6.4.1. Data (and information) reporting

Updated 1 October 2025
Syndromic Reporting

Syndromes are to be reported based on the date the patient presents to the health facility. Total numbers of cases of the syndromes listed in the “Weekly data collection” section of Appendix 1. A template for a weekly reporting form that is used in-country is given in Appendix 1.2.

Case definitions for the syndromes under regional surveillance are contained in Appendix 4. Guidelines on etiologies associated with syndromes and appropriate sample collection are contained in Appendices 5 and 6.

Syndromic surveillance should be conducted in major public health facilities so that emerging public health threats can be detected early; however it need not be island wide. For example, a country may conduct syndromic surveillance in all or selected public health centers and accident and emergency departments of public hospitals, but only a few sentinel private practitioners. Once completeness of reporting is known, trends can be monitored over time, although rates may be difficult to determine.

 

Hospital Ward Notifications

There is an established mechanism for the routine monitoring of persons admitted into a hospital (participating in the surveillance system) with one of the syndromes under regional surveillance. This mechanism must include the notification of cases based on the date of onset of illness to the epidemiologist Epi Unit).  The sample Case Notification form contained in Appendix 7 may be used to collect and transmit this information. The need for an epidemiological Case Investigation will be determined by the National Epidemiologist.

 

Four-weekly reporting of specific diseases

 

Confirmed cases are to be reported based on the date of onset of illness. Age and sex specific data on confirmed cases of diseases listed in the “Four-weekly data collection” section of Appendix 1

 

Laboratory surveillance

 

The laboratory has a critical role in public health surveillance and disease control. In the revised communicable disease surveillance system, the primary role of the public health laboratory remains confirmation of etiology. However, the laboratory has a key role in assisting with outbreak detection and confirmation, especially when the same serotype/subtype is detected from several sources or places in the absence of clinical or epidemiological information to suggest that there is an outbreak. Also, sometimes laboratory surveillance data can be used to predict an epidemic, e.g. if a change in dengue serotype is detected, after many years of another type(s), it would be predicted that an outbreak may be imminent. The laboratory also has a crucial role in anti- microbial resistance surveillance, which is almost entirely laboratory-dependent; in enhanced surveillance and research studies; and in confirming elimination or eradication, as with measles, polio, etc.

On a weekly basis, in-country laboratories shall make available to the office of the National Epidemiologist results for all specimens that test positive for communicable diseases. Individual, case-based data (Laboratory case Notification form) must be reported, with at least the parameters described in the laboratory surveillance minimum dataset (Appendix 13). Also, any unusual findings with respect to test yield or antimicrobial resistance patterns are to be immediately reported to the office of the National Epidemiologist.

Data shall be transmitted from the reference or public health laboratories to the office of the National Epidemiologist via facsimiles or mail.

The office of the National Epidemiologist shall report individual, case-based data on all samples testing positive for communicable diseases except STIs to CAREC on a weekly basis. Data shall be transmitted by 12 noon on Wednesday of the following epidemiological week (e.g. data for week 10 is to be transmitted to CAREC by noon on Wednesday of week 11). This data shall be maintained in CAREC’s laboratory information system (LABIS). Data shall be transmitted to CAREC via one of the following mechanisms:

  • A hard copy of an Excel spreadsheet (template available from CAREC)
  • An electronic copy and Excel spreadsheet (template available from CAREC)
  • A hard or electronic report generated by a laboratory information or surveillance system

For some countries, the CAREC laboratory functions as an extension of in-country national laboratories, especially in virology. As such, the maintenance of one database at CAREC (LABIS), with CAREC as well as in-country laboratory data, will facilitate harmonization of test results and minimize duplication in analyses at the regional level.

In addition to the minimum dataset that the laboratory shall routinely transmit to the office of the National Epidemiologist, the laboratory shall also routinely monitor:

  • The proportion of ‘positive tests of all tests conducted’ for a specific pathogen
  • The results of antimicrobial susceptibility tests
  • Quality assurance pre and post analytic indicators as outlined in the CAREC Quality Assurance Training Manual and Module 4 of Managing Laboratories to Assure Quality – “A How to Guide”: Operational Systems.

All samples referred to CAREC shall be accompanied by the laboratory investigation form in Appendix 14. This form is also used for in-country communicable disease laboratory requisitions and reports. The minimum data for inclusion on specimen labels are:

  • Patient identifier (name or alphanumeric code)
  • Date of specimen collection
  • Specimen type
  • Patient date of birth

Guidelines on the referral of specimens to CAREC can be found in the CAREC Laboratory User Manual. Samples should be routinely taken and tested during endemic periods. However, during epidemics, once etiology has been established, only a systematic selection of samples should be taken and tested. Guidelines on sample testing during epidemic and endemic periods can be found in the CAREC ‘Guidelines for the Collection of Clinical Specimens’ in Appendix 6 and ‘Clinical and laboratory guidelines for dengue fever and dengue hemorrhagic fever/dengue shock syndrome’.

 

Outbreak reports

The office of the National Epidemiologist shall provide an ‘alert’ (early notification) of an outbreak. All unusual disease situations must be looked into, and every identified outbreak must be investigated by the appropriate authorities.

The following table also contains details pertaining to section 2.2.8. on information dissemination.