A COMMUNITY PEDIATRIC INFORMATION-SYSTEM - A TOOL FOR MEASLES SURVEILLANCE IN A FRAGMENTED HEALTH WARD

A community paediatric geographical information system using hospital-based inpatient data was created to monitor longitudinal child health trends, to define paediatric priorities and to generate research ideas and interventions in a large and very fragmented health ward. This epidemiological tool has been used to describe measles admission trends over a 4-year period (1987-1990), which included a severe measles epidemic. The examination of these trends in progressively finer geographical categories has identified a number of areas with a particularly high incidence of measles and has provided useful guidelines for subsequent community-based research. The demonstration of low vaccination coverage in areas designated as high incidence areas by this system suggests that these trends are accurate and that they can reliably be used for routine measles surveillance. The use of this system for measles surveillance on a prospective basis is expected to enable workers in this area to identify any increase in measles incidence rapidly, to pinpoint where this increase is occurring, and to make it possible to respond in a more focused manner to outbreaks when they occur.