Journal Information
Journal ID (publisher-id): OJPHI
ISSN: 1947-2579
Publisher: University of Illinois at Chicago Library
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©2013 the author(s)
open-access: This is an Open Access article. Authors own copyright of their articles appearing in the Online Journal of Public Health Informatics. Readers may copy articles without permission of the copyright owner(s), as long as the author and OJPHI are acknowledged in the copy and the copy is used for educational, not-for-profit purposes.
Electronic publication date: Day: 4 Month: 4 Year: 2013
collection publication date: Year: 2013
Volume: 5E-location ID: e87
Publisher Id: ojphi-05-87

The Organizational Structures and Human Resources Allocation of Infectious Disease Surveillance System in Rural China
Biao Xu*1
Qi Zhao1
Huijian Cheng2
Tao Tao1
Yipin Zhu1
Miao Yu1
Hui Yuan2
1School of Public Health, Fudan University, Shanghai, China;
2Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, China
*Biao Xu, E-mail:


To understand the structure and capacity of current infection disease surveillance system, and to provide baseline information for developing syndromic surveillance system in rural China.


To meet the long-term needs of public health and social development of China, it is in urgency to establish a comprehensive response system and crisis management mechanism for public health emergencies. Syndromic surveillance system has great advantages in promoting early detection of epidemics and reducing the burden of disease outbreak confirmation (1). The effective method to set up the syndromic surveillance system is to modify existing case report system, improve the organizational structures and integrate new function with the traditional system.


Since August 2011, an integrated syndromic surveillance project (ISSC) has been implemented in China. Before the launching of the project, a cross-sectional study was carried out in Fengxin County and Yongxiu County of Jiangxi province during October 11 to 18, 2010. Institution information were investigated in the county hospital, township hospital and County Center for Disease Control and Prevention (CDC) to understand the performance of existing case report system for notifiable infectious diseases with regard to its structure, capacity and data collection procedure. Health care workers from each township hospital and village health station were questionnaire interviewed for information on qualification of human resources, basic healthcare delivery condition, hardware and software needs for ISSC.


An internet-based real-time (quasi real-time) case report system for notifiable infectious diseases, based on the three-tier public health service System, had been established in these two counties since 2004. The farthest end of net user in case report system was township hospital. Blood routine test, urine routine test, B ultrasound and electrocardiogram were available in all township hospitals. There was no laboratory equipment in village health stations in these two counties. All the township hospitals in these two counties were equipped with land-line telephones and desktop computers. The internet covers all township hospitals in both counties. Most clinical doctors in township hospital(TH) and village health station(VHS) were male. The age of doctors ranged from 21 to 72 years old, with the average at 42 and median at 40 years. The village health workers were significantly older, less educated and served in health care longer than the township hospital doctors. In Yongxiu County, 95.6% of the village health stations were equipped with computers, including private-owned computers, and 80.7% of them had access to the internet; while in Fengxin County, 66.5% of the village health stations possessed computers, among which most were private property of village doctors, and only 44.2% of them had access to the internet.


The current case report system, with full coverage and stable human resource, has established a solid basis for developing syndromic surveillance system in rural China. The syndromic surveillance system could play its role in early detection of infectious disease outbreaks in rural area where laboratory service for infectious disease diagnosis are not available. However, the lack of computerized patient registration in village and township health care facilities and incomplete internet coverage in rural area and relatively low quality of human resource in village level should be taken into consideration seriously before establishing the syndromic surveillance system in rural China.


This study was funded by [European Union’s] [European Atomic Energy Community’s] Seventh Framework Programme ([FP7/2007–2013] [FP7/2007–2011]) under grant agreement no. [241900].

1.. Heffernan R, Mostashari F, Das D, et al. Syndromic Surveillance in Public Health Practice, New York CityEmerging Infectious Diseases 2004;10(5):858–864.

[Figure ID: f1-ojphi-05-87]
Figure 1 

Flowchart of case report system for notifiable infectious disease in different level of health facilities in Fengxin and Yongxiu County

Article Categories:
  • ISDS 2012 Conference Abstracts

Keywords: Syndromic surveillance, rural area, human resources, case report system.