Health Surveillance and Disease Prevention and Control / Chronic Diseases
Chronic Disease Prevention and Control: Home Page | ||||||||||||||
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Risk-Factor,
Stroke Surveillance | Chronic disease now make the greatest proportion of the total burden of disease and injuries in the counties of Latin America and Caribbean. Many of these conditions are amenable to preventive measures. However, effective action to prevent and control disease depends on timely access to accurate and reliable information, both to inform where resources should best be targeted and to monitor and evaluate the impact of the actions taken. In the countries, many components needed for the surveillance of chronic noncommunicable diseases (CNCDs) and associated determinants are already in place. However significant gaps remain; and it is widely recognized that CNCD surveillance can be improved upon by building on, harmonizing and complementing existing systems. PAHO has a mandate to support capacity-building for CNCD surveillance through technical cooperation. The position paper on CNCD surveillance outlines the orientation and main directions of technical cooperation, and the operational plan for 2009 provides information on the activities proposed by the secretariat for this twelve-month period. Surveillance is essential in monitoring and controlling disease; the lack of robust systems for chronic disease surveillance is critical for successfully monitoring the health situation and responding to interventions on the policy, community, and health-system side. PAHO/WHO has developed an instrument to facilitate the countries' identifying the gaps in their surveillance capacity through The national/subnational CNCD surveillance capacity profile, one part of larger instrument. To facilitate selection, standardization, and comparability of indicators for CNCD surveillance, in 2007–2008 a PAHO working group developed a minimum dataset, which has a the manual that is currently being piloted in the Caribbean. 
For risk-factor (RF) surveillance, PAHO has adapted the original instrument and methodology in the WHO Stepwise Approach to Risk-Factor (RF) Surveillance with PanAm STEPS, a simple, standardized method for collecting, analyzing, and disseminating RF data in Member Countries that is better equipped to meet the specific needs of the countries of the Americas. By using the same standardized questions and protocols, all countries can use STEPS information, not only for monitoring trends within the country, but also for making comparisons across countries. The approach encourages the collection of small amounts of useful information on a regular and continuing basis. The methodology offers the instrument itself, a detailed Manual, and software support for data entry, data processing, and reporting. and PanAm steps. 
A special area of RF surveillance is related to youth. The Global School Health Survey (GSHS), student-based, is part of a global surveillance system designed to provide accurate data to periodically monitor the prevalence of important health risk behaviors and protective factors among students 13–15 years of age. The GSHS is relatively low-cost and uses a self-administered questionnaire to obtain data from a representative sample of students. Countries implementing the GSHS receive technical assistance from WHO in collaboration with the CDC. 
For stroke, PAHO has adopted the WHO STEPwise Method to Stroke Surveillance, STEPS Stroke, which forms a framework for standardized surveillance and data collection and analysis. As the Regional Office for the Americas, PAHO will facilitate use in the countries of this useful tool to improve data collection, prevention, and treatment for stroke, which is why it had the manual translated into Spanish, and Portuguese to complement the original English version produced by WHO. 
Disease registries have an enormous potential for improving chronic disease management. In addition to providing support for individual follow-up, the results therein can be aggregated and analyzed on a population basis. Regarding cancer registries, information can be found on the website of the International Agency for Research on Cancer (IARC) at CancerMondial, as well as on the WHO Cancer page. For statistics on CNCDs in general, see the country information on the WHO website as well as the WHO Global InfoBase. For meetings on CNCD surveillance, see the list below:
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Improving Cancer Information in the Americas, Quito, 2009: