1. The Profile of Vietnam health sector & current Surveillance capacity of the infectious Diseases in Vietnam MBDS Vietnam

2. Contents n General information n National surveillance system n Goal, objectives n Principles n Database system n Existing analysis tools

3. General Information n Population:80 902 000 n Provinces:64 n Districts:659 n Communes:10,516 n Regions: 4 ( North, Center, South, Highland ) n Climate:Tropical and subtropical n Rainfall:1500-2000 ml/year (average) n Profession:80% agriculture n GDP (2004):450 US$/pers

4. n Hospitals: 856 (30 central hospitals, 800 provincial hospitals); 196,311 beds n Commune health centers: 10,516 n Number of medical doctors: 50,100 n Doctor per 10,000 inhabitant: 6.1 n Life expectancy at birth: 71.3 n IMR: 21% o n Under 5 MR: 32.8% o n MMR: 85.0/100,000 lbs

5. n Under weight malnutrition children < 5: 28.4% n Fully vaccinated (%): 96.7 n % of communes with MD: 65.4 n % of communes have communal health workers: 79.8 n % of communes have midwife or pediatric, obstetrict assistants: 93.1 n % of people used safe water: 60.9 n % of food poor households: 10.0

6. National surveillance system

7. Goals n To reduce the adverse impact of communicable disease on health and social and economic status in Vietnam.

8. Medium-term objectives n Strengthening ability to detect, identify and respond rapidly to epidemic-prone and emerging infectious diseases. n To integrate communicable diseases surveillance system, health information system and specific diseases program.

9. 64 Centers for preventive medicine at provincial level 3 Centers for Occupational and Environmental health 20 Centers for social Diseases control 659 district health centers (preventive medicine teams) 29 Centers for malaria control -National institute of hygiene and epidemiology -Pasteur institute in HCMC -Institute of hygiene and epidemiology in highland -Pasteur institute in Nha trang -National institute of occupational and environmental health -Institute of hygiene and Public health -Nutritional institute -National institute of Malaria-parasitological- Entomology -Sub-institute of Malaria-parasitological- Entomology in HCMC -Institute of Malaria-parasitological- Entomology in Quinhon -National center for quality control of Biological (Cencobi) - Poliovac center -Vaccine institute in Nhatrang - Company for production of vaccines and biological No.1 Ministry of health G.Dept.of preventive medicine 7 Frontier health Quarantine centers

10. Surveillance system for communicable disease in Vietnam Ministry of health General dept. of preventive medicine & HIV/aids control NIHE General clinics, children clinics, infectious clinics Central hospitals Regional Surveillance Unit Regional HE/Pasteur Institutes Pediatrics, infectious wards Central hospitals General clinics, children clinics, infectious clinics Provincial hospitals Surveillance Unit Provincial Preventive Medicine Centers Pediatrics, infectious wards Provincial hospitals General clinics, children clinics, infectious clinics District hospitals Private clinics Surveillance Unit District surveillance teams Commune medical station

11. List of communicable diseases n Cholera (A00) n Typhoid and paratyphoid (A01) n Bacterial dysentery (A03) n Ameba dysentery (A06) n Diarrhoea (A09) n Acute encephalitis syndrome (A83-A89) n Dengue fever n Dysentery syndrome

12. List of communicable diseases n Viral hepatitis A,B,C,D,E (B15-B19) n Rabies (A82) n Meningococcal meningitis (A39) n Chicken pox-zona (B01, B02) n Diphtheria (A36) n Pertussis (A37) n Neonatal tetanus (A33) n Other tetanus (A35)

13. List of communicable diseases n Acute flaccid paralysis n Measles (B05) n Mumps (B26) n Influenza (J10,11), including H5N1 n APC-Adeno virus (B30) n Plague n Anthrax n Leptospirosis n HIV/AIDS n Malaria

14. Principles n Regional institutes responsible for provinces in region. n Centre for Preventive Medicine implements surveillance activities. n District Preventive Medicine Team usually take surveillance action in the field and clinic, hospital, it is important for the early warning systems in area.

15. Principles n Urgent report for outbreaks: Within 24 hours. n Routine report: - Weekly report - Monthly report n Annual report

16. Number of SARS cases by day as of April 28,2003

17. Reporting periods Urgent report Weekly report Monthly report Diseases:SARS, H5N1, Cholera, Plague, any outbreak. SARS, H5N1, Cholera, Typhoid, Plague, DF/DHE, Measles. 26 diseases How to report: Telephone, Fax. Fax, official letter, Email

18. Other EWARS n NAMRU – 2 n Rumor: Press, newspaper, unofficial. n Pro-MED

19. Location of database system n Centre for Preventive Medicine at province level. n Regional Institutes. n Communicable diseases Division – MHO.

20. Existing analysis tools n Routine surveillance data: - Excel - EPI-INFO - GIS n Research data: - STATA - SPSS.

21. Distribution of sars in vietnam Ha Noi Ninh Binh

22. Future plan n Strategy up to 2010 – Electronic data transmission. –Standardize database network. –FETP Training. –Laboratory verification. –Improve communication.

23. recommendations  Establish mechanism for collaboration between ministries and international organizations in sharing information and organizing immediate control activities.  Support the establishment of Regional Task Force Committee for control of diseases, natural and other disasters.

24. recommendations  Establish information system, diseases report in the MBDS countries and with WHO. Establish website to inform and exchange experiences on communicable disease control.  Collaborate in study of epidemiologic characters of dangerous diseases such as SARS, influenza A (H5N1); establish Regional Center to research influenza.