investigation of outbreaks of target diseases andsubmission of regular update reports for these outbreaks, will be a long process

that will require the full time attention of dedicated, interested, trained andempowered staff.

Active support from senior decision makers, particularly the Director Generals,

Directors Livestock and Dairy Development Department, will be essential toprovide the required leadership, empowerment and direction for the system and

to ensure the provision of the required funding and resources after transferringfrom SLSP.

A programme of active data collection will be required to provide required high

quality data, and to assist in establishing SLSP baseline and in assessing theimpact of project activities. The basic informations of targeted districts for

planning and implementation of field studies and surveys, and the analysis andinterpretation of findings will be asked from concerned districts staff through

their respective administrative. A set of Performa included as Annexs.

A fundamental requirement of the proposed Epidemiological Network is that theinformation it produces will be used to inform the disease control decisionmaking process. The success of the Epidemiological Network could be measuredin efficiency improvements in reporting the disease incidences, using disease

control resources, reductions in disease frequency, production losses and risks tohuman health.

The total support of senior officers of Livestock and DairyDevelopment Department will be critically important to the success ofefforts to establish an Epidemiological Network for functional diseasesurveillance and reporting system at Federal, Provincial and targeteddistricts level.

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Farmers & livestock owners(Primary information source)

Level

Village/field

Veterinary Centres

Private PractitionersVet. assists., AI

techs, stock assts.etc

Sub-district

Vet. Hospital & Diag LabVet./senior vet. officer

Deputy DLO Animal Health

DDLO -Poultry

District Livestock Officer

DistrictDistrict Laboratory

Asst. diseaseinvestigation officer

Provincialepidemiology unit

KeyOfficial epidemiological reportingpathway

Information only not part of the information transmissionpathway

Diagramatic representation of epidemiological information flow fromfield level to district level by Gavin Thomson

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Outline of idealized animal disease information flow from field level to Federal leveland feed-back/action pathway by Gavin Thomson

Provinciallevel

Districtlevel

Fieldlevel

Primary data collection

Data consolidation, store &analysis

Data consolidation, storage & analysisProvincial policy formulation &

communication

Federallevel

Data consolidation, storage & analysisNational policy formulation & policycommunication

KeyInformation flow

Feed-back

Action

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The establishment of Epidemiological network will be carried out in four phases:

4.1 Phase 1 (October 1, 2006 to June 30, 2007)

Objectives with activities include:

Conductions of workshops to identify stack holders and to analyse

the present situation of disease surveillance and reporting system

at National, provincial and Targeted Districts level.

Conductions of consultative meeting and workshops at National and

Provincial level to define the role and mandates of Epi units byinvolving concerned personals.

Developments of action plan for the implementation of define roles

and mandates for each Epidemiological Unit.

Establishing the important technical foundations for the

Epidemiological Network by development of MoUs at national ,

provincial level, including definitions of terms, reporting formats,etc.

Conduction of consultative meetings and workshops to assess the

needs of each Epidemiological Units by involving concernedpersonals.

Procurements procedure in place by SLSP to fulfil the needs of eachEpidemiological unit.

Identification and notification of staff and place for each

Epidemiological unit by the higher ups of Livestock department.

Identification of training institute/personals for the Epidemiological

Units.

Conduction of Training workshops for private veterinarians on

disease reporting in target districts.

Development of farmers awareness messages and published

materials on disease reporting for field days.

Conduction of stake holders awareness campaign, seminars and

field days on disease surveillance and reporting.

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Conduction of collaborative training workshops on diagnosis and

control of Transboundry Animal disease.

Providing of support to the MINFAL in meeting the requirements of

OIE after submission of Rinderpest Infection free dossier.

4.2 Phase 2 (July 1, 2007 to June 30, 2008)


In this optional phase the Epidemiological network and other reporting functionsof the veterinary field service would be placed. Electronic data capture usingdesk top or laptop computers would be introduced at progressively district level

to federal level in the reporting chain. These various levels would be linkedthrough WANs or internet connections to enable easy transmission of data

through the system.

Procurement and distribution of vehicles, computers, and equipments

for each Epidemiological Unit will be made.

A unified disease information system will be in placed as a soft ware to

make the Epidemiological network functional.

Trainings on IT and technical aspects for the staff working at

Epidemiological Units will be got from concerned institutes.

