Decision No. 4782/QD-BYT dated November 18, 2020 on promulgating criteria framework for epidemic risk assessment

MINISTRY OF HEALTH --------	SOCIALIST REPUBLIC OF VIETNAM Independence - Freedom - Happiness ---------------
No. 4782/QD-BYT	Hanoi, November 18, 2020

DECISION

PROMULGATING CRITERIA FRAMEWORK FOR EPIDEMIC RISK ASSESSMENT

MINISTER OF HEALTH

Pursuant to the Law on Prevention and Control of Infectious Diseases dated November 21, 2007;

Pursuant to the Government’s Decree No. 75/2017/ND-CP dated June 20, 2017 on functions, duties, powers and organizational structure of the Ministry of Health;

Pursuant to Plan No. 1103/KH-BYT dated 17/7/2020 by the Ministry of Health on development of criteria framework for epidemic risk assessment;

At the request of the General Director of Health Environment Management Agency, Ministry of Health,

HEREBY DECIDES:

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Article 2.The criteria framework for epidemic risk assessment shall provide the basis for formulation of risk assessment criteria for each infectious disease.

Article 3.General Department of Preventive Medicine shall take charge and cooperate with Health Environment Management Agency, regulatory bodies/institutes/schools affiliated to the Ministry of Health and relevant units and organizations in formulating risk assessment criteria for some common and dangerous infectious diseases.

Article 4.This Decision takes effect from the date on which it is signed.

Article 5.Head of Office of the Ministry of Health, General Director of Health Environment Management Agency, General Director of General Department of Preventive Medicine; heads of affiliates of the Ministry of Health; heads of Institutes of Hygiene and Epidemiology and Pasteur Institutes; Directors of Departments of Health; heads of health units of other Ministries and central authorities; and heads of relevant units shall implement this Decision./.

P.P. THE MINISTER
THE DEPUTY MINISTER

Do Xuan Tuyen

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(Promulgated together with Decision No. 4782/QD-BYT dated November 18, 2020 by Ministry of Health)

I. Criteria framework for assessment

No.

Name of criterion

Definition

Measuring method

Data source

Remark

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I.A

Prevalence among humans

Average number of cases per 100.000 people in the past 1 year or 5 years.

Number of active cases in the past 1 year or 5 years per 100.000 people living in the commune.

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- Infectious disease surveillance data reported according to Circular No. 54/2015/TT-BYT.

- Annual medical statistics.

- Health station.

- Other surveillance data sources (if any).

The health station of the commune shall collect data according to Circular No. 54/2015/TT-BYT from the district-level healthcare establishment.

Number of reported cases or detected carriers in the past 1 year or 3 years or 5 years in the commune.

(Applicable to very rare diseases such as diphtheria, whose prevalence is under 0,01/100.000 people).

Number of reported cases or detected carriers in the past 1 year or 3 years or 5 years in the commune.

...

- Infectious disease surveillance data reported according to Circular No. 54/2015/TT-BYT.

- Annual medical statistics.

- Health station.

- Other surveillance data sources (if any).

Select a 1-year/3-year/5-year time frame as appropriate to each disease’s characteristics.

Number of reported cases or detected carriers in the past 1-5 years in adjacent areas.

(Applicable to very rare diseases (such as diphtheria) or diseases recently brought to Vietnam (such as COVID-19)).

Number of reported cases or detected carriers in the past 1-5 years in adjacent areas.(adjacent communes of the same district, a different district or a different province that are adjacent to, have regular contact with or are involved in economic, cultural, religious, ethnic, etc. exchange with the commune in question).

...

- Infectious disease surveillance data reported according to Circular No. 54/2015/TT-BYT.

- Annual medical statistics.

- Health station.

- Other surveillance data sources (if any).

As it is difficult to obtain full information on number of cases in other communes, this criterion is only applicable to rare diseases (such as diphtheria) or diseases recently brought to Vietnam (such as COVID-19).

Does an epidemic break out in the commune on an annual basis?

An epidemic breaks out in the commune on an annual basis or every 2-5 years.

Yes/No

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- Local surveillance data (if any).

- May be based off local epidemic reports.

- The criteria for each disease shall provide for number of cases constituting an epidemic.

Change to pathogens (number of subtypes, genotypes, mutation of hereditary characteristics, etc.)

Distribution of genotypes, subtypes, pathogen mutations related to transmission potential and virulence.

Yes/No; Existing subtype(s)

- Surveillance data.

- Data from research units.

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I.B

Prevalence in animals and the environment

Is the disease prevalent in animals in the commune?

The disease is found in animals in the commune in the past 5 years.

Yes/No

Data from regular surveillance, focused surveillance and research by the district-level veterinary medicine authority.

If the commune has no veterinary official, collect data from the district-level agriculture authority.

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Ratio of vaccinated animals to total number of animals in the commune reported.

(Number of vaccinated animals/ total number of animals in the commune at the time of data collection) x 100%.

Data reported by the district-level veterinary medicine authority.

Are the pathogens present in the locality?

Presence of pathogens in the soil, water, food, feces, wastewater, etc. in the past 5 years.

