Case Fatality Ratio (CFR) for most common diseases

Probability of dying as a result of a given disease. Is a result of a mixture of disease severity and quality of health care.

Numerator

Total number of fatalities related to the disease in a defined administrative or health area in a given time period

Denominator

Total number of cases related to the disease in the same administrative or health area and the same time period

Disaggregation

Administrative area; health area; sex

Indicator used for response monitoring ?

Yes

Types

Baseline

Threshold / Standard

Cholera : 1 per cent or lower; Shigella dysentery : 1 per cent or lower; typhoid : 1 per cent or lower; meningococcal meningitis : varies, 5-15 per cent; malaria : varies, aim for <5 per cent in severely ill malaria patients; measles : varies, 2-21 per cent reported in conflict-affected settings, aim for <5 per cent. Follow-up of trends

General guidance

Interpretation: the CFR is an indicator of the quality of case management, late arrival at the facility or severity of disease. Limitations: most likely to be biased upwards because only more severe cases normally go to clinics.

Guidance on phases

There is a differing level of quality of data which can be collected at different phases of the emergency depending on the context, eg the data available and the systems for data collection in place before the crisis, the accessibility of the affected areas, the resources on the ground, etc...

Phase applicability

Pre-crisis/Baseline

Phase 1

Phase 2

Phase 3

Phase 4

Data Sources

Numerator: health facility based surveillance; routine health facility reporting system Denominator: health facility based surveillance; routine health facility reporting system

Comments

Further guidance: IDSR guide CDC Afro. NB: This indicator is relevant to WASH only for certain diseases. (http://www.cdc.gov/globalhealth/dphswd/idsr/pdf/Technical%20Guidelines/IDSR%20Technical%20Guidelines%202nd%20Edition_2010_English.pdf)