GAPS IN THE UNDERSTANDING OFDISEASE EARLY WARNING SYSTEM BY HEALTH CARE WORKERS IN DISTRICT SWAT, KHYBER PAKHTUNKHWA, PAKISTAN

Objective: To identify deficiencies in the Knowledge and practices of Health Care Workers working at First Level
health Care Facilities.
Methods: It was a cross-sectional study conducted on sixty nine Health Care Workers trained on Disease Early
Warning System, from twenty nine randomly selected Basic Health Units and Civil Dispensaries in District Swat in the
Khyber Pakhtunkhwa province, Pakistan. A structured interviewer administered questionnaire was used. Data analysis
was done through SPSS version 16.Frequencies and Percentages were obtained for categorical variables and 95%
Confidence Intervals were calculated.
Results: 95.7 % of the respondents (95% CI: 91-100) could correctly identify diseases under Disease Early Warning
System’s surveillance. Only a 47.8% of respondents (95% CI: 36-60) could correctly identify single case alert
diseases in non endemic areas.89.9% (95% CI: 83-97) observed immediate alert reporting. Only 20.3% (95% CI: 11-
30) observed recording DEWS data simultaneously at the time of consultation. Training was the source of information
on DEWS for 94.2% of respondents (95% CI: 87-100).Only 15.9% (95% CI: 7-25) had attended refresher trainings.13.1%
(95% CI: 5-21) had communication problems while reporting data to DEWS cell.
Conclusion: Lack of refresher trainings, lack of interest in literature on Diseases Early Warning System, inability to
identify single-case alert diseases and inability to plot a graph on weekly watch chart were some of the notable gaps
in the understanding of DEWS by Health Care Workers. Determination, co-ordination, supportive supervision,
frequent refreshers and on job trainings could further strengthen the system at District level.
Keywords: WHO, Surveillance, Infectious Diseases, Disaster, Epidemic