Disease Surveillance And It’s Role In Public Health

Project and Seminar Material for Public Health

Disease Surveillance And It’s Role In Public Health


Abstract


This study examined disease surveillance and it’s role in public health. Descriptive survey research design was used. Using simple random sampling technique, a total of 80 health workers comprised medical doctors, laboratory scientists, pharmacists and nurses participated in the questionnaire administration. The researcher developed Questionnaire tagged: Challenges of Health Sector Questionnaire (CHSQ) with reliability coefficient 0.89 was used for data collection. Descriptive statistics of mean and pie-chart were used for analyzing and presenting research questions 1 and 2. Research question 3 was analyzed using regression analysis. The findings revealed that poor health infrastructure, insufficient financial investment, inadequate sufficient health personnel, meager remuneration for health workers, poor leadership and management, shortage of personal protective equipment (PPE), inadequate personnel, under-equipped of laboratory and reduction in supply chain drugs were among the challenges facing health sector and its workforces in managing Covid-19 pandemic crisis. It was also found out that occupational safety of health sector workers is at risk during this pandemic period. Based on the findings, the study recommends among other things that Government at all levels in Nigeria need to increase the percentage of resources for the health in their annual budget, there is need for sincerity of purpose on the part of government for better welfare packages in terms of wages and salaries and others fringe benefits for front health workers curtaining the spread of Covid-19 in the country.


Table of Content


  • Title Page
  • Certification
  • Dedication
  • Acknowledgement
  • Table of Content
  • List of Tables
  • Abstract

Chapter One:

Introduction

  • 1.1 Background of the Study
  • 1.2 Statement of the Problem
  • 1.3 Objective of the Study
  • 1.4 Research Questions
  • 1.5 Research Hypothesis
  • 1.6 Significance of the Study
  • 1.7 Scope of the Study
  • 1.8 Limitation of the Study
  • 1.9 Definition of Terms
  • 1.10 Organisations of the Study

Chapter Two:

Review of Literature

  • 2.1 Conceptual Framework
  • 2.2 Theoretical Framework
  • 2.3 Empirical Review

Chapter Three:

Research Methodology

  • 3.1 Research Design
  • 3.2 Population of the Study
  • 3.3 Sample Size Determination
  • 3.4 Sample Size Selection Technique and Procedure
  • 3.5 Research Instrument and Administration
  • 3.6 Method of Data Collection
  • 3.7 Method of Data Analysis
  • 3.8 Validity of the Study
  • 3.9 Reliability of the Study
  • 3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

  • 4.1 Data Presentation
  • 4.2 Analysis of Data
  • 4.3 Answering Research Questions
  • 4.4 Test of Hypotheses
  • 4.5 Discussion of Findings

Chapter Five:

Summary, Conclusion and Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendation
  • References
  • APPENDIX
  • QUESTIONNAIRE

Chapter One


Introduction

1.1 Background to the Study

The Nigerian health sector is currently facing significant challenges which include, among others an uncompleted agenda on the containment of infectious disease, as well as the rapid and on-ongoing emergence of non-communicable diseases. Life expectancy at birth in Nigeria stands at 46.8years for men and 48.4years for women, while there is a dire shortage of health workers as a result of economic and social brain drain(Faisal, Jamil, &Alauddin, 2017). It has been estimated that there are only 27 physicians per 100,000 people in Nigeria.7 These multifaceted challenges are compounded by arisen economic policies and socio-political factors in the country history a limited institutional capacity to provide efficient responses at a population level. Lack of commitment on the part of the government, especially during military rule has worsened the fragile sector(Faisal, Jamil, &Alauddin, 2017). According to the UNDP report 2004 both public and private expenditure as a percentage of GDP is 0.8% and 2.6% respectively. Successive governments have on many occasions set out their commitment to this sector, but unfortunately, this rhetoric is not met with tangible and enduring actions, particularly in the area of health system financing. There is a window of opportunity available for initiatives aimed at enhancing the emergence of an integrative approach to public health problems in Nigeria, taking into account the social, cultural and economic determinants of health and also structuring the health system as an efficient channel for health services delivery.
Due to multiple drug resistances, migration of populations, and emerging pathogens infectious diseases represent a continuous and increasing threat to human health and welfare. Despite the availability of antibiotics and vaccines against many of the causative pathogens, the mortality rates remain high. According to estimations of the WHO, infectious diseases caused 14.7 million deaths each in 2001, accounting for 26% of the total global mortality (http://www.who.int). AIDS, tuberculosis, and malaria furthermore range among the five major obstacles to increased life expectancies (Ayara, 2011).