Conduction of consultative workshops to document and approve the

Standard Operational Procedures of each Epidemiological unit.

Preparation of contingency plans for Transboundry Animal disease in the

light of approved SOPs.

Conduction of annual review meetings to update the SOPs (if

necessary).

Follow up of disease information on Transboundry Animal Disease

especially Rinderpest or Rinderpest like disease.

Carry out (If required) necessary disease surveillance (active or

passive) activities for Rinderpest or Rinderpest like disease.

Procurement and distribution of ELISA kits for PPR control and

eradication collaborative study.

Information sharing activities by publishing reports, periodical and news

letters.

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Conduction of Training workshops for private veterinarians on disease

reporting in target districts.

Development of farmers awareness messages and published materials

on disease reporting for field days.

Conduction of stake holders awareness campaign, seminars and field

days on disease surveillance and reporting.

Conduction of collaborative training workshops on diagnosis and control

of Transboundry Animal disease.

Providing of support to the MINFAL in meeting the requirements of OIE

after submission of Rinderpest Infection free dossier.

Suitable consultancy (National or International) on the subject will be

hired as and when required.

4.3 Phase 3 (July 1, 2008 to June 30, 2009)


In 3rd phase, the Epidemiological network and other reporting functions of the

veterinary field service would be functional and operational. Electronic datacapture using desk top or laptop computers would be working and disseminating

from district level to Federal level in the reporting chain. These various levelswould be strengthened with trained staff and equipments, linked through WANs

or internet connections to enable easy transmission of data through the system.

Procurement and distribution of vehicles, computers, and equipments

for each Epidemiological Unit will be made if it was not possible in 2nd

phase due to unavoidable circumstances.

Trainings on IT and technical aspects for the staff working at

Epidemiological Units will be got from concerned institutes in not

completed in 2nd phase.

Preparation of contingency plans for Transboundry Animal disease in the

light of approved SOPs.

Conduction of annual review meetings to update the SOPs (if

necessary).

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Follow up of disease information on Transboundry Animal Disease

especially Rinderpest or Rinderpest like disease.

Carry out (If required) necessary disease surveillance (active or

passive) activities for Rinderpest or Rinderpest like disease.

Procurement and distribution of ELISA kits for PPR control and

eradication collaborative study.

Information sharing activities by publishing reports, periodical and news

letters.

Conduction of Training workshops for private veterinarians on disease

reporting in target districts.

Development of farmers awareness messages and published materials

on disease reporting for field days.

Conduction of stake holders awareness campaign, seminars and field

days on disease surveillance and reporting.

Conduction of collaborative training workshops on diagnosis and control

of Transboundry Animal disease.

Providing of support to the MINFAL in meeting the requirements of OIE

after submission of Rinderpest Infection free dossier.

Suitable consultancy (National or International) on the subject will be

hired as and when required.

4.4 Phase 4 (July 1, 2009 to September 30, 2009)

4.4.1 Sustainability and ownership of the Epidemiological Network

In this phase SLSP will hand over the functional Disease surveillance and

reporting system to concerned livestock department. Long term survival andsuccess of the proposed Epidemiological Network will depend in larger part on

ownership of the system by the Livestock and Dairy Development Department.To this end it is recommended that a surveillance working group of concerned

officers of the Livestock and Dairy Development Department be formed andinvolved in the working of Epidemiological network at each level.In the 4th phase of proposed Epidemiological Network, the surveillance workinggroup of each province will organises a participatory workshop in order to agree

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upon and own the aim, objectives and basic working methods of theEpidemiological Network as their part of departmental activities.

The transparent and strong support for the ownership of Epidemiologicalnetwork by the higher ups of Livestock department will be essential to thesustainability and success of Disease Surveillance and reporting system. In the

last phase the meetings to hand over the operational and functionalEpidemiological network will be conducted at National level.

Level Extension service Research service

Provincial

Federal

Provincial/regionaldiagnostic laboratory

DG: LDD

Veterinary ResearchInstitute

National VeterinaryLaboratories

Federalepidemiology

unit

AHC -MINFAL

Internationalliaison & OIE

reporting

DG: Research

National PoultryReference

Laboratory

Poultrysurveillance

network

laboratoriesProvincialepidemiologyunit

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Diagramatic representation of a proposed epidemiological reporting pathway atprovincial & Federal levels by Gavin Thomson


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4.4.2Managing the Epidemiological Network

The SLSP and AHC would assume responsibility for design and operation of the

Epidemiological Network at National, Provincial and targeted districts level.

In summary it is proposed that:

The Epidemiological Network is permanently established with appropriate

linkages to:

Provincial Livestock departments, senior decision makers, Stake

Holders, National and International agencies.

The veterinary laboratory services for the testing/ examination of

outbreak specimens, conducting systematic investigations of

disease outbreaks, and implementing field studies and surveys.

The veterinary field service (Veterinary Officers, Veterinary

Assistants, Private veterinarians and the other sources of required

and reported data).

The livestock owners, farmers in providing the feed back on their

queries of disease out break.

The Epidemiological Network is assured of adequate supplies, equipment,

transport facilities, office accommodation etc at National, Provincial andtargeted district level.

The Epidemiological Network is staffed by qualified officers. For this

purpose the SLSP will provides funds for specialist and targeted trainingof a number of veterinary epidemiologists for National, Provincial and

targeted District Epidemiological Units. This training should cover theprinciples and practical application of veterinary epidemiology, basic

principles of biometrics (to enable staff to communicate withstatisticians), basic principles of animal health economics (to enable staffto communicate with livestock economists), and basic principles ofdatabase management systems (to enable staff to communicate with IT

specialists), Staff selected for training should be veterinarians who arededicated, enthusiastic, interested in disease surveillance and reporting.

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4.4.3Improving the disease reporting system

In this context the Disease Surveillance working Group will address and suggest

for the improvements in the disease reporting system, the passive diseasereporting system; the early warning system, and investigation of disease

outbreaks.

5. Targets diseases for reporting system

The routine reporting system focuses on a number of priority diseases. In thecontext of Epidemiological Network, OIE requirements and software used fordisease information system, the diseases will be selected on socio-economic

importance, presence of a control strategy or policy for the disease, ability torespond to reports of disease occurrence, need to know, existing disease

patterns (enzootic, epizootic, sporadic), etc. The list of OIE diseases and list ofdisease for Epidemiological Network is included as Annex.

5.1 Identifying disease outbreaks

All the disease incidences/outbreaks rather that disease occurrence will be

reported by the field staff of targeted districts. In this regards the trainingworkshop to identify and report the disease will be conducted in each targetdistrict. The Disease Surveillance Working Group will identify a simple andpractical system to allocate a serial number at the district level:

District/Year/serial number

orDistrict/Year/disease/serial number

These outbreak identifiers would be used to identify all data relating to one

outbreak and will be in built in the soft ware used for the disease informationsystem of Epidemiological Network.

5.2 Disease reporting orientation workshops

These would beheld at the target district level for veterinary officers atdistrict headquarters and the veterinary hospitals and dispensaries (asappropriate). To be effective these workshops must have the strong and

overt support of senior officers (eg by their attendance at workshops, orat a minimum the distribution of a written statement of clear support and

instruction for reporting all occurrences of target diseases). Theworkshops will include the following:

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Aims and objectives of disease surveillance and reporting (eg

Rinderpest pathway, international trade, enable effective use ofresources, rapidly identify new disease threats, identify trends inenzootic diseases etc).

Surveillance techniques: early warning, outbreak investigations,

update reports, field surveys and studies (including sero-epidemiological surveys, questionnaire surveys, longitudinalstudies).

Basic epidemiological principles and terminology of relevance to

disease surveillance and reporting.

Importance of early warning and its principles.

Outbreak investigations principles, a standardised approach,importance of collection and submissions of specimens forlaboratory examination.

Continued (update) reporting of disease events. Reporting formats,

definitions, etc.

Identification / clinical signs and typical epidemiological patterns of

occurrence of the target diseases

Collection of specimens for laboratory diagnosis of target diseases

Programme to create / enhance awareness of livestock owners and

private veterinary workers of (a) the clinical signs andepidemiology of the target diseases, and (b) the need toimmediately report the suspected occurrence of any of these

diseases or other disease events (eg new disease, unusualpatterns of behaviour of a known disease, or occurrence of

unusually large numbers of clinical cases and or deaths).

5.3 Creating awareness amongst livestock owners and privateveterinary workers

The master trainers, PDS Experts and VOs who have attended a

disease orientation workshop will utilise their new knowledge andconduct awareness sessions with livestock owners in the villages inthe jurisdiction of their veterinary hospital.

