Active, population‐based surveillance for infectious diseases
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Abstract:
Active, population-based surveillance is a powerful tool for monitoring infectious diseases and evaluating disease prevention strategies. When carefully implemented and maintained, this type of surveillance can provide accurate data on disease incidence that are generalizable to larger populations, capture changes in disease epidemiology, and reliably measure the impact of public health and provider-initiated disease interventions. Because this model is resource intensive, the disease chosen for surveillance should provide important, actionable information. In this chapter, we discuss the methods and key components of establishing and evaluating active, population-based surveillance. We also describe the advantages and challenges, using examples taken from active, population-based surveillance systems in the both the USA and Thailand.Keywords:
Disease Surveillance
Epidemiological surveillance
Public health surveillance
Disease monitoring
Epidemiologic Surveillance
Active, population-based surveillance is a powerful tool for monitoring infectious diseases and evaluating disease prevention strategies. When carefully implemented and maintained, this type of surveillance can provide accurate data on disease incidence that are generalizable to larger populations, capture changes in disease epidemiology, and reliably measure the impact of public health and provider-initiated disease interventions. Because this model is resource intensive, the disease chosen for surveillance should provide important, actionable information. In this chapter, we discuss the methods and key components of establishing and evaluating active, population-based surveillance. We also describe the advantages and challenges, using examples taken from active, population-based surveillance systems in the both the USA and Thailand.
Disease Surveillance
Epidemiological surveillance
Public health surveillance
Disease monitoring
Epidemiologic Surveillance
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With the introduction of the new meningitis A conjugate vaccine in 2012, Benin has opted for case-by-case surveillance for bacterial meningitis. The study aims to assess the case-by-case surveillance system for the meningitis epidemic in Benin during the period 2016 to 2018. A retrospective and evaluative study with a mixed approach (qualitative and quantitative) was conducted, on the three sites identified for sentinel surveillance of meningitis in Benign. The evaluation of the performance of the surveillance system was based on the updated guidelines of the Center for Disease Prevention and Control to evaluate a public health surveillance system. All criteria except sensitivity, specificity and positive predictive value were measured. Semi-structured individual interviews were conducted with the agents of the surveillance system surveyed and the normative documents as well as the notice forms were examined. This study reveals that all the centers had the case definition and notification forms. The ratio of notified cases to registered cases was 0.77. We found that the monitoring system in place had five levels. The system performance was recognized with simplicity at 80.8%, good acceptability (completeness: 98.5%; Promptitude: 88.9%) and responsiveness of 85%. The completeness of the health facilities was 45%. This study shows that it is imperative to strengthen the knowledge of the actors involved in epidemiological surveillance through periodic training to improve the performance of the surveillance system.
Disease Surveillance
Epidemiological surveillance
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Health Surveillance
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During May, 83 of the 120 districts in Uganda had reported malaria cases above the upper limit of the normal channel. Across all districts, cases had exceeded malaria normal channel upper limits for an average of six months. Yet no alarms had been raised! Starting in 2000, Uganda adopted the World Health Organization (WHO) Integrated Disease Surveillance and Response (IDSR) strategy for disease reporting, including for malaria. Even early on, however, it was unclear how effectively IDSR and DHIS2 were being used in Uganda. Outbreaks were consistently detected late, but the underlying cause of the late detection was unclear. Suspecting there might be gaps in the surveillance system that were not immediately obvious, the Uganda FETP was asked to evaluate the malaria surveillance system in Uganda. This case study teaches trainees in Field Epidemiology and Laboratory Training Programs, public health students, public health workers who may participate in evaluation of public health surveillance systems, and others who are interested in this topic on reasons, steps, and attributes and uses the surveillance evaluation approach to identify gaps and facilitates discussion of practical solutions for improving a public health surveillance system.
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Improvement in methods to control measles requires robust surveillance systems to ensure completeness and specificity. Measles surveillance in countries with limited resources is well defined and has evolved to meet the needs of increasingly ambitious measles control efforts. In these countries, surveillance for measles builds on the infrastructure and methods developed by the World Health Organization for poliomyelitis eradication surveillance. These include a tiered case definition, case-based surveillance, a strong laboratory component, molecular epidemiology, and surveillance quality measures. As measles eradication progresses, continued evaluation and innovation will be required to assure that surveillance remains adequate.
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Disease Eradication
Poliomyelitis eradication
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Dengue was first reported in Puerto Rico in 1899 and sporadically thereafter. Following outbreaks in 1963 and 1969, the Centers for Disease Control and Prevention has worked closely with the Puerto Rico Department of Health to monitor and reduce the public health burden of dengue. During that time, evolving epidemiologic scenarios have provided opportunities to establish, improve, and expand disease surveillance and interventional research projects. These initiatives have enriched the tools available to the global public health community to understand and combat dengue, including diagnostic tests, methods for disease and vector surveillance, and vector control techniques. Our review serves as a guide to organizations seeking to establish dengue surveillance and research programs by highlighting accomplishments, challenges, and lessons learned during more than a century of dengue surveillance and research conducted in Puerto Rico.
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Definitions of epidemiological concepts regarding disease monitoring and surveillance can be found in textbooks on veterinary epidemiology. This paper gives a review of how the concepts: monitoring, surveillance, and disease control strategies are defined. Monitoring and surveillance systems (MO&SS) involve measurements of disease occurrence, and the design of the monitoring determines which types of disease occurrence measures can be applied. However, the knowledge of the performance of diagnostic tests (sensitivity and specificity) is essential to estimate the true occurrence of the disease. The terms, disease control programme (DCP) or disease eradication programme (DEP), are defined, and the steps of DCP/DEP are described to illustrate that they are a process rather than a static MO&SS.
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The epidemiology of West Nile disease (WND) is influenced by multiple ecological factors and, therefore, integrated surveillance systems are needed for early detecting the infection and activating consequent control actions. As different animal species have different importance in the maintenance and in the spread of the infection, a multispecies surveillance approach is required. An integrated and comprehensive surveillance system is in place in Italy aiming at early detecting the virus introduction, monitoring the possible infection spread, and implementing preventive measures for human health. This paper describes the integrated surveillance system for WND in Italy, which incorporates data from veterinary and human side in order to evaluate the burden of infection in animals and humans and provide the public health authorities at regional and national levels with the information needed for a fine tune response.
West Nile virus
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Disease Surveillance
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Foodborne disease continues to be an important global public health problem. Surveillance is essential to efforts to measure, control, and prevent foodborne disease. Capacity is increased with the increasing complexity of the surveillance system, which can be classified on a spectrum ranging from no formal surveillance to syndromic surveillance, laboratory-based surveillance, and, finally, integrated food-chain surveillance. While syndromic surveillance is usually not specific enough for most foodborne surveillance needs, it may be useful in countries with insufficient resources to establish laboratory-based surveillance. Specific strategies for surveillance include: (1) routine surveillance for notifiable diseases, (2) subtyping of pathogens, (3) sentinel site surveillance, (4) hospital discharge records and death registration, (5) foodborne disease complaints systems, and (6) outbreak reports. This chapter describes the advantages, disadvantages, and relevance of these surveillance strategies for various public health situations and objectives. Additional uses of surveillance data, opportunities for improving foodborne disease surveillance, and efforts to enhance surveillance internationally are discussed.
Disease Surveillance
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Notifiable disease
Epidemiological surveillance
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Health Surveillance
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Disease Surveillance
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