Infectious diseases are not only a problem of certain areas in the world, although developing countries are carrying the major part of the burden. As indicated by the appearance and dissemination of the human immunodeficiency virus and the outbreak of the severe acute respiratory syndrome (SARS) (David & Emmanuel, 2020), infectious diseases concern the whole world and can only be solved by internationally coordinated and interdisciplinary approaches. In order to enable and facilitate the long-term control of infectious diseases, molecular biologists, biochemists and pharmacologists have to collaborate closely with physicians, epidemiologists and public health researchers in order to insure the transfer and application of scientific data to the field. In parallel, governmental institutions have to collaborate with private funding partners and industrial partners without losing influence on the research agenda. Control of infections can only be successful if priority is given to combating the individual suffering and its structural and socioeconomic causes rather than to serving political or economic interests (Dunlop, Howe, Li ,& Allen, 2020).

The Nigerian health sector is currently facing significant challenges which include, among others an uncompleted agenda on the containment of infectious disease, as well as the rapid and on-ongoing emergence of non-communicable diseases. Life expectancy at birth in Nigeria stands at 46.8years for men and 48.4years for women, while there is a dire shortage of health workers as a result of economic and social brain drain.7 It has been estimated that there are only 27 physicians per 100,000 people in Nigeria.7 These multifaceted challenges are compounded by arisen economic policies and socio-political factors in the country history a limited institutional capacity to provide efficient responses at a population level. Lack of commitment on the part of the government, especially during military rule has worsened the fragile sector.8 According to the UNDP report 2004 both public and private expenditure as a percentage of GDP is 0.8% and 2.6% respectively.8 Successive governments have on many occasions set out their commitment to this sector, but unfortunately, this rhetoric is not met with tangible and enduring actions, particularly in the area of health system financing. There is a window of opportunity available for initiatives aimed at enhancing the emergence of an integrative approach to public health problems in Nigeria, taking into account the social, cultural and economic determinants of health and also structuring the health system as an efficient channel for health services delivery.


1.2 Statement of the Research Problem

The inadequate programs designed to address the numerous health problems in Nigeria have led to the little improvement in our health status. Overall life expectancy at birth is 54 years; infant mortality rate is 86 per 1000 live birth while maternal mortality ratio is 840 per 100,000 live births.4 Besides the continued neglect of the importance of addressing public health issues would make matters worse for poor Nigerians most of who are at the receiving end. Nigerians will continue to die unnecessarily from preventable conditions and disease if there are no proper programs designed to address each of these problems. The first WHO Global Status Report on non-communicable disease listed Nigeria and other developing countries as the worst hit with deaths from non-communicable diseases(Etyang). These diseases with a rising burden in Nigeria include cardiovascular disease, cancer, diabetes, chronic respiratory diseases, sickle cell disease, asthma, coronary heart disease, obesity, stroke, hypertension, road traffic injuries and mental disorders. According to the 2011 World Health Statistics, malaria mortality rate for Nigeria is 146 per 100,000 population (Etyang, 2020). Nigeria has one of the highest Tuberculosis burden in the world (311 per 100,000) resulting in the largest burden in Africa.The proper design of programs to address the public health problems in Nigeria will no doubt go a long way in improving the health status of the people. Though there are programs designed to address some of the health issues, there is a need to solve many other health problems.(Etyang, 2020).


1.3 Research Objective

The main objective of this study is to investigate disease surveillance and it’s role in public health. Specific objectives include:

  1. To identify the challenges facing health sector in Nigeria during Covid-19 pandemic period.
  2. To identify the challenges facing health sector workers in managing Covid-19 pandemic crisis in Nigeria.
  3. To examine the impact of Covid-19 pandemic crisis on the occupational safety of health sector workers in Nigeria.

