Pro Surveillance System

[Gaby Zenz]

Launchedin December 2019, the Surveillance System for Attacks on Health Care (SSA) is a global and standardized monitoring system for the collection of primary data about attacks on health care. The system is used in emergency-affected countries and fragile, conflict-affected and vulnerable settings that are priority areas of the WHO Health Emergencies Programme. The dashboard aggregates global data and allows users to filter the data for tailored analysis.

Impact: This data represents the number of attacks in which each health resource was impacted. It does not indicate the total number of resources that were attacked. For example, one attack could have an impact on patients, transports and supplies at the same time.

Recently reported attacks: Users can access the full report by clicking on the Attack ID of interest. All attacks from the selected data range can be viewed in full using the button on the bottom right of the table.

Annual data: The annual data chart is linked to the country filter selected by the user and does not take into account selected date ranger nor selected types of attacks. When no country is selected, this chart reflects global numbers.

Definition: WHO defines an attack on health care as any act of verbal or physical violence or obstruction or threat of violence that interferes with the availability, access and delivery of curative and/or preventive health services during emergencies. The nature and types of attacks vary across contexts and can range from violence with heavy weapons to psychological threats or intimidation.

Each reported attack is assigned a level of certainty by a designated WHO staff member which conveys a level of confidence that the reported attack has occurred. The level of certainty applies to whether the attack occurred, but does NOT apply to the detailed data about the attack.

Database: Reported attacks on health care are entered in the SSA web-enabled secure global database. Reports that have been verified and cleared by a designated personnel and the WHO Representative are further published on the SSA dashboard.

Data displayed in this dashboard is available for download using the Export to Excel button on the bottom right of the Recently Reported Attacks table. The data export function takes into account filters selected by the user.

Protecting the confidentiality of victims and contributors who share information about an attack is the main priority whenever data is made available on the public dashboard. The SSA does not collect any personal information about victims of an attack. Personal information about partners is collected as part of the verification process but is not shared publically. For security purposes, WHO Country Offices can request the withdrawal of data from the public dashboard at any time.

WHO supports open access to the published output of its activities as a fundamental part of its mission and a public benefit to be encouraged wherever possible. Permission from WHO is not required for the use of the Surveillance System for Attacks on Health Care dashboard material or data available for download. It is important to note that:

The WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) was launched in 2015 to foster AMR surveillance and inform strategies to contain AMR. The system started with surveillance of AMR in bacteria causing common human infections and has expanded its scope to include surveillance of antimicrobial consumption (AMC), invasive fungal infections, and a One Health surveillance model relevant to human health. To meet future challenges, it is in continuous evolution to enhance the quality and representativeness of data to inform the AMR burden accurately. As of the end of 2022, 127 countries, territories and areas participate in GLASS.

The fifth GLASS report, produced in collaboration with Member States, summarizes 2020 data on AMR rates in common bacteria from countries, territories, and areas. The report brings new features, including analyses of population testing coverage or AMR trends. For the first time, the report presents 2020 data on AMC at the national level. A new interactive dashboard allow users to explore AMR and AMC global data, country profiles and download the data.

This report marks the end of the early implementation phase of GLASS. In addition to presenting data collected through the latest data call, this report provides a summary of five years of national AMR surveillance data contributed to GLASS from its initiation, presents AMR findings in the context of progress of country participation in GLASS and in global AMR surveillance coverage and laboratory quality assurance systems at (sub)national level.

Patterns of antimicrobial consumption are presented by country with a particular focus on antibacterials. The report also presents the antimicrobial consumption according to the WHO AWaRe antibiotic classification, for penicillins and cephalosporines. From a One Health perspective, the report presents antimicrobial consumption data in the human sector expressed in tons to allow a comparison with antimicrobial consumption from other sectors (not included in this report).

The Behavioral Risk Factor Surveillance System (BRFSS) is an annual statewide landline and cellular phone health surveillance system designed by the Centers for Disease Control and Prevention (CDC) and coordinated by all 50 states, the District of Columbia, and territories.

WEDSS is a secure, web-based system designed to facilitate reporting, investigation, and surveillance of communicable diseases in Wisconsin. It is designed for public health staff, infection control practitioners, clinical laboratories, clinics, and other disease reporters.

According to Wis. Stats. 252.05, any health care provider who knows or has reason to believe a person treated or visited by him or her has a communicable disease is required to report. Per Wis. Admin. Code DHS 145.04(1), this includes reporting of a case or suspected case.

WEDSS documents are located on the WEDSS SharePoint site. You must have a Wisconsin Logon Management System (WILMS) account in order to use WEDSS or access these documents. If you do not have a WILMS account, please send an email to DPH WEDSS staff to request instructions.

The Texas Behavioral Risk Factor Surveillance System (BRFSS), initiated in 1987, is a federally supported landline and cellular telephone survey that collects data about Texas residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services. Texas BRFSS is an important tool for decision-making throughout DSHS and the public health community. Public and private health officials at the federal, state, and local levels rely on the BRFSS to identify public health problems, set priorities and goals, design policies and interventions, as well as evaluate the long-term impact of these efforts.

This surveillance can be used to monitor the Healthy People 2030 Objectives for current smoking, obesity, high blood pressure, exercise and physical activity, flu and pneumonia vaccinations, cholesterol and cancer screenings, seat belt use, as well as other risk factors. We administer the BRFSS under the direction of the Centers for Disease Control and Prevention (CDC) so that survey methods and much of the questionnaire are standardized across all BRFSS surveys in the 50 states, three territories, and the District of Columbia. As a result, comparisons can be made among states and to the nation overall.

CDC provides a core questionnaire that the states may choose to supplement with optional modules and state-added questions. We extensively edit the monthly files for accuracy compile an annual file shortly after the end of the calendar year. You can access prevalence estimates of risk factors, health indicators, and preventive health practices through the Texas BRFSS query system.

Texas Syndromic Surveillance (TxS2) is the statewide syndromic surveillance system hosted by the Texas Department of State Health Services (DSHS) for use by Local Health Departments (LHDs), DSHS Public Health Regions (PHRs, view map of DSHS PHRs), DSHS central office, and data providers (hospitals, free standing emergency centers, and urgent care centers, for example) for enhanced surveillance of emerging public health conditions or threats. Syndromic surveillance utilizes trend analysis to establish a baseline and then uses algorithms to compare the current data to that baseline and issue alerts when aberrations are detected. DSHS has authority to operate TxS2 under Chapter 81 of the Texas Health and Safety Code.

To submit data to TxS2, an organization needs to register intent, sign an MOU, test their data stream between their EHR and the TxS2 system, and follow the quality and frequency guidelines once testing is complete and they are moved into production. For a complete explanation of the onboarding process, please see the Data Provider and TxS2 User Registration and Onboarding Procedure.

The purpose of syndromic surveillance is to protect the health of the community through public health interventions based on enhanced surveillance of emerging public health conditions and consolidation of health-related data statewide. Syndromic surveillance allows for early detection of abnormal disease patterns that could result in high morbidity and mortality. The basic functions of syndromic surveillance include early event detection, situational awareness, and retrospective analysis.

In April 2011, DSHS conducted a survey of existing syndromic surveillance systems in Texas. At that time, there were at least six different analysis systems being used in various parts of the state with no data sharing between them. As of October 2019, there are three syndromic surveillance systems in Texas: the North Texas Syndromic Surveillance System (NTXSS) hosted by Tarrant County Public Health covering PHR 2/3, a system hosted by Houston Health Department covering PHR 6/5S, and the TxS2 system. NTXSS is fully incorporated into TxS2, and the Houston Health Department system is currently working with TxS2 to become fully integrated. The former TALHO system was fully incorporated into TxS2 and no longer exists. TxS2 is working to connect other data providers statewide to integrate syndromic data from across the state into one system.

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