Measles Surveillance Attributes Assessment Based on The Puskesmas Surveilance Officers’ Perception in Surabaya

ABSTRACTMeasles is one of infectious diseases that potentially lead to death when complications occur. Based on the data from East Java Health Department, Surabaya is the area where the most measles cases occur in East Java and increase in the last three years. As one of measles controlling efforts, surveillance has been expected to provide qualified data and information as the basis for any decision making for a treatment or intervention. Therefore, an evaluation is needed in order to assure the effectiveness and efficiency of the surveillance application in achieving the goals. This study is a descriptive research aiming at evaluating the attributes of measles epidemiology surveillance system in Surabaya on 2012. The evaluation was done by assessing the attributes of surveillance then compared to Technical Guide for Measles Surveillance 2012, The Decree of The Health Ministry of The Republic of Indonesia No.1116/MENKES/SK/VIII/2003 On Guide for Conducting Surveillance System of Health Epidemiology and Guidelines for Evaluating Surveillance Systems from Center for Disease Control and Prevention 2001. The data collection method employed interview and observation or study documentation. The respondents of this study were 39 surveillance officers at 39 Puskesmas in Health Department Surabaya working area. The variabels of this study were simplicity, flexibility, data quality, acceptability, sensitivity, predictive value positive, representativeness, timeliness, and stability. The results of this study showed that the simplicity is complicated. The flexibility from CBMS is not flexible whereas the flexibility from EWARS is flexible. The data quality, acceptability, sensitivity and representativeness are low. The predictive value positive has not been able to be scored. The stability is high and the timeliness is punctual.Keywords: surveillance, evaluation, attribute, measles

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An Evaluation of the Zambia Sentinel Surveillance System, 2011-2017

10.21203/rs.2.16794/v1 ◽

2019 ◽

Author(s):

paul simusika ◽

Stefano Tempia ◽

Edward Chentulo ◽

Lauren Polansky ◽

Mazyanga Mazaba ◽

...

Keyword(s):

Data Quality ◽

Surveillance System ◽

Low Cost ◽

Influenza Viruses ◽

Influenza Surveillance ◽

Surveillance Systems ◽

Quality Of Data ◽

African Countries ◽

Control And Prevention ◽

External Funds

Abstract Background Over the past decade, influenza surveillance has been established in several African countries including Zambia. However, information on the on data quality and reliability of established influenza surveillance systems in Africa are limited. Such information would enable countries to assess the performance of their surveillance systems, identify shortfalls for improvement and provide evidence of data reliability for policy making and public health interventions. Methods We used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza surveillance system (ISS) in Zambia during 2011-2017 using 9 attributes: (i) data quality and completeness, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability, (viii) utility, and (ix) sustainability. Each attribute was evaluated using pre-defined indicators. For each indicator we obtained the proportion (expressed as percentage) of the outcome of interest over the total. A scale from 1 to 3 was used to provide a score for each attribute as follows: <60% (as obtained in the calculation above) scored 1 (weak performance); 60-79% scored 2 (moderate performance); ≥80% scored 3 (good performance). An overall score for each attribute and the ISS was obtained by averaging the scores of all evaluated attributes. Results The overall mean score for the ISS in Zambia was 2.6. Key strengths of the system were the quality of data generated (score: 2.9), its flexibility (score: 3.0) especially to monitor viral pathogens other than influenza viruses, its simplicity (score: 2.8), acceptability (score: 3.0) and stability (score: 2.6) over the review period and its relatively low cost ($310,000 per annum). Identified weaknesses related mainly to geographic representativeness (score: 2.0), timeliness (score: 2.5), especially in shipment of samples from remote sites, and sustainability (score: 1.0) in the absence of external funds. Conclusions The system performed moderately well in our evaluation. Key improvements would include improvements in the timeliness of samples shipments and geographical coverage. However, these improvements would result in increased cost and logistical complexity. The ISSS in Zambia is largely reliant on external funds and the acceptability of maintaining the surveillance system through national funds would require evaluation.

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An Evaluation of the Zambia Influenza Sentinel Surveillance System, 2011-2017

10.21203/rs.2.16794/v2 ◽

2019 ◽

Author(s):

paul simusika ◽

Stefano Tempia ◽

Edward Chentulo ◽

Lauren Polansky ◽

Mazyanga Mazaba ◽

...

