Estimation of the under-reporting rate for the surveillance of Escherichia coli O157[ratio ]H7 cases in Ontario, Canada
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Two models estimating the proportion of Escherichia coli O157[ratio ]H7 cases not reported in the Ontario notifiable diseases surveillance system are described. The first model is a linear series of adjustments in which the total number of reported cases is corrected by successive under-reporting coefficients. The structure of the second model is based on a relative difference in the proportion of E. coli O157[ratio ]H7 cases which are hospitalized between the surveillance database and the underlying population. Based on this analysis, the rate of under-reporting of symptomatic cases of E. coli O157[ratio ]H7 infection in Ontario ranges from 78 to 88% corresponding to a ratio of 1 reported case for approximately 4–8 symptomatic cases missed by the surveillance system. This study highlights the need to increase awareness among public health workers of the potential biases that may exist in the interpretation of routine surveillance data.Keywords:
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Under-reporting
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.
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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.
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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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Background: One of the core responsibilities of the Epidemiology Program at the Georgia Department of Public Health is to detect and respond to population health events through traditional and novel surveillance. One type of event that we have planned for over the years has been conducting disease surveillance during a mass sheltering event.
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ABSTRACT This paper aims to discuss the political and organizational trajectory of the Health Surveillance System in Brazil. The paper is an exploratory and descriptive study, whose data were obtained through a literature review carried out in public domain databases from 1998 to 2013. The authors present a brief trajectory of the field of epidemiological, environmental and health surveillance toward a more integrated system, with case-resolution capacity. Finally, a debate was promoted on the advances and challenges of articulating proposals for organizational change and integrating practices in search of more effective responses within the scope of Health Surveillance. ERDS Public health surveillance; Integrality in health; Evaluation; Review. SAUDE DEBATE | rio de Janeiro, v. 39, n. 104, p. 255-267, Jan-Mar 2015 255 Sistema de Vigilância em Saude no Brasil avanos e desafios Health Surveillance System in razil: advances and challenes Catia Martins de Oliveira 1 , Marly Marques Cruz
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A dengue fever outbreak occured in French Guiana in 2006. The objectives were to study the value of a syndromic surveillance system set up within the armed forces, compared to the traditional clinical surveillance system during this outbreak, to highlight issues involved in comparing military and civilian surveillance systems and to discuss the interest of syndromic surveillance for public health response. Military syndromic surveillance allows the surveillance of suspected dengue fever cases among the 3,000 armed forces personnel. Within the same population, clinical surveillance uses several definition criteria for dengue fever cases, depending on the epidemiological situation. Civilian laboratory surveillance allows the surveillance of biologically confirmed cases, within the 200,000 inhabitants. It was shown that syndromic surveillance detected the dengue fever outbreak several weeks before clinical surveillance, allowing quick and effective enhancement of vector control within the armed forces. Syndromic surveillance was also found to have detected the outbreak before civilian laboratory surveillance. Military syndromic surveillance allowed an early warning for this outbreak to be issued, enabling a quicker public health response by the armed forces. Civilian surveillance system has since introduced syndromic surveillance as part of its surveillance strategy. This should enable quicker public health responses in the future.
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The publication of the Decree creating the National Epidemiological Surveillance Network, 7 years ago now, invites us to reflect on public health surveillance systems in our country and to highlight those aspects that help or obstruct these systems in meeting their basic objective of providing information that can be used to facilitate disease control. Many of the events that have taken place in the health arena in recent years, labeled as health crises by the communications media, have been considered by the population as unacceptable risks that the health system should have avoided; defects in surveillance systems are one of the errors always mentioned in this respect. Some of these defects arise because of limitations of the instruments used to measure and classify health problems, but others are due to an inappropriate understanding of surveillance, which make it difficult to assess the true impact of health problems. A discussion of the two types of defects will not solve surveillance problems, but it may help many people to stop asking our surveillance systems for what they cannot offer.
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Evaluate the Tuberculosis (TB) surveillance system in the Ga West Municipality to determine if it is achieving its objectives, and to assess its attributes and usefulness.Descriptive analysis of primary and secondary data.Stakeholder interviews and record reviews on the objectives and operation of the surveillance system at all levels of the system.We evaluated the system's operation from 2011-2015 using the Centers for Disease Control and Prevention (CDC) updated guidelines for evaluating public health surveillance systems and the World Health Organisation (WHO) TB surveillance checklist for assessing the performance of national surveillance systems.The TB surveillance system in the municipality was functional and operated at all levels for timely detection of cases, accurate diagnosis, and case management. The system improved management of TB/HIV co-infections. The average time taken to confirm a suspected TB case was one day. The registration of a confirmed case and subsequent treatment happen immediately after confirmation. The municipality detected 109 of 727 TB cases in 2015 (case detection rate=15%). The positive predictive value (PPV) was 6.4%. There was one diagnostic centre in the municipality. Private facilities involvement in TB surveillance activities was low (1/15).The Tuberculosis surveillance system in the Ga West Municipality is well structured but partially meeting its objectives. The system is timely, stable and acceptable by most stakeholders and useful at all levels. It has no major data quality issues. Private health facilities in the municipality should be well incorporated into TB surveillance.This work was supported by Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana through the support of the West Africa Health Organization (Ref.: Prog/A17IEpidemSurveillN° 57212014/mcrt) to B-YA.
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Abstract This chapter provides an overview of the legal issues relating to public health surveillance and field epidemiology. It discusses the general legal authorities for surveillance and public health investigations provided by the U.S. Constitution and by state laws; legal milestones in the evolution of public health surveillance, outbreak investigations, and disease control in the United States; and legal issues related to the collection, analysis, and dissemination of surveillance data. The chapter also presents information about new surveillance challenges beyond traditional infectious disease models, including the influence of bioterrorism preparedness on surveillance activities.
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