|Cerebrospinal Meningitis Epidemics and Surveillance Systems in the Sudan, Ethiopia and Chad (Centre for Research on the Epidemiology of Disasters, 1990, 40 p.)|
|II. COUNTRY REPORTS|
|C. Republic of Chad|
|2. Referral and Epidemiological Surveillance Systems|
The system is highly centralised and like the other parts of the health system is also under modification.
- The Bureau de Statistiques, Planification et Etudes (BSPE).
This department is under the direct authority of the General Director of Health (cfr. Organigram). It has three different main objectives.
Statistics: to coordinate all the MOH activities through data collection system.
Planing: to organise the division of the country into health districts
Etudes: Development and evaluation of projects. There is no epidemiologist in the department.
- Division of Epidemiology
Formerly, Service des Grandes Endes, this division is one of the Direction of the Preventive Medicine and Rural Health Division (DMPSR). If an alarming message gets to the BSPE, the division of epidemiology is informed.
In the restructuring proposal of the MOH, this division would disappear.
Centralised in the BSPE, the system, implemented in 1988 is quite effective in collecting information, but it is not a system for early detection.
The notifiable diseases are reported monthly. The data are first compiled by the Chef the Prefecture, and then sent to the BSPE. The data are not analysed.
- Delays and Regularity:
Theoretically, it takes 30 days for a monthly report to get from the peripheral level (e.g. formation de base) to the BSPE. The BSPE receives approximately 90% of the reports. The monthly reports are mailed to the prefectures and from there to the BSPE.
- Compilation and use of the information:
The data are first compiled in the chef de Prefecture and then sent in the BSPE. The BSPE, centralises all the information, computes the data, and produces regional and national annual reports. There is no systematic feed-back information. Information is sent back only upon request.
- Type of information:
The type of information depends on the disease
- on cases:
N° of cases per age group per month
no information on sex distribution
- on deaths:
only N° of deaths in hospital per specialty
- N° of vaccination performed
- no information on stocks
- Communication with other countries:
There is not any systematic information sharing with neighbouring countries.
- Rapid information System: The weekly telegramme
This system which is still only a project has been implemented temporarily on a trial basis only.
The information covered in the message concerns cholera, meningitis, measles cases and deaths and unusual mortality.
The age, but not the sex, is reported. From the peripheral level to the Chef de Prcture, the information is brought either by mail or by messenger. The nine subsahelian Chef de Prctures (FED project) have radio communication with N'Djamena. In the rest of the country, the MOH has no other communication than the mail.