These sessions will be repeated as and when required or according

to the agreed work plan.

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The SLSP will assist this process by designing, printing and

supplying the awareness published material ( pamphlets, leaflets

and posters)in local versions.

5.4 The production and distribution of a regular EpidemiologyNewsletter.

This will be an extremely important strategy which aims, to demonstrate

that incoming data are being checked, evaluated and used. Thenewsletters will contain the following:

Progress of the Epidemiological Network at National, Provincial and

target district level over the reported period. It will representresults of reports from field staff to show the reportingperformance of each district especially highlighting the diseasecalendar, disease patterns (simple tables and maps), simple

interpretations of disease patterns, successes and problems withEpidemiological Units, work plans etc.

News about regional and global disease patterns, any new threats

to and Pakistans livestock populations, news from FAO, OIE, WHOas appropriate.

New developments in diagnosis, vaccines, epidemiology, etc.

Future recommendations for disease control, work plans, purchase

of medicines, vaccines and conduction of vaccination campaign intarget areas.

Any other relevant Livestock and Dairy Development Department

news.

This newsletter will be distributed to all DLOs and veterinary hospitalsthrough concerned provincial livestock departments.

6. Monthly reporting of disease and disease related data.

6.1Format of report

Each district submits a disease outbreak report at the end of each month as

required by the provincial livestock departments records. A unified

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recommended format by the DSWG for epidemiological network will be usedcovering the following basic information. Different formats are presented as

Annex

Names the target diseases and allocates one or more rows for each

for recording outbreak data, or one row per species Unique identifier for each outbreak

Date of index case

Number of villages affected

Production system

Species affected

Age group affected

Number of cases

Number of deaths

Number slaughtered

Number of animals vaccinated in month (whether or not in

response to, outbreak)

7. Data management

The proposed Epidemiological network will be only functional with the provisionand application of agreed data base or unified soft ware (Disease information

system). In this regards:

Disease outbreak data could be entered into the latest version

of TADinfo (Java-based). This will enable easy transmission from

the point of data entry (initially the district, later the provincial)

to the next level, and production of reports for the OIE. TADinfowould serve as the initial store for data.

As required, data will be exported to Excel for analyses, and / or

then imported into a customised Access disease datamanagement system linked to Arcview. This would enableanalysis and evaluation of data and production of tailored

reports (tables, charts and maps) required by decision makers.

8. Conclusions

Establishment of functional Disease Surveillance and Reporting System at

National, Provincial and District level, reflecting the actual status of livestockdisease in the country is a dream for Livestock department. With the proposed

workable concept of Epidemiological network, the dream may become true if;

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The commitment for the ownership of the Epidemiological network by the

Livestock department could be ensured by agreements and MoUs.

The concerned Livestock Department will coordinate by providing suitable

staff and place for proposed units at National, Provincial and target

Districts.

The role and Mandates for Epidemiological Units at National, Provincial

and Districts level could be defined and approved by the concernedcompetent authorities of Livestock departments.

The working atmosphere of FPMU SLSP will be favourable to initiate /

implement the planned activities under the Result 2 of project.

List of SLSP Targeted Districts

Province Punjab1. Chakwal.

2. Kasur3. Toba Tek singh

4. Gujrat

5. Bahawalpur6. Bhakkar

Province Sindh

1. Thatta

2. Badin3. Sanghar

4. Dadu5. Tharparkar

Province Balochistan

1. Pishin

2. Zhob3. kalat

4. Qila Saifullah5. Loralai

6. Mastung

Province NWFP

1. Peshawar2. Charsadda

3. Wsat

4. Mardan

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5. Abbottabad6. Nowshera

FPMU Sub Units

1. AJK

2. NAs3. FATA

4. ICT

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#S

#S

#S

#S

#S

#S #S

#S

#S#S

#S

#S

#S #S

#S

#S

#S

#S#S

#S#S#S

#S #S

#S

#S

PAKISTAN PROVINCESAJKBalochistanFATAICT

NWFPNorthern AreasPunjabSindh

#S SLSP DISTRICTS

S

N

EW

SLSP DISTRICTS IN PAKISTAN

ARABIAN SEA

IRAN

INDIA

CHINA

AFGHANISTAN

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article concept report

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