Toward Integration of STD, HIV, TB, and Viral Hepatitis Surveillance

Abstract

Public health surveillance is "the ongoing systematic collection, analysis, and interpretation of outcome-specific data for use in the planning, implementation , and evaluation of public health practice." 1 While the fundamental activities of surveillance include data collection, analysis, and dissemination, the value of surveillance is measured through its impact on public health practice. The integration of surveillance data on sexually transmitted diseases (STDs), human immunodeficiency virus (HIV), tuberculosis (TB), and viral hepatitis is important insofar as an understanding of the intersection of these diseases geographically, in different populations, and by risk behaviors impacts the ability of public health programs to operate more efficiently and effectively. As Jennings et al. 2 recommend in this special supplement of Public Health Reports, surveillance systems should be patient-based rather than case-based because program services themselves are most effective when they are patient-based. As many of the articles in this supplement illustrate, it is at the local and state levels where duplication and inefficiencies are felt most. These inefficiencies are felt by the patients who do not get the care they need in a timely fashion or who get fragmented care, by the programs that are being asked to accomplish more with diminished resources, and by the public, who are often provided fragmented rather than comprehensive summaries of problems of importance to their communities. This special supplement highlights approaches to the integrated use of data by STD epidemiologists in the Outcome Assessment through Systems of Integrated Surveillance (OASIS) workgroup. OASIS was originally funded in 1998 by the Centers for Disease Control and Prevention's (CDC's) National Center for HIV, STD, and TB Prevention (the name was changed to the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention [NCHHSTP] in 2007) to promote the integrated interpretation and use of surveillance data across disease programs. The work of OASIS, only partially reflected in this supplement, demonstrates that state and local health departments, which have the most to gain from program integration, truly are the laboratories