Keyword(s):

Data Quality ◽

Surveillance System ◽

Low Cost ◽

Influenza Viruses ◽

Influenza Surveillance ◽

Surveillance Systems ◽

Quality Of Data ◽

African Countries ◽

Control And Prevention ◽

External Funds

Abstract Background Over the past decade, influenza surveillance has been established in several African countries including Zambia. However, information on the on data quality and reliability of established influenza surveillance systems in Africa are limited. Such information would enable countries to assess the performance of their surveillance systems, identify shortfalls for improvement and provide evidence of data reliability for policy making and public health interventions. Methods We used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza surveillance system (ISS) in Zambia during 2011-2017 using 9 attributes: (i) data quality and completeness, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability, (viii) utility, and (ix) sustainability. Each attribute was evaluated using pre-defined indicators. For each indicator we obtained the proportion (expressed as percentage) of the outcome of interest over the total. A scale from 1 to 3 was used to provide a score for each attribute as follows: <60% (as obtained in the calculation above) scored 1 (weak performance); 60-79% scored 2 (moderate performance); ≥80% scored 3 (good performance). An overall score for each attribute and the ISS was obtained by averaging the scores of all evaluated attributes. Results The overall mean score for the ISS in Zambia was 2.6. Key strengths of the system were the quality of data generated (score: 2.9), its flexibility (score: 3.0) especially to monitor viral pathogens other than influenza viruses, its simplicity (score: 2.8), acceptability (score: 3.0) and stability (score: 2.6) over the review period and its relatively low cost ($310,000 per annum). Identified weaknesses related mainly to geographic representativeness (score: 2.0), timeliness (score: 2.5), especially in shipment of samples from remote sites, and sustainability (score: 1.0) in the absence of external funds. Conclusions The system performed moderately well in our evaluation. Key improvements would include improvements in the timeliness of samples shipments and geographical coverage. However, these improvements would result in increased cost and logistical complexity. The ISSS in Zambia is largely reliant on external funds and the acceptability of maintaining the surveillance system through national funds would require evaluation.

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An Evaluation of the Zambia Influenza Sentinel Surveillance System, 2011-2017

10.21203/rs.2.16794/v3 ◽

2019 ◽

Author(s):

paul simusika ◽

Stefano Tempia ◽

Edward Chentulo ◽

Lauren Polansky ◽

Mazyanga Lucy Mazaba ◽

...

Keyword(s):

Data Quality ◽

Surveillance System ◽

Low Cost ◽

Influenza Viruses ◽

Influenza Surveillance ◽

Surveillance Systems ◽

Quality Of Data ◽

African Countries ◽

Control And Prevention ◽

External Funds

Abstract Background Over the past decade, influenza surveillance has been established in several African countries including Zambia. However, information on the on data quality and reliability of established influenza surveillance systems in Africa are limited. Such information would enable countries to assess the performance of their surveillance systems, identify shortfalls for improvement and provide evidence of data reliability for policy making and public health interventions. Methods We used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza surveillance system (ISS) in Zambia during 2011-2017 using 9 attributes: (i) data quality and completeness, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability, (viii) utility, and (ix) sustainability. Each attribute was evaluated using pre-defined indicators. For each indicator we obtained the proportion (expressed as percentage) of the outcome of interest over the total. A scale from 1 to 3 was used to provide a score for each attribute as follows: <60% (as obtained in the calculation above) scored 1 (weak performance); 60-79% scored 2 (moderate performance); ≥80% scored 3 (good performance). An overall score for each attribute and the ISS was obtained by averaging the scores of all evaluated attributes. Results The overall mean score for the ISS in Zambia was 2.6. Key strengths of the system were the quality of data generated (score: 2.9), its flexibility (score: 3.0) especially to monitor viral pathogens other than influenza viruses, its simplicity (score: 2.8), acceptability (score: 3.0) and stability (score: 2.6) over the review period and its relatively low cost ($310,000 per annum). Identified weaknesses related mainly to geographic representativeness (score: 2.0), timeliness (score: 2.5), especially in shipment of samples from remote sites, and sustainability (score: 1.0) in the absence of external funds. Conclusions The system performed moderately well in our evaluation. Key improvements would include improvements in the timeliness of samples shipments and geographical coverage. However, these improvements would result in increased cost and logistical complexity. The ISSS in Zambia is largely reliant on external funds and the acceptability of maintaining the surveillance system through national funds would require evaluation.