1.4 Research Questions

  1. What are the challenges facing health sector in Nigeria during Covid-19 pandemic period?
  2. What are the challenges facing health sector workers in managing Covid-19 pandemic crisis in Nigeria?
  3. What are the impacts of Covid-19 pandemic crisis on the occupational safety of health sector workers in Nigeria?

1.5 Significance of the Study

This study is important to students and scholars in the field of medical sciences. The study is also important to the general public. The findings of this study will help the general public associated with the risk of infectious diseases. The recommendations of this study will provide a guide as to how infectious diseases can be controlled and prevented. This study is also very important to stakeholders in the health sector and the Nigerian government.


1.6 Scope of the Study

This study was conducted in three (3) local government areas in Ogun State, Nigeria. The three local government areas are Ado-Odo Ota, Ikenne and ImekoAfon local government areas of Ogun State. They were selected ahead of the other local governments because they are the epicenter of the pandemic in the state. In terms of contents coverage, the challenges facing health sector and workers during Covid-19 pandemic period and the impacts of Covid19 pandemic crisis on the occupational safety of health sector workers were examined.


1.7 Limitation of the Study

This study was constrained by some factors. Firstly, the time frame allocated for the completion of this study was not enough for the researcher to extensively carry out research based on the theme of this research work. On the other hand, the research participants were not willing to participate in responding to the administered questionnaire of this study. Also, the required materials like journals and articles needed for the proper completion of this study were not readily available online and offline. All these constraint put together, ultimately determined the extent to which the researcher was able to go in this study.


1.8 Definition of Terms

Disease:

A particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury Diseases are often known to be medical conditions that are associated with specific signs and symptoms. A disease may be caused by external factors such as pathogens or by internal dysfunctions. For example, internal dysfunctions of the immune system can produce a variety of different diseases, including various forms of immunodeficiency, hypersensitivity, allergies and autoimmune disorders.

In humans, disease is often used more broadly to refer to any condition that causes pain, dysfunction, distress, social problems, or death to the person affected, or similar problems for those in contact with the person. In this broader sense, it sometimes includes injuries, disabilities, disorders, syndromes, infections, isolated symptoms, deviant behaviors, and atypical variations of structure and function, while in other contexts and for other purposes these may be considered distinguishable categories. Diseases can affect people not only physically, but also mentally, as contracting and living with a disease can alter the affected person’s perspective on life.

Infectious Diseases:

Also known as infectiology, is a medical specialty dealing with the diagnosis and treatment of infections. An infectious diseases specialist’s practice consists of managing nosocomial (healthcare-acquired) infections or community-acquired infections and is historically associated with hygiene, epidemiology, clinical microbiology, travel medicine and tropical medicine.

Pandemic:

An epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of individuals. A widespread endemic disease with a stable number of infected individuals is not a pandemic. Widespread endemic diseases with a stable number of infected individuals such as recurrences of seasonal influenza are generally excluded as they occur simultaneously in large regions of the globe rather than being spread worldwide.

Throughout human history, there have been a number of pandemics of diseases such as smallpox. The most fatal pandemic in recorded history was the Black Death—also known as The Plague—which killed an estimated 75–200 million people in the 14th century. The term had not been used then but was used for later epidemics, including the 1918 influenza pandemic—more commonly known as the Spanish flu.
Current pandemics include HIV/AIDS and COVID-19.

Public Health:

“the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals”. Analyzing the determinants of health of a population and the threats it faces is the basis for public health.[3] The public can be as small as a handful of people or as large as a village or an entire city; in the case of a pandemic it may encompass several continents. The concept of health takes into account physical, psychological, and social well-being.

Public health is an interdisciplinary field. For example, epidemiology, biostatistics, social sciences and management of health services are all relevant. Other important sub-fields include environmental health, community health, behavioral health, health economics, public policy, mental health, health education, health politics, occupational safety, disability, oral health, gender issues in health, and sexual and reproductive health. Public health, together with primary care, secondary care, and tertiary care, is part of a country’s overall health care system. Public health is implemented through the surveillance of cases and health indicators, and through the promotion of healthy behaviors. Common public health initiatives include promotion of hand-washing and breastfeeding, delivery of vaccinations, promoting ventilation and improved air quality both indoors and outdoors, suicide prevention, smoking cessation, obesity education, increasing healthcare accessibility and distribution of condoms to control the spread of sexually transmitted diseases.

COVID-19:

a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was identified in Wuhan, China, in December 2019.[7] The disease quickly spread worldwide, resulting in the COVID-19 pandemic.

The symptoms of COVID 19 are variable but often include fever,[8] cough, headache,[9] fatigue, breathing difficulties, loss of smell, and loss of taste. Symptoms may begin one to fourteen days after exposure to the virus. At least a third of people who are infected do not develop noticeable symptoms. Of those who develop symptoms noticeable enough to be classified as patients, most (81%) develop mild to moderate symptoms (up to mild pneumonia), while 14% develop severe symptoms (dyspnea, hypoxia, or more than 50% lung involvement on imaging), and 5% develop critical symptoms (respiratory failure, shock, or multiorgan dysfunction). Older people are at a higher risk of developing severe symptoms. Some people continue to experience a range of effects (long COVID) for months after recovery, and damage to organs has been observed Multi-year studies are underway to further investigate the long-term effects of the disease.

COVID 19 transmits when people breathe air contaminated by droplets and small airborne particles containing the virus. The risk of breathing these is highest when people are in close proximity, but they can be inhaled over longer distances, particularly indoors. Transmission can also occur if contaminated fluids are splashed or sprayed in the eyes, nose, or mouth, or, more rarely, via contaminated surfaces. People remain contagious for up to 20 days and can spread the virus even if they do not develop symptoms.[16][17]

Testing methods for COVID-19 to detect the virus’s nucleic acid include real-time reverse transcription polymerase chain reaction (rRT PCR), transcription-mediated amplification, and reverse transcription loop-mediated isothermal amplification (RT LAMP) from a nasopharyngeal swab.

Pharmacist:

Also known as a chemist (Commonwealth English) or a druggist (North American and, archaically, Commonwealth English), is a healthcare professional who deals with the preparation, properties, effects, use and distribution of medications. The pharmacist provides pharmaceutical advices to the community and primary health services, with the aim of preventing and promoting Public Health. They also serve as primary care providers in the community. Pharmacists undergo university or graduate-level education to understand the biochemical mechanisms and actions of drugs, drug uses, therapeutic roles, side effects, potential drug interactions, and monitoring parameters. This is mated to anatomy, physiology, and pathophysiology. Pharmacists interpret and communicate this specialized knowledge to patients, physicians, and other health care providers.

Among other licensing requirements, different countries require pharmacists to hold either a Bachelor of Pharmacy, Master of Pharmacy, or Doctor of Pharmacy degree.

The most common pharmacist positions are that of a community pharmacist (also referred to as a retail pharmacist, first-line pharmacist or dispensing chemist), or a hospital pharmacist, where they instruct and counsel on the proper use and adverse effects of medically prescribed drugs and medicines.[3][4] In most countries, the profession is subject to professional regulation. Depending on the legal scope of practice, pharmacists may contribute to prescribing (also referred to as “pharmacist prescriber”) and administering certain medications (e.g., immunizations) in some jurisdictions. Pharmacists may also practice in a variety of other settings, including industry, wholesaling, research, academia, formulary management, military, and government.


1.9 Organization of the Study

This research work is categorized in five chapters, for easy understanding, as follows.

  1. Chapter one is concern with the introduction, which consist of the (overview, of the study), background to the study, statement of problem, objectives of the study, research questions, significance of the study, scope and limitation of the study, definition of terms.
  2. Chapter two encompasses the conceptual review theoretical review and empirical reviews on which the study is based.
  3. Chapter three deals on the research design and methodology adopted in the study.
  4. Chapter four concentrate on the data collection and analysis and presentation of finding.
  5. Chapter five gives summary, conclusion, and recommendations made of the study.

