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For the complete DHIS2 documentation index, see llms.txt.
Santé
Surveillance des maladies
Surveillance de la COVID-19
COVID-19 Événements de surveillance[Interrompu]

COVID-19 Surveillance Line-list Design

Demo: https://covid.dhis2.org

Objectif

The COVID-19 Surveillance Event Program System Design document provides an overview of the design principles and guidance used to develop the digital data package for aggregate COVID-19 surveillance. This document is intended for use by DHIS2 implementers at country and regional level to be able to support implementation and localisation of the package. The COVID-19 metadata package can be adapted to local needs and national guidelines. In particular, local work flows and national guidelines should be considered in the localization and adoption of the programs included in this package.

Contexte

The COVID-19 digital data package was developed in response to an expressed need from countries to rapidly adapt a solution for managing COVID-19 data. UiO has developed COVID-19 surveillance packages for three types of data models (tracker, event-based aggregate) to enable countries to select the model that is most appropriate for their context given the burden of disease and available resources. These models and their relative benefits/limitations are summarized below:

Type de Package de surveillance Surveillance basée sur les cas (Tracker) Surveillance (Événement) Surveillance (Agrégat )
Description Permet d'enregistrer un cas et de le suivre dans le temps grâce à la confirmation en laboratoire et au résultat relatif au cas Permet de saisir les détails relatifs à un cas critique sous forme de liste de lignes Permet la déclaration quotidienne ou hebdomadaire des principaux points de données agrégées
Pros La grande granularité des données et les multiples dimensions temporelles de l'analyse peuvent permettre de décentraliser le flux de travail c'est-à-dire tous les événements liés au cas. Caractéristique plus granulaire qu'agrégée et pouvant saisir les principales dimensions temporelles (c'est-à-dire la date du rapport par rapport à l'apparition des symptômes) ; réduction de la charge de saisie des données par rapport au tracker et niveau de complexité peu élevé Peu complexe, facile à mettre en œuvre, plus facile à gérer lorsque le nombre de cas est élevé
Cons Le volume de données à saisir peut être écrasant lorsque le nombre de cas atteint le seuil ; ceci peut rendre la mise en œuvre complexe Ne prend pas en charge le suivi des cas ou d'autres flux de travail décentralisés Une granularité plus faible pour l'analyse détaillée (c'est-à-dire une analyse basée exclusivement sur la date de notification du cas, une désagrégation limitée)

This document covers only the design of the surveillance event program package; separate system design documents are available for DHIS2 Tracker and aggregate packages.

L'OMS "exhorte tous les pays à se préparer à l'arrivée éventuelle de COVID-19 en préparant des systèmes d'intervention d'urgence, en augmentant la capacité à détecter et à soigner les patients, en veillant à ce que les hôpitaux disposent de l'espace, du matériel et du personnel nécessaires et en mettant au point des interventions médicales visant à sauver des vies".

Les objectifs du progiciel de surveillance du COVID-19 sont les suivants :

  1. surveiller les tendances de la maladie là où il y a transmission interhumaine ;
  2. détecter rapidement les nouveaux cas dans les pays où il n'y a pas de circulation du virus ;
  3. fournir des informations épidémiologiques pour effectuer des évaluations des risques aux niveaux national, régional et mondial ; et
  4. fournir des informations épidémiologiques pour orienter les mesures de préparation et d'intervention.

The system design builds upon existing disease surveillance principles and information system requirements that have been developed collaboratively between the WHO and UiO since 2017. The COVID-19 package was developed with the intent to align to WHO technical guidance on nCoV-19 surveillance and case definitions, last updated March 20, 2020. Note that this design may not necessarily reflect the latest available interim global guidance developed by WHO as updates may be released rapidly. National guidelines and policies may vary and it is recommended to adapt this package to local context.

Résumé de la conception du système

This package is designed as a DHIS2 Event Program. The Event Program is not designed to capture all data variables contained in the WHO case reporting template. To capture a complete set of WHO case reporting variables, please refer to the DHIS2 COVID-19 Case-based Surveillance Tracker. Rather, the event program is a simplified program that captures a subset of minimum critical data points to facilitate high data quality when the number of caseloads or burden of reporting exceeds capacity for successfully completing the full line-list for suspected COVID-19 cases. For implementers who wish to capture the complete WHO line-listing, please refer to the COVID-19 Case-based Surveillance Tracker Package.

The COVID-19 Surveillance Event Program data package includes:

  1. Event program and data elements case reporting
  2. Indicateurs de base
  3. Tableau de bord

Use Case: Simplified line-listing of COVID-19 cases

As cases increase rapidly, some countries may struggle with case-based reporting as the burden becomes too high. The event package is designed to capture the most critical data points in a line-list and analytical capacities for surveillance and response. The event package is designed as a standalone program. However, countries may use the event package in combination with other packages (i.e. event reports and daily aggregate reporting); or, they may shift from tracker to event to aggregate as caseloads and reporting burden increases. _Countries should plan carefully how they intend to implement these packages in combination, including reporting flows, transitioning from one data model to another, and how to maintain historical data for analysis if transitioning between data models. _

The design of the event-based line-listing program assumes that WHO case definitions are followed in the use case; countries should follow national case definitions for classifying cases as suspected, probably or confirmed.

