Zimbabwe National Health Account

STANDARD CASE DEFINITIONS

STANDARD CASE DEFINITIONS

DISEASES / CONDITIONS

DEFINITIONS

Cholera

Suspected Case

Any patient age 5 years or more with severe dehydration or death from acute watery diarrhoea

If There Is A Cholera Epidemic: any person age 2 years or more with acute watery diarrhoea, with or without vomiting

Confirmed Case

A suspected case in which Vibrio cholerae O1 or O139 has been isolated in the stool

Dysentery

Suspected Case

A person with diarrhoea and visible blood in the stool

Confirmed Case

Suspected case with stool culture positive for Shigella dysenteriae type 1

Typhoid

Suspected Case

Any person with gradual onset of steadily increasing and then persistently high fever, chills, malaise, headache, sore throat, cough, and, sometimes, abdominal pain and constipation or diarrhoea

Confirmed Case

Suspected case confirmed by isolation of Salmonella typhi from blood, bone marrow, bowel fluid or stool

Malaria

Suspected Case

Any person living in a malaria area or history of travelling in a malaria area within the last 6weeks, presenting with fever , malaise, chills, and rigors, without signs of severe disease such as vital organ dysfunction

Confirmed Case

Uncomplicated Cases: A suspected uncomplicated malaria with laboratory diagnosis by malaria blood slide or RDT for malaria parasites

Complicated Cases: A patient hospitalized with P. falciparum asexual parasitaemia as confirmed by laboratory tests with accompanying symptoms of severe disease (vital organ dysfunction)

Anthrax

Suspected Cases

a. Cutaneous form: Any person with skin lesion evolving over 1 to 6 days from a papular through a vesicular stage, to a depressed black eschar invariably accompanied by oedema that may be mild to extensive

b. Gastro-intestinal: Any person with abdominal distress characterized by nausea, vomiting, anorexia and followed by fever

c. Pulmonary (inhalation): any person with brief prodrome resembling acute viral respiratory illness, followed by rapid onset of hypoxia, dyspnoea and high temperature, with X-ray evidence of mediastinal widening

d. Meningeal: Any person with acute onset of high fever possibly with convulsions, loss of consciousness, meningeal signs and symptoms; commonly noted in all systemic infections

Confirmed Case

A confirmed case of anthrax in a human can be defined as a clinically compatible case of cutaneous, inhalational or gastrointestinal illness that is laboratory-confirmed by:

a. isolation of B. anthracis from an affected tissue or site; or

b. Other laboratory evidence of B. anthracis infection based on at least two Supportive laboratory tests.

Rabies

Suspected Case

A person with one or more of the following: headache, neck pain, nausea, fever, fear of water, anxiety, agitation, abnormal tingling sensations or pain at the wound site, when contact with a rabid animal is suspected.

Confirmed Case

A suspected case that is laboratory confirmed

Plague

Suspected Case

Severe malaise, prostration and very painful swelling of lymph nodes, or cough with blood stained sputum, chest pain, and difficulty in breathing.

Confirmed Case

Suspected case confirmed by isolation of Yersinia pestis from blood or aspiration of buboes, or epidemiologic link to confirmed cases or outbreak.

Influenza

Suspected Case

A person with sudden onset of fever (> 38 C) AND cough or sore throat in the absence of other diagnoses

Confirmed Case

Is a case that meets the clinical case definition and is laboratory confirmed (laboratory results must be positive for influenza virus).

SARI

Any severely ill person presenting with manifestations of acute lower respiratory infection with:

 Sudden onset of fever (>38ºC) and

 Cough or sore throat and

 Shortness of breath, or difficulty breathing with or without clinical or radiologic findings of pneumonia

SARS

Suspected Case

Any individual with a history of fever, or documented fever  38 °C and One or more symptoms of lower respiratory tract illness (cough, difficulty breathing, shortness of breath) and Radiographic evidence of lung infiltrates consistent with pneumonia or Acute Respiratory Disease Syndrome (ARDS) or autopsy findings consistent with the pathology of pneumonia or ARDS without an identifiable cause and No alternative diagnosis can fully explain the illness

Confirmed Case

An individual who tests positive for SARS-CoV infection by the WHO recommended testing procedure

Measles

Suspected Case

Any person with fever and maculopapular (non-vesicular) generalized rash and cough, coryza or conjunctivitis (red eyes) or any person in whom a clinician suspects measles

Confirmed Case

A suspected case with laboratory confirmation (positive IgM antibody) or epidemiological link to confirmed cases in an outbreak

Acute Flaccid Paralysis (AFP)/ Poliomyelitis

Suspected Case Any child under 15 years of age with acute flaccid paralysis including Guillain-Barré Syndrome or any person with paralytic illness at any age in whom the clinician suspects poliomyelitis

Confirmed Case

A suspected case with virus isolation in stool

Neonatal Tetanus (NNT)

Any newborn with a normal ability to suck and cry during the first two days of life, and who, between the 3rd and 28th day of age, cannot suck normally, and becomes stiff or has convulsions or both. It can result in death

Meningitis

Suspected Case

Any person with sudden onset of fever (>38.5ºC rectal or 38.0ºC axillary) and one of the following signs: neck stiffness, altered consciousness or other meningeal signs

Confirmed Case

A suspected case confirmed by isolation of N. meningitidis from CSF or blood.

Maternal Death

The death of a woman while pregnant or within 42 days of the delivery termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes