Integrated Disease Surveillance Program
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Integrated Disease Surveillance Programme IDSP India 2024 2025
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Here is a complete, well-structured overview of the Integrated Disease Surveillance Programme (IDSP), drawing from Park's Textbook of Preventive and Social Medicine and the official NCDC/MoHFW data.
Integrated Disease Surveillance Programme (IDSP)
Background and Launch
IDSP is a decentralized, state-based disease surveillance system launched in November 2004 as a project with World Bank funding. It was initially a 5-year project (up to March 2010), was restructured and extended to March 2012, and then continued under the 12th Five Year Plan with domestic budget support as part of the National Health Mission (NHM) for all states and UTs.
- Park's Textbook of Preventive and Social Medicine, p. 539
Objectives
- Strengthen and maintain a decentralized, laboratory-based, IT-enabled disease surveillance system for epidemic-prone diseases.
- Monitor disease trends and detect outbreaks in the early rising phase.
- Respond to outbreaks promptly through trained Rapid Response Teams (RRTs).
- Provide essential data to monitor progress of ongoing disease control programmes.
- Help allocate health resources more efficiently.
- Establish a decentralized district-based system covering both communicable and non-communicable diseases.
Organizational Structure
The programme operates at three tiers:
| Level | Unit | Location |
|---|---|---|
| National | Central Surveillance Unit (CSU) | National Centre for Disease Control (NCDC), Delhi |
| State | State Surveillance Units (SSU) | All State/UT headquarters |
| District | District Surveillance Units (DSU) | All districts across the country |
An IT network connecting 776 sites in states/district headquarters and premier institutes was established with the help of the National Informatics Centre (NIC) and ISRO for data entry, training, video conferencing, and outbreak discussions.
Data Collection - Reporting Formats
Data on epidemic-prone diseases is collected weekly using three standard formats:
| Format | Type | Filled by |
|---|---|---|
| S Form | Syndromic (Suspected Cases) | Health Workers |
| P Form | Presumptive (Probable Cases) | Clinicians |
| L Form | Laboratory-Confirmed Cases | Laboratory Staff |
Reporting Units (RUs) - 2025 data:
- S Form (Syndromic): 1,84,895 RUs covered; 1,42,888 (77%) reported
- P Form (Presumptive): 43,180 RUs covered; 35,003 (81%) reported
- L Form (Lab-confirmed): 36,414 RUs covered; 29,949 (82%) reported
Data is collected from sub-centres, PHCs, CHCs, government and private hospitals, and medical colleges. More than 90% of districts report weekly data through the IDSP-IHIP portal.
Components of Surveillance Activity
- Collection of data
- Compilation of data
- Analysis and interpretation
- Follow-up action
- Feedback
Why Surveillance is Needed
The surveillance system is designed to:
- Recognize cases or clusters to initiate interventions
- Prevent transmission and reduce morbidity/mortality
- Assess the public health impact of health events
- Measure disease trends over time
- Demonstrate the need for public health intervention programmes
- Monitor effectiveness of prevention and control measures
- Identify high-risk groups or geographical areas for targeted interventions
- Develop hypotheses about risk factors for disease causation, propagation, and progression
Types of Integration in IDSP
(a) Sharing of surveillance information across disease control programmes
(b) Effective partnership with health and non-health sectors
(c) Including both NCDs and communicable diseases in the surveillance system
(d) Private sector and NGO partnership in surveillance activities
(e) Academic institutions and medical colleges brought into primary public health surveillance
Rapid Response Teams (RRTs)
Whenever there is a rising trend of illness in any area, it is investigated by RRTs - a multi-specialty team comprising:
- An Epidemiologist
- A Clinician
- A Microbiologist
- Other specialists as per requirement
On average, 40 outbreaks are reported to the CSU every week.
Laboratory Network
A two-pronged lab system:
- District Public Health Laboratories (DPHLs): Basic routine testing and outbreak investigation
- State Referral Laboratories (SRLs): Referral testing of outbreak-related samples
Metropolitan Surveillance Units (MSUs)
Under the Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), dedicated surveillance units have been set up in 20 major cities. Currently 17 MSUs are operational in cities including Mumbai, Ahmedabad, Bhubaneswar, Nagpur, Chennai, Bengaluru, Pune, Thane, Patna, Hyderabad, Gurugram, and others.
Key objectives of MSUs:
- Serve as Surveillance Hubs
- Facilitate planning and coordination for outbreak response
- Capacity building
IDSP to IHIP Upgrade
The programme evolved into the Integrated Health Information Platform (IHIP) - a next-generation digital surveillance platform that:
- Tracks 33 diseases (vs. 18 earlier)
- Provides near-real-time data in digital mode (replaced paper-based working)
- Has done away with manual/paper-mode reporting
Outbreak Data Trends (CSU Reports)
| Year | Outbreaks Reported |
|---|---|
| 2020 | 554 |
| 2021 | 728 |
| 2022 | 1,027 |
| 2023 | 1,862 |
| 2024 | 3,020 |
| 2025 | 2,285 |
The rising trend in reported outbreaks largely reflects improved surveillance sensitivity and reporting rather than a true increase in disease burden.
Key Information Collected Under IDSP
- Who gets the disease
- How many get the disease
- Where did they get the disease
- Why did they get the disease
- What needs to be done as a public health response
Sources:
S Form surveillance
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IDSP S Form syndromic surveillance format diseases list health workers
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Here is a thorough, exam-ready breakdown of S Form (Syndromic) Surveillance under IDSP.