Utilisateurs cibles

  • Les utilisateurs dans les établissements de santé : saisissent et communiquent des données principales sur les cas de COVID-19 et les décès qui se présentent dans les établissements de santé
  • Autorités sanitaires nationales et locales : suivi et analyse des données de surveillance des maladies au moyen de tableaux de bord et d'outils d'analyse permettant de réaliser des évaluations des risques et de planifier les interventions ; production de rapports en vue des rapports régionaux et global

Déroulement

Unlike the tracker program, there are limitations to decentralization of the data reporting workflow in an Event program. The most significant limitation is that the Case Outcome (recovery or death) is often not known until days or weeks after the case is reported. The current program design allows for the following workflow options:

  1. Event is created when a suspected case is reported. All known data is entered, but the event is not completed. A user can select an ‘Active Event’ from a working list based on User filters and criteria. When missing data becomes available (i.e. the case outcome), the user can enter the remaining data fields and complete the event. Cases can be identified in the event list by the Case ID data element. See the image below as an example which can be accessed within the Capture App:

    Capture App

  2. Event is created. All case related data is entered retrospectively, including the Outcome. Event is completed. The limitation is this approach is timeliness of the data reporting, as new suspected cases might not be captured until their outcome which is often too late for decision making.

Structure du programme

The program is called ‘COVID-19 Cases (events)’

Section Description
Date of report Event Date
Countries may re-name the event date to apply to their protocols.
Section 1
Basic Information		 Records basic demographic data.
Countries may add data elements as desired.
- Patient ID
Can be used to filter events in working lists, eg. Active events
- Sex
- Age
Section 2
Case Details		 Records information about the case including symptoms, severity, testing, etc.
- Symptoms
Options: Yes / No
Specifies whether a case has any symptoms at time of notification

- Date of symptoms onset
Only appears if symptoms are present;
Date of symptoms onset, if available, will replace “Date of Report” in data analytics and reporting.

- Case Severity (at time of notification)
Options: Mild / Moderate / Severe / Critical
- Laboratory tested?
Options: Yes / No/ Unknown
Specifies whether a case has been laboratory tested for COVID-19

- Test Result
Only appears if the case was laboratory tested
Options: Inconclusive / Positive / Negative / Unknown
The program is designed to capture only the final test result. Results for each individual test (if available) and the total number of tests performed are not captured.
- Case Classification
Options: Suspected case / Probable case / Laboratory confirmed case
Automatically assigned values
The values are assigned by Program rules in accordance with WHO case definitions
This feature can be useful in filtering active cases in the working lists.
Section 3
Exposures		 - Has the case traveled in the 14 days prior to symptoms onset?
Options: Yes / No / Unknown
Specifies travel history of the case.

- Likely Infection Source
Options: Imported case* / Local Transmission / Exposure unknown
* Imported case option appears only if the case traveled in the 14 days prior to symptoms onset

- Specify local source
Only appears if Likely Infection Source is Local Transmission
Options: Community (workplace, public transport, etc.) / Household / Healthcare Facility / Close Contact with Other Infected Individual / Exposure Unknown

- Case Type
Options: New index case / Linked to existing cluster / Unknown
Specifies whether the case is connected to an existing cluster or is a new index case
Section 4
Treatment		 - Hospitalised
Options: Yes / No

- Did the case receive care in an intensive care unit (ICU)?
Only appears if the case is hospitalised
Options: Yes / No
Section 5
Contacts		 - Total number of contacts followed for this case
Records number of contacts
Section 6
Outcome		 - Health outcome
Options: Recovered / Death
Section 7
Assigned Date of onset of symptoms		 - Calculated onset date (for Indicators)
This section is used only to calculate indicators based on report date vs. date of onset of symptoms]
This automatically assigned date is used in program indicators. Initially, it is the report date. If the date of onset of symptoms is available, the date is replaced by the date of onset of symptoms.
Status This is a generic field included in all Event Program
Complete event
Option: Yes
The event should only be marked as ‘complete’ if all data entry has been completed. If the user is waiting to complete certain fields (such as case outcome), the event should be left not complete.
Events that are not marked as ‘Complete’ are maintained as active and can be more easily searched by the user in a working list
Section 9
Comments		 - Comments
Optional comments and remarks. Note that these comments will not display in the analytics and can only be accessed through the Capture app used to enter line-listed data.

Groupes d'utilisateurs

Le package de métadonnées englobe les groupes d’utilisateurs ci-après :

  1. Administrateur COVID19 -- réservé aux administrateurs système autorisés à modifier les métadonnées
  2. Saisie des données COVID19 -- destiné au personnel de saisie des données qui devraient pouvoir accéder et saisir des données
  3. COVID19 access -- intended for users such as analytics users who should be able to view the data, but not edit metadata.

Currently, only users assigned to the COVID19 data capture group will have access to capture data in the program. Please refer to the installation guidance for more instructions.

Règles de programme

The following program rules have been configured for the program:

Nom de la règle du programme Description de la règle du programme
Assign Empty Value to Class Classification Automation: Assign Empty Value to Class Classification
Assign Event Date Automation: Assign Event date if to onset date if no Onset date is available
Assign 'Laboratory Confirmed Case' to Case Classification Automation: Assign 'Laboratory Confirmed Case' to Case Classification
Assign Onset Date Automation: Assign Symptoms Onset Date if available
Assign 'Probable Case' to Case Classification Automation: Assign 'Probable Case' to Case Classification
Assign 'Suspected Case' to Case Classification Automation: Assign Suspected Case' to Case Classification
Hide Case Classification Field Hide Case Classification Field until Lab Test question is answered
Hide ICU field Hide ICU field unless Hospitalised
Hide 'Imported Case' Hide 'Imported Case' if not traveled
Hide Onset of Symptoms Date Hide Onset of Symptoms Date if no symptoms
Hide Outcome Options Hide irrelevant Outcome Options
Hide 'Specify Local Infection Source' Hide 'Specify Local Infection Source' unless Local Transmission is selected
Hide Test Result Field Hide Test Result Field until Lab Test question is answered with yes
Hide Test Result Options Hide Irrelevant Test Result Options
Hide Unknown Options Hide Irrelevant Unknown Options

Vous pouvez en savoir plus sur les règles du programme ici :

https://docs.dhis2.org/master/en/user/html/configure_program_rule.html

Indicateurs et indicateurs de programme

From the data captured in the COVID-19 line-listing program, we can calculate the following indicators, including those recommended by the WHO for daily and weekly reporting, present them in a dashboard. All COVID-19 program indicators based on the event program are assigned to the Program Indicator Group ‘COVID-19 Events.’
COVID-19 - Cases admitted in intensive care unit (ICU) COVID-19 Cases admitted in intensive care unit (ICU)
COVID-19 - Cases exposed through healthcare facility Cases where infection is suspected to have occurred in a health care setting
COVID-19 - Cases infected by community transmission Cases where infection is suspected to have occurred through community spread
COVID-19 - Cases infected by household transmission Cases where infection is suspected to have occurred within the household
COVID-19 - Cases infected by local transmission Cases where infection is suspected to have occurred locally, not in another country
COVID-19 - Cases infected through other contact with other infected individual Cases where infection is suspected to have occurred through other close contact with an infected individual (excluding those listed: household, known cluster, HCF)
COVID-19 - Cases linked to known cluster Cases where infection is suspected to have occurred by linkage to a known cluster of cases
COVID-19 - Cases with unknown exposure Cases where source of infection or exposure is unknown
COVID-19 - Deaths COVID-19 related deaths (deaths recorded among all suspected cases)
COVID-19 - Cas confirmés et hospitalisés Number of confirmed cases that were admitted into hospital
COVID-19 - Cas importés Cases where likely source of infection is recorded as another country or imported from another country.
COVID-19 - Cas confirmés en laboratoire Suspected cases that were confirmed through laboratory testing (multiple lab tests may be conducted; this indicator assumes that the last test result is "Positive"); displayed by report date
COVID-19 - Cas confirmés en laboratoire - en fonction de l'apparition des symptômes Suspected cases that were confirmed through laboratory testing (multiple lab tests may be conducted; this indicator assumes that the last test result is "Positive"); displayed by date of onset of symptoms
COVID-19 - Cas testés en laboratoires Number of suspected cases that received a laboratory test (includes inconclusive lab testing results)
COVID-19 - Cas probables Suspected cases with inconclusive laboratory results or not tested for any reason, by reported date
COVID-19 - Cas probables - en fonction de l'apparition des symptômes Suspected cases with inconclusive laboratory results or not tested for any reason, by date of onset of symptoms
COVID-19 - Recovered cases Number of cases that are recovered (By date of onset of symptoms)
COVID-19 - Cas suspects Total number of cases suspected with COVID-19, by report date
COVID-19 - Cas suspects - en fonction de l'apparition des symptômes Total number of cases suspected with COVID-19, by date of onset of symptoms
COVID-19 - Suspected cases not tested Total number of suspected cases without a lab result
COVID-19 Event - case fatality rate COVID-19 related deaths (deaths recorded among all suspected cases)
COVID-19 : Décès par sexe et par tranche d'âge Male, 0-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, 85+
Female, 0-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, 85+
COVID-19 : Cas confirmés par sexe et par tranche d'âge Male, 0-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, 85+
Female, 0-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, 85+
COVID-19 : Cas suspects par sexe et groupe d'âge Male, 0-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, 85+
Female, 0-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65-74, 75-84, 85+

Références