The Profile of Vietnam health sector &

current Surveillance capacity of the infectious

Diseases in Vietnam

MBDS Vietnam

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

General Information Population: 80 902 000 Provinces: 64 Districts: 659 Communes: 10,516 Regions: 4 (North, Center, South, Highland) Climate: Tropical and subtropical Rainfall: 1500-2000 ml/year (average)

Profession: 80% agriculture GDP (2004): 450 US$/pers

Hospitals: 856 (30 central hospitals, 800 provincial hospitals); 196,311 beds

Commune health centers: 10,516 Number of medical doctors: 50,100 Doctor per 10,000 inhabitant: 6.1 Life expectancy at birth: 71.3 IMR: 21%o

Under 5 MR: 32.8%o

MMR: 85.0/100,000 lbs

Under weight malnutrition children < 5: 28.4%

Fully vaccinated (%): 96.7 % of communes with MD: 65.4 % of communes have communal health

workers: 79.8 % of communes have midwife or

pediatric, obstetrict assistants: 93.1 % of people used safe water: 60.9 % of food poor households: 10.0

National surveillance system

Goals

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

Medium-term objectives

Strengthening ability to detect, identify and respond rapidly to epidemic-prone and emerging infectious diseases.

To integrate communicable diseases surveillance system, health information system and specific diseases program.

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 andPublic 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

Surveillance system for communicable disease in Vietnam

Ministry of healthGeneral dept. of preventive medicine & HIV/aids control

NIHE

General clinics, children clinics, infectious clinics

Central hospitals

Regional Surveillance UnitRegional HE/Pasteur Institutes

Pediatrics, infectious wardsCentral hospitals

General clinics, children clinics, infectious clinics

Provincial hospitals

Surveillance UnitProvincial Preventive

Medicine Centers

Pediatrics, infectious wardsProvincial hospitals

General clinics, children clinics, infectious clinics

District hospitals Private clinics

Surveillance Unit District surveillance teams

Commune medical station

List of communicable diseases

Cholera (A00) Typhoid and paratyphoid (A01) Bacterial dysentery (A03) Ameba dysentery (A06) Diarrhoea (A09) Acute encephalitis syndrome (A83-A89) Dengue fever Dysentery syndrome

List of communicable diseases

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

List of communicable diseases

Acute flaccid paralysis Measles (B05) Mumps (B26) Influenza (J10,11), including H5N1 APC-Adeno virus (B30) Plague Anthrax Leptospirosis HIV/AIDS Malaria

Principles

Regional institutes responsible for provinces in region.

Centre for Preventive Medicine implements surveillance activities.

District Preventive Medicine Team usually take surveillance action in the field and clinic, hospital, it is important for the early warning systems in area.

Principles

Urgent report for outbreaks: Within 24 hours.

Routine report: - Weekly report

- Monthly report

Annual report

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

1

0 0 0 0

1 1

12

7 7

3

2

6

1 1

3

0

1 1 1

6

0

1

2

0

1

0 0 0 0 0 0 0 0 0 0 0

1

0

1

0

1

2

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00

2

4

6

8

10

12

25/0

226

/02

27/0

228

/02

01/0

302

/03

03/0

304

/03

05/0

306

/03

07/0

308

/03

09/0

310

/03

11/0

312

/03

13/0

314

/03

15/0

316

/03

17/0

318

/03

19/0

320

/03

21/0

322

/03

23/0

324

/03

25/0

326

/03

27/0

328

/03

29/0

330

/03

31/0

301

/04

02/0

403

/04

04/0

405

/04

06/0

407

/04

08/0

409

/04

10/0

411

/04

12/0

413

/04

14/0

415

/04

16/0

417

/04

18/0

419

/04

20/0

421

/04

22/0

423

/04

24/0

425

/04

26/0

427

/04

28/0

4

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

Fax, official letter, Email

Other EWARS

NAMRU – 2

Rumor: Press, newspaper, unofficial.

Pro-MED

Location of database system

Centre for Preventive Medicine at province level.

Regional Institutes.

Communicable diseases Division – MHO.

Existing analysis tools

Routine surveillance data:

- Excel

- EPI-INFO

- GIS Research data:

- STATA

- SPSS.

Distribution of sars in vietnam

Ha Noi

Ninh Binh

Future plan

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

recommendations

1. Establish mechanism for collaboration between ministries and international organizations in sharing information and organizing immediate control activities.

2. Support the establishment of Regional Task Force Committee for control of diseases, natural and other disasters.

recommendations

3. Establish information system, diseases report in the MBDS countries and with WHO. Establish website to inform and exchange experiences on communicable disease control.

4. Collaborate in study of epidemiologic characters of dangerous diseases such as SARS, influenza A (H5N1); establish Regional Center to research influenza.