S Form - Syndromic Surveillance under IDSP
What is the S Form?
The S (Syndromic/Suspect) Form is the first-line, community-level reporting format under IDSP. It captures data on suspected cases based on broad clinical syndromes - without requiring a definitive diagnosis. The information does not need laboratory confirmation; the health worker simply identifies the clinical syndrome.
- Filled by: Health Workers, ANMs (Auxiliary Nurse Midwives), volunteers, ASHA workers at Sub-Centres
- Frequency: Weekly submission to the PHC
- Purpose: Early warning signal detection for impending outbreaks
Role of Health Worker (Sub-Centre) in S Form Surveillance
As per IDSP guidelines (Park's, p. 539-540), the health worker's duties include:
- Surveillance for any abnormal increase in cases of:
- Diarrhoea / Dysentery
- Fever with rigors
- Fever with rash
- Fever with jaundice
- Fever with unconsciousness
- Immediate reporting of any cluster/outbreak based on syndromic surveillance
- High level of alertness for any unusual health event, and reporting with appropriate action
- Weekly submission of the 'S' Form report to the PHC as per IDSP guidelines (Essential duty)
Clinical Syndromes Under S Form Surveillance
The paramedical health staff undertake disease surveillance based on 6 broad clinical syndrome categories:
| # | Syndrome | Diseases It Picks Up |
|---|---|---|
| 1 | Fever < 7 days without any localizing signs | Malaria, Typhoid, Dengue, Measles, JE |
| 1b | Fever with rash | Measles, Dengue, Chickenpox |
| 1c | Fever with altered sensorium or convulsions | JE, Meningitis, Cerebral malaria |
| 1d | Fever with bleeding from skin or mucous membrane | Dengue haemorrhagic fever, VHFs |
| 1e | Fever > 7 days with or without localizing signs | Typhoid, Brucellosis |
| 2 | Cough > 3 weeks duration | Tuberculosis |
| 3 | Acute Flaccid Paralysis (AFP) | Polio |
| 4 | Diarrhoea | Cholera, Acute diarrhoeal disease |
| 5 | Jaundice | Hepatitis, Leptospirosis, Dengue, Malaria, Yellow fever |
| 6 | Unusual events causing death or hospitalization | Anthrax, Plague, Emerging/undiagnosed conditions |
- Park's Textbook of Preventive and Social Medicine, p. 539-540
Diseases Under Regular Surveillance (Picked Up by S Form)
| Category | Disease |
|---|---|
| Vector-borne | Malaria |
| Water-borne | Acute Diarrhoeal Disease (Cholera), Typhoid |
| Respiratory | Tuberculosis |
| Vaccine-preventable | Measles |
| Eradication | Polio |
| Other conditions | Road Traffic Accidents (linked to police computers) |
| International commitments | Plague |
| Unusual clinical syndromes | Meningoencephalitis, Respiratory distress, Haemorrhagic fevers, undiagnosed conditions |
Sentinel/Special Surveillance (Also Covered)
| Category | Disease |
|---|---|
| STD/Blood-borne | HIV/HBV/HCV |
| Other | Water quality, Outdoor air quality |
Warning Signs of an Impending Outbreak (Trigger Events)
The S Form is designed to detect these early warning signals:
| Syndrome | Trigger Event for Investigation |
|---|---|
| Acute watery stools | Single case of severe dehydration/death in >5 yrs with diarrhoea; or >10 houses with at least 1 case of loose stools per village |
| Fever < 7 days (only fever) | 5 cases per 1,000 population |
| Fever with rash (Measles/Dengue) | 2 similar cases in a village (1,000 population) |
| Fever with altered consciousness | 2 cases in village/1,000 population |
| Fever with bleeding | 2 cases in village/1,000 population |
| Fever with convulsions | 2 cases in village/1,000 population |
| Fever > 7 days | More than 2 cases in village/1,000 population |
| Jaundice | More than 2 cases in village/1,000 population |
| Unusual event | More than 2 deaths or hospitalizations |
Also, even a single case is a trigger for: Measles, AFP (Polio), Cholera, Plague, Dengue, JE.
Reporting Units for S Form Surveillance
| Area | Public Sector | Private Sector |
|---|---|---|
| Rural | Sub-centres, PHCs, CHCs, District Hospitals | Sentinel private practitioners, Sentinel hospitals |
| Urban | Urban hospitals, ESI/Railway/Medical college hospitals | Sentinel private nursing homes, Medical colleges, Private and NGO laboratories |
Reporting hierarchy:
- Sub-centre (health worker/ANM) - reports all patients fulfilling clinical syndromes (S Form)
- PHC/CHC medical officers - report as probable cases (P Form); lab-confirmed if available
- Sentinel private practitioners, district hospitals - report laboratory-confirmed cases (L Form)
Key Distinction Among the Three Forms
| Feature | S Form | P Form | L Form |
|---|---|---|---|
| Type | Syndromic/Suspected | Presumptive/Probable | Laboratory Confirmed |
| Filled by | Health Workers / ANMs | Clinicians / Doctors | Laboratory Staff |
| Level | Sub-centre | PHC/CHC | District/Sentinel Labs |
| Basis | Clinical syndrome only | Clinical judgment | Lab investigation |
Summary: The S Form is the earliest and most sensitive layer of IDSP's surveillance pyramid. It relies on syndromic case definitions - broad enough to capture disease clusters before a specific diagnosis is available - making it the backbone of the system's early warning capability.
- Park's Textbook of Preventive and Social Medicine, pp. 539-540
- NCDC/MoHFW - IDSP Data Management
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