2014.ISDS.Abstracts.Final.pdf


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ISDS 2014 Conference Abstracts

Methodology of Epidemic Risk Management in 
Kazakhstan with Open-Source EIDSS
Aizhan Esmagambetova2, Alexey Burdakov*1, Stanislav Kazakov3, Andrey Ukharov1, Erlan 
Sansyzbaev3 and Vladimir Kazakov3

1Black & Veatch, Overland Park, KS, USA; 2Agency of the Republic of Kazakhstan on Consumer Rights Protection, Astana, 
Kazakhstan; 3Kazakh Scientific Center of Quarantine and Zoonotic Diseases, Almaty, Kazakhstan

Objective
Development and approbation of the epidemic risk estimation 

and management methodology based on multivariate analysis per 
administrative clusters of Kazakhstan using the Electronic Integrated 
Disease Surveillance System (EIDSS) technical capabilities.

Introduction
In order to transition the forecasting, estimation and management 

of epidemic risks to individual administrative areas, the Agency for 
Consumer Rights Protection of Kazakhstan has developed a concept 
for modernizing the existing national system of the epidemiological 
surveillance (SES).

It is proposed that the data from the SES (epidemiology, sanitary 
and epidemiological background, external environmental objects and 
database) will be consolidated to generate a new epidemic risk control 
and management tool called the Regional Sanitary-Epidemiological 
Passport (RSEP) for each of Kazakhstan’s districts. The RSEP will 
contain infectious incidence rate dynamics according to the primary 
(marker) infections (7 nosologies) including a forecast for 2-3 years, 
and natural and soil foci GIS maps for especially dangerous pathogens 
(EDP) with a 3-5 year forecast of their activity.

The RSEP is planned as a new working tool for epidemiologists 
to aid in making objective estimates, forecasting epidemic risks in 
particular areas of Kazakhstan, and taking preventive steps to lower 
epidemic risks.

Methods
The RSEP methodology is based on area specific data of infectious 

incidence rate marker indicators, and the environmental conditions 
based on sanitary-epidemiological and socio-economic spheres. 
Basic nosological forms registered in all regions and determining the 
overall infectious morbidity are used as the epidemic process markers 
for districts. The average long-term morbidity data per 100,000 of 
population for a period of 10+ years is used to determine the marker 
levels permissible (typical) for a particular area.

An auxiliary forecast component is the immune background for the 
main vaccines in use, including BCG vaccination of children up to 1 
year of age in maternity hospital.

EDP natural and soil foci and their activity of epizootic 
manifestations determine the risk level for populations living in 
unfavorable areas. Since population sporadic morbidity in these foci 
hinders the ability to forecast morbidity, RSEP also contains GIS 
maps of natural (soil) foci both basic and significant for most of the 
areas, and their distribution and epizootic activity based on long-term 
observations.

Public catering facilities, schools and food industry facilities have 
the greatest impact on the markers of the epidemic process selected 
in RSEP.

Based on a set of risk assessment sanitary-epidemiological 
indicators, an aggregate report is generated, which describes the 
situation in the region with the control criteria for the markers.

The open-source EIDSS will serve as the main tool of the proposed 
methodology in addition to its functions of collecting, processing and 
analyzing epidemiological, clinical and laboratory information on 64 
controlled infectious diseases in 269 institutions of the Agency as the 
national SES.

In 2012-13 we tested the EIDSS capability to forecast the disease 
risk for the Kazakhstani population of contracting the Crimean-Congo 
hemorrhagic fever. The forecast provided by the application proved to 
be 81.3/88.9% accurate [1].

Results
The concept and template methodology of estimation and 

management of epidemic risks have been developed. Its approbation 
by the CCHF has been conducted, and a high level of accuracy was 
shown [1]. Tasks for the detailed design and implementation of the 
methodology were formulated, including:

• Adjustment of estimation methods (increasing of the number of
factors, use of specific algorithms for individual nosologies)

• Formation of a reach back data bank 15-20 years deep on 7
infections based on historical data

• Creation of an electronic archive of GIS maps of EDP natural foci
• Application of EIDSS for implementation of a substantial portion 

or the whole methodology.

Conclusions
The methodology approbation results (CCHF) and availability of 

the EIDSS electronic system at the disposal of the Agency allow us 
to conclude the efficiency of the methodology and, upon its further 
development, to introduce it as a tool available to epidemiologists 
from national to district levels for effective risk assessment and 
management.

Keywords
risk management; EIDSS; marker indicators; surveillance system

References

1. Esmagambetova A., et.al. Accuracy of EIDSS software prognosis
on CCHF natural foci activity in Kazakhstan. OJHPI. 2014; 6(1).

*Alexey Burdakov
E-mail: burdakov@usa.net    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 7(1):e127, 2015