Clinician’s role in disease surveillance and response

Each country and regional adaptation of the Clinician’s role in disease surveillance and response differed. In Uganda and Sierra Leone, this training manual was adapted to help support the WHO/CDC IDSR (Integrated Disease Surveillance and Response) approach, to strengthen the active involvement of clinician’s in early recognition of notifiable diseases, their reporting and response to an outbreak.

The Uganda adaptation included sections on influenza/SARI and viral hemorrhagic fever with person-to-person transmission.  The training manual was used late in the 5 day Quick Check+ training course. The entire clinical team from each hospital (doctors, nurses, auxiliaries and managers) came together to respond to cases presented by an expert patient trainer, doing an emergency Quick Check assessment and responding to emergency signs while forming a rapid differential diagnosis.

Sierra Leone moved from the Ebola response to preparedness for other outbreaks in 2016. After thousands had been trained using the WHO Ebola Clinical Team training (2014-2015) and most PHCUs and non-Ebola hospitals received IPC or Ebola screening plus IPC training. Following this, the MOH and WHO country office sponsored adaptation and training using an adapted Clinician’s role in disease surveillance and response which included only a short introduction to the Quick Check, with emphasis on priority pathogens for immediate reporting. Sections included general concepts of disease surveillance and response and clinician’s role; infection prevention and control; surveillance of acute viral hemorrhagic fevers; surveillance and response to cholera; and other priority conditions with fever with emphasis on differential diagnosis of patients with fever and skin signs including measles, monkeybox, and  meningococcal meningitis. This training was piloted in 2016 then scaled up to all district hospitals and most large health centres with beds in 2017, training 418 participants in both two training of trainer courses and cascade training. 

The Myanmar adaptation, after a short sections on surveillance emphasizing immediately reportable diseases with epidemic potential, emphasized infection prevention and control, response to COVID-19 according to current transmission, and surveillance of influenza, novel coronaviruses, and other severe acute respiratory infections.

In the SEARO IMAI SARI tools, this training manual was shortened and modified for an emphasis on SARI in particular COVID-19 and other coronaviruses and influenza and infection prevention and control (link to SEARO SARI Clinician’s role).