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Title page 1
Contents 4
Foreword 5
Abbreviations 6
Executive summary 8
Introduction 12
Methods 14
Overview of health-care and health information systems in Bhutan 17
Cross-cutting surveillance system features 21
Sexually transmitted infections (STIs) 24
Sexually transmitted infections (STIs): cross-cutting features 25
HIV/syphilis: cross-cutting features 27
HIV/AIDS 28
Syphilis 31
Gonorrhoea 33
Hepatitis: cross-cutting features 35
Hepatitis B 36
Hepatitis C 38
Neglected tropical diseases (NTDs) 40
Leprosy 41
Vector-borne diseases (VBDs): cross-cutting features 45
Chikungunya 45
Dengue 48
Zika 51
Leishmaniasis 53
Malaria 56
Lymphatic filariasis 61
Other infectious diseases 63
Food-, waterborne and zoonotic diseases: cross-cutting surveillance issues 64
Cholera 65
Enteric fever (Salmonella Typhi/typhoid) 69
Leptospirosis 71
Scrub typhus 73
Airborne diseases 76
Tuberculosis 76
Syndromes 81
Influenza-like illness (ILI) 82
General recommendations 85
References 87
Annex 90
Fig. 1. Information flow of health-related data in Bhutan 19
Fig. 2. Flowchart for reporting weekly and immediately notifiable diseases in Bhutan 20
Fig. 3. Data flow and reporting for HIV/AIDS surveillance in Bhutan 30
Fig. 4. Leishmania case reporting form in Bhutan 54
Fig. 5. Reporting and feedback flowchart in Bhutan 58
Fig. 6. Communication flowchart for malaria preparedness 59
Fig. 7. Reporting of foodborne disease surveillance data by health-care centres in Bhutan 66
Fig. 8. Flow of information for reporting of cholera cases in Bhutan 67
Fig. 9. Access rights in the TbISS platform in Bhutan 77
Fig. 10. Data flow in the TB programme in Bhutan 78
Fig. 11. Data flow for ILI surveillance in Bhutan 83
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