Yes/No

Data from annual surveillance, focused surveillance and research by veterinary medicine authorities.

- Healthcare

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Herd immunity

Vaccination coverage

- Vaccination coverage >=90%

- Vaccination coverage 70- <90%

- Vaccination coverage 50% - < 70%

- Vaccination coverage less than 50%

- Vaccination coverage of a village being less than 30%

Vaccination coverage is the percentage of at-risk people who live in the commune and have received enough doses.

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- Data from vaccination reports (Expanded Program on Immunization, vaccination paid out of pocket and vaccination for epidemic prevention).

An epidemic in the commune in the past 1-2 years infected many and resulted in high herd immunity.

Yes/No; Infection rate; Serology testing.

Annual surveillance data and data on serology testing from research units.

I.D

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Indicators for vector presence and density.

Presence and density of vectors such as mosquitoes, fleas and other vectors.

Formulas for calculation of presence and density of each disease’s vectors.

Surveillance data of the locality or a higher level authority.

Example for dengue fever: percentage of houses infested with Aedes larvae and/or pupae; percentage of water-holding containers infested with Aedes larvae or pupae;

Other risk factors (contact with poultry, animal husbandry, consumption of raw blood pudding, fish salads and tap water, containing rain water in jars, etc.).

People’s behaviors and factors increasing the infection risk.

...

Surveillance data or local reports.

Behaviors and customs of local people. Choose this criterion if it is suitable for the disease.

Natural features and socio - economic characteristics

II.A

Climate features

Average monthly rainfall (mm).

Average monthly rainfall (mm) in the locality.

...

Hydrometeorology station of the province/city and other data sources.

Some infectious diseases are related to climate and weather conditions. Collect average data of the province/city from the hydrometeorology station through the province’s CDC.

Average monthly temperature (^oC)

Average monthly temperature (^oC) in the locality.

Average monthly temperature (^oC).

Hydrometeorology station of the province/city and other data sources.

Number of heat waves in a year.

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Number of waves.

Hydrometeorology station of the province/city and other data sources.

Number of days with rainfall greater than 100mm in a year.

Number of days with great rainfall (measurable rainfall >100mm/24h) recorded in a year.

Number of days.

Hydrometeorology station of the province/city and other data sources.

Natural and manmade disasters occurring in the commune last year.

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Yes/No; Number of times; Intensity; Affected areas;

Department of Agriculture and Rural Development (provincial steering committee for natural disaster prevention, search and rescue), hydrometeorology station of the province/city and other data sources.

II.B

Geographical features and urbanization level

- Class I city

- Class II city

...

- Class IV city

- Class V city

- Rural area

- Mountainous area

- Class I city

- Class II city

- Class III city

- Class IV city

- Class V city

...

- Mountainous area

According to the Government’s regulations.

Urbanization level and city class are related to the outbreak of some infectious diseases such as dengue fever.

II.C

Socio-economic characteristics

Population density of the commune.

Population density of the commune expressed as people/km².

Total population of the commune/ land area of the commune in km².

...

Poverty rate

Percentage of poor households in the commune assessed according to regulations in Clause 1 Article 2 of Circular No. 17/2016/TT-BLDTBXH.

(Total number of poor households / total number of households in the commune) x 100%.

The People’s Committee of the commune and other sources.

Main jobs of people living in the commune

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Main jobs of people living in the commune:

employeeOfficial/Public

Agriculture

Aquaculture

Forestry

productionCrop

Service

Tourism

processingFood

...

The People’s Committee of the commune and other sources.

Some infectious diseases are related to occupational characteristics. E.g., crop production is linked to dengue fever.

II.D

Hygiene practice and habits facilitating disease development

Knowledge, attitude and practice concerning epidemic prevention of people living in the commune.

Knowledge, attitude and practice concerning epidemic prevention of people living in the commune (based on qualitative or quantitative survey by health officials).

Employ linear numeric scale or 3, 4 or 5-point scale for qualitative assessment.

Quick survey of 100 target respondents/ households or qualitative assessment by local health officials.

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Percentage of households using clean water

Percentage of households using water satisfying the Ministry of Health’s or local regulations.

(Number of households using qualified water/ Total number of households in the commune) x 100

- The People’s Committee of the commune

- Health station and other sources.

Percentage of households using latrines meeting hygienic conditions.

...

(Number of households using qualified latrines/ Total number of households in the commune) x 100%

- The People’s Committee of the commune

- Health station and other sources.

Proportion of people washing their hands with soap and clean water frequently and properly

Proportion of people washing their hands with soap and clean water frequently and properly when necessary (before eating, after using the toilet and before food preparation)

Number of people washing their hands with soap and clean water frequently and properly when necessary (before eating, after using the toilet and before food preparation)/ total number of survey respondents

Health station shall conduct a quick survey with a random sample of at least 100 people in the commune.

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Proportion of people frequently wearing face masks.

Proportion of people frequently wearing face masks in public.

Number of people frequently wearing face masks in public/ total number of survey respondents

Health station shall conduct a quick survey with a random sample of at least 100 people in the commune.

II.DD

Business conditions and mass gathering

Border checkpoints, airports, seaports

...

Yes/No