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ISDS 2012 Conference Abstracts

The Organizational Structures and Human Resources
Allocation of Infectious Disease Surveillance System in
Rural China
Biao Xu*1, Qi Zhao1, Huijian Cheng2, Tao Tao1, Yipin Zhu1, Miao Yu1 and Hui Yuan2

1School of Public Health, Fudan University, Shanghai, China; 2Jiangxi Provincial Center for Disease Control and Prevention,
Nanchang, China

Objective
To understand the structure and capacity of current infection dis-

ease surveillance system, and to provide baseline information for de-
veloping syndromic surveillance system in rural China.

Introduction
To meet the long-term needs of public health and social develop-

ment of China, it is in urgency to establish a comprehensive response
system and crisis management mechanism for public health emer-
gencies. Syndromic surveillance system has great advantages in pro-
moting early detection of epidemics and reducing the burden of
disease outbreak confirmation (1). The effective method to set up the
syndromic surveillance system is to modify existing case report sys-
tem, improve the organizational structures and integrate new func-
tion with the traditional system.

Methods
Since August 2011, an integrated syndromic surveillance project

(ISSC) has been implemented in China. Before the launching of the
project, a cross-sectional study was carried out in Fengxin County and
Yongxiu County of Jiangxi province during October 11 to 18, 2010.
Institution information were investigated in the county hospital, town-
ship hospital and County Center for Disease Control and Prevention
(CDC) to understand the performance of existing case report system
for notifiable infectious diseases with regard to its structure, capacity
and data collection procedure. Health care workers from each town-
ship hospital and village health station were questionnaire interviewed
for information on qualification of human resources, basic healthcare
delivery condition, hardware and software needs for ISSC.

Results
An internet-based real-time (quasi real-time) case report system

for notifiable infectious diseases, based on the three-tier public health
service System, had been established in these two counties since
2004. The farthest end of net user in case report system was township
hospital. Blood routine test, urine routine test, B ultrasound and elec-
trocardiogram were available in all township hospitals. There was no
laboratory equipment in village health stations in these two counties.
All the township hospitals in these two counties were equipped with
land-line telephones and desktop computers. The internet covers all
township hospitals in both counties. Most clinical doctors in township
hospital(TH) and village health station(VHS) were male. The age of
doctors ranged from 21 to 72 years old, with the average at 42 and
median at 40 years. The village health workers were significantly
older, less educated and served in health care longer than the town-
ship hospital doctors. In Yongxiu County, 95.6% of the village health
stations were equipped with computers, including private-owned
computers, and 80.7% of them had access to the internet; while in
Fengxin County, 66.5% of the village health stations possessed com-
puters, among which most were private property of village doctors,
and only 44.2% of them had access to the internet.

Conclusions
The current case report system, with full coverage and stable

human resource, has established a solid basis for developing syn-
dromic surveillance system in rural China. The syndromic surveil-
lance system could play its role in early detection of infectious disease
outbreaks in rural area where laboratory service for infectious dis-
ease diagnosis are not available. However, the lack of computerized
patient registration in village and township health care facilities and
incomplete internet coverage in rural area and relatively low quality
of human resource in village level should be taken into consideration
seriously before establishing the syndromic surveillance system in
rural China.

Figure1 Flowchart of case report system for notifiable infectious disease in
different level of health facilities in Fengxin and Yongxiu County

Keywords
Syndromic surveillance; rural area; human resources; case report sys-
tem

Acknowledgments

This study was funded by [European Union’s] [European Atomic Energy
Community’s] Seventh Framework Programme ([FP7/2007-2013]
[FP7/2007-2011]) under grant agreement no. [241900].

References

1. Heffernan R, Mostashari F, Das D, et al.Syndromic Surveillance in
Public Health Practice, New York City. Emerging Infectious Dis-
eases2004;10(5):858- 864.

*Biao Xu
E-mail: bxu@shmu.edu.cn

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e87, 2013