Sumera Aziz Ali, Shama Razzaq and Adeel Ahmed Khan
Pakistan is at high risk of epidemics because of overcrowded cities, unsafe drinking water, inadequate sanitation, poor socioeconomic conditions, low health awareness and inadequate vaccination coverage. The diarrheal diseases contribute to the major disease burden under five along with pneumonia in Pakistan. Unlike vaccine preventable diseases like Polio, measles and maternal & neonatal tetanus, Pakistan does not have any formal responsive surveillance system to monitor the burden of diarrheal diseases and to respond to the outbreaks. Previously, the technical assistance used to be provided by Disease Early Warning System (DEWS WHO) to the outbreaks. Unfortunately, this system is no more functional in Pakistan and WHO had built the technical capacity of the Government staff and had advised health department to carry out their own efforts to monitor the trends of the various diseases including Diarrhea. Thus the objective of this short communication was to identify the gaps in the existing system and to propose a Surveillance mechanism for diarrheal diseases. We conducted in-depth interviews from Government authorities as well as DEWS officials to understand the surveillance system of various diseases especially for diarrheal diseases placed in Pakistan. We met with Surveillance officer and DEWS officials, headed by provincial coordinator at Directorate Health Service Office, Karachi. These officials informed us about the reporting tools and monitoring system at different levels. After having detailed discussions, we were able to identify certain gaps and loop holes in the currently existing surveillance system and based on that we adopted WHO guidelines to propose surveillance system of diarrheal diseases.
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