Kyasanur Forest Disease, is our surveillance system healthy to prevent a larger outbreak? A mixed-method study, Shivamogga, Karnataka, India: 2019

Abstract

Background: Kyasanur Forest disease (KFD) is a tick-borne zoonosis that is endemic in Karnataka. Against the backdrop of the recent geographical expansion of KFD, indicating the inadequacy of policy and surveillance systems, the present study was performed to evaluate the KFD surveillance system in Shivamogga. Methods: US Centers for Disease Control and Prevention guidelines for surveillance system evaluation were followed. Nine attributes of the system towards its objectives were evaluated in a mixed study in Shivamogga. Results: Two of three medical officers and four of six health staff at the institutions visited were found to be untrained in KFD surveillance. Integrated disease surveillance formats did not capture KFD data. Surveillance (tick, monkey, human) was mostly driven by the Health Department. Some of the critical findings of the evaluations were the absence of an animal and entomological surveillance line list, non-standardized reporting formats for human suspects, varying delays in the time-to-test across laboratories (2-16 days), and a lack of systematic data-sharing practices. Significant issues that emerged in the interview were deforestation with a change in ecosystem dynamics, limited diagnostic capacity, non-availability of point-of-care tests, outdated surveillance guidelines, a confusing surveillance perimeter (5 km), non-existing co-ownership among stakeholders, limited vaccine production capacity, and inadequate operational research. Conclusions: The system should consider integrating a One Health approach with defined ownership of activities among stakeholders. Revision of the guidelines is mandatory.

Predicting Kyasanur forest disease in resource-limited settings using event-based surveillance and transfer learning

“…Furthermore, weekly updates on the status of outbreaks, such as disease progression and applied interventions, were sometimes missing. Our finding is consistent with another study in Karnataka that found similar reporting delays and data quality issues; That study concluded that the KFD surveillance conducted at the district and state level might not have fully integrated with the national IDSP portal system 56 . Moreover, KFD case reporting systems were not maintained by health authorities at the state or district level.…”

Sociodemographic factors associated with Kyasanur forest disease in India - a retrospective study

“…However, there is still a need to strengthen surveillance activities, implement unified data reporting protocols and tools in all states, and adopt transparent data sharing practices. This issue has also been raised by Bhat et al [30] who found that human case reporting measures are not standardized across local public health centers; there were delays in testing, lack of systematic data sharing practices, outdated surveillance guidelines, limited vaccine production capacity, inconsistent training and attitudes among surveyed personnel, and inadequate operational research.…”

“…We recommend that public health agencies standardize their reporting format for KFD for human cases, deaths, and monkey deaths systematically, which is maintained in the same format for all the KFD states [7 , [30] , [31] , [32] . Investing in open and transparent data reporting practices and effectively training staff and personnel in disease reduction and prevention measures is crucial.…”