Chapter Five


Summary, Conclusion and Recommendations

5.1 Summary of Findings

The results showed that the health sector in Nigeria had a number of obstacles during the Covid-19 pandemic, including poor health infrastructure, insufficient financial investment, a lack of appropriate health employees, minimal pay for health workers, and weak leadership and administration. The findings also showed that one of the difficulties faced by workers in the health sector in managing the Covid-19 pandemic crisis in Nigeria was a lack of personal protective equipment (PPE), as well as a lack of personnel, inadequate laboratory equipment, and a reduction in supply chain drugs. They also showed that occupational safety of health sector workers is at risk during the Covid-19 pandemic crisis. These results concur with Whenayon, Odusanya, and Joshi’s (2020) investigation of the covid-19 outbreak scenario in Nigeria and the necessity of competent community health workers’ involvement in epidemic interventions. Their research may have shown signs of continuing and expanding community transmission of COVID-19 infections, as well as insufficient diagnostic capacity and a shortage of medical resources.

In light of the significant skilled manpower shortage in the health sector, they also revealed the infection of several healthcare professionals. According to Faisal, Jamil, and Alauddin (2017), Nigeria faces a number of serious public health issues, including infectious diseases, the management of certain vector-borne illnesses, maternal and infant mortality, poor sanitation and hygiene, disease surveillance, noncommunicable diseases, road traffic injuries, etc. Omoleke and Taleat (2017) investigated the current problems and difficulties facing the Nigerian health industry. According to the results of their research, hospitals in Nigeria are now dealing with a variety of social, economic, and environmental issues. These issues include brain drain, low pay, outdated infrastructure, insufficient medical facilities, and underfunding of hospitals.


5.2 Conclusion

Emerging and neglected infectious diseases are a real public health threat, and infectious disease outbreaks can have serious social, political, and economic effects. Much have been learned from previous outbreak events and far-reaching advances have been made since the landmark IOM report, which underscored the important concept of emerging infectious diseases. Pandemic preparedness however remains a major global challenge. A complex number of factors relating to human behaviour and activities, pathogen evolution, poverty, and changes in the environment as well as dynamic human interactions with animals have been found to contribute to infectious disease emergence and transmission. Aggressive research is warranted to unravel important characteristics of pathogens necessary for diagnostics, therapeutics, and vaccine development and possibly enable detection of those pathogens with the potential to cause epidemic. National and international organizations networking, effective interagency and international research collaborations, appropriate financial support of the public health infrastructure, and poverty reduction are very vital for addressing emerging and neglected infectious disease threats.

Before the outbreak of Covid-19 pandemic crisis in the world, Nigeria health sector has been facing series of challenges and this pandemic further showed the weakness of the sector. On that note, the following conclusions were drawn based on the findings of the study that poor health infrastructure, insufficient financial investment, inadequate sufficient health personnel, meager remuneration for health workers, poor leadership and management, shortage of personal protective equipment (PPE), inadequate personnel, under-equipped of laboratory and reduction in supply chain drugs were among the challenges facing health sector and its workforces in managing Covid-19 pandemic crisis in Nigeria and that, occupational safety of health sector workers is at risk during this pandemic period.


5.3 Recommendation

Based on these findings, the following recommendations were provided:

  1. There is need for provision of infection prevention and control practices, especially in healthcare facilities across all states in Nigeria.
  2. Government at all levels in Nigeria need to increase the percentage of resources for the health in their annual budget.
  3. There is need for sincerity of purpose on the part of government for better welfare packages in terms of wages and salaries and others fringe benefits for front health workers curtaining the spread of Covid-19 in the country.
  4. There is need for adequate provision of personal protective equipment (PPE) for front health workers curtaining the spread of Covid-19 in the country.
  5. Government need to employ more personnel in terms of medical doctors, laboratory scientists, pharmacists and nurses into our health sector to solve the challenges of inadequate manpower.

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Frequently Asked Questions


What is an example of public health surveillance?

Public health surveillance provides and interprets data to facilitate the prevention and control of disease. For example, the objective of surveillance for tuberculosis might be to identify persons with active disease to ensure that their disease is adequately treated.

What is surveillance data in public health?

Public health surveillance is the ongoing collection, analysis and dissemination of health related data to provide information that can be used to monitor and improve the health of populations. Such surveillance systems can be established in many settings to study a variety of populations and conditions.

What is the purpose of disease surveillance?

Disease surveillance is the process of monitoring the spread of certain diseases in order to establish their progression and minimize the risks of an outbreak occurrence. Aside from predicting the harm caused by an outbreak, disease surveillance also hopes to increase information about possible factors that may contribute to diseases. 

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