Global Alert and Response (GAR)

Early warning system in Darfur region, Sudan

In April and May 2004, WHO, in collaboration with other United Nations agencies, nongovernmental organizations, Federal Ministry of Health and State Ministries of Health developed an early warning system to detect, respond to and control outbreaks in camps and host communities for displaced people in North, South and West Darfur states. The total internal displaced population is almost 1 300 000, with only c.20% of the people having access to primary health care facilities.

To achieve this objective, priority health events, those health events considered to be major threats to the population of two age groups, 0-4 and 5 or more years of age, have been identified.

In addition to severe malnutrition and injuries, surveillance data is being collected for the following communicable diseases: acute watery diarrhoea, bloody diarrhoea, acute flaccid paralysis, acute respiratory infections, neonatal tetanus, malaria, suspected measles, suspected meningitis, acute jaundice syndrome and acute unknown fever. A threshold for each health event is defined whereby an unusual pattern or occurrence will trigger prompt investigations and responses.

Standardized data entry, analysis and reports have been tested in a computerized system. Using this system, cases and deaths for each of the health events are entered weekly from each camp, sent to the state health authorities and then to the Federal Ministry of Health.

Training in the computerized system is underway for health care staff and for epidemiologists at state and federal level.

Additional needs for an effective early warning system have also been identified, including strengthening diagnostic capacity and equipment at state laboratories, transporting specimens from the camps to laboratories, and preparing stocks of drugs and other supplies in readiness for a major outbreak.

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