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Evaluation of Neonatal Tetanus Surveillance System in Sana'a city, Yemen (Preprint)

10.2196/preprints.27606 ◽

2021 ◽

Author(s):

Khaled Mohammed Al-Jamrah ◽

Basheer Abdulgalil Al Nabehi ◽

Khaled Abdullah Almoayed ◽

Labiba Saeed Anam ◽

Yousef S Khader

Keyword(s):

Data Quality ◽

Surveillance System ◽

Poor Performance ◽

Neonatal Tetanus ◽

Focal Points ◽

Quality Of Data ◽

Healthcare Facilities ◽

Cdc Guidelines ◽

Usefulness Score ◽

Control And Prevention

BACKGROUND The Neonatal Tetanus Surveillance System (NTSS) in Yemen was established in 2009 to identify high-risk areas, determine trends, and evaluate elimination activities. Since its launch, the NTSS had never been evaluated. OBJECTIVE This study aimed to assess the performance of NTSS and determine its strength and weaknesses to recommend improvements. METHODS The Centers for Disease Control and Prevention (CDC) guidelines were used for evaluating the NTSS. The centrals' stakeholders, districts' surveillance coordinators, and facilities' focal points were interviewed to rate the attributes of the NTSS. The percent scores for attributes were ranked as poor (<60%), average (≥ 60- <80%) and good (≥ 80%. RESULTS The overall usefulness score percent was 38%, which indicates a poor performance. The performance of the NTSS was rated as an average on the flexibility (Score percent: 68%) and acceptability (Score percent: 64%) attributes and was rated as poor on stability (Score percent: 33%), simplicity (Score percent: 57%), and representativeness (Score percent: 39%) attributes. About 65% of investigation forms were filled within 48 hours of notification date. The data quality was poor as 41% of the core variables were missing. CONCLUSIONS The overall performance of the NTSS was poor. Most of the system attributes require improvement such as stability, simplicity, quality of data and completeness of investigation. To improve the performance of NTSS, the followings are recommended: Capacity building of staff (focal points), strengthening NTSS through technical support and government funding to ensure its sustainability, establishing an electronic investigation forms for improving the system data quality, and expansion of the NTSS coverage to include all private healthcare facilities.

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The epidemiology of infectious syphilis in the Republic of Ireland

Eurosurveillance ◽

10.2807/esm.09.12.00495-en ◽

2004 ◽

Vol 9 (12) ◽

pp. 11-12 ◽

Cited By ~ 19

Author(s):

M Cronin ◽

L Domegan ◽

L Thornton ◽

M Fitzgerald ◽

S Hopkins ◽

...

Keyword(s):

Surveillance System ◽

Oral Sex ◽

Surveillance Systems ◽

Anal Sex ◽

The Mean ◽

The Republic ◽

Sex With Men ◽

Set Up ◽

Time Evaluation ◽

Ongoing Monitoring

In response to the increasing numbers of syphilis cases reported among men having sex with men (MSM) in Dublin, an Outbreak Control Team (OCT) was set up in late 2000. The outbreak peaked in 2001 and had largely ceased by late 2003. An enhanced syphilis surveillance system was introduced to capture data from January 2000. Between January 2000 and December 2003, 547 cases of infectious syphilis were notified in Ireland (415 were MSM). Four per cent of cases were diagnosed with HIV and 15.4% of cases were diagnosed with at least one other STI (excluding HIV) within the previous 3 months. The mean number of contacts reported by male cases in the 3 months prior to diagnosis was 4 (range 0-8) for bisexual contacts and 6 for homosexual contacts (range 1-90). Thirty one per cent of MSM reported having had recent unprotected oral sex and 15.9% of MSM reported having had recent unprotected anal sex. Sixteen per cent of cases reported having had sex abroad in the three months prior to diagnosis. The results suggest that risky sexual behaviour contributed to the onward transmission of infection in Dublin. The outbreak in Dublin could be seen as part of a European-wide outbreak of syphilis. The rates of co-infection with HIV and syphilis in Ireland are comparable with rates reported from other centres. There is a need to improve surveillance systems in order to allow real time evaluation of interventions and ongoing monitoring of infection trends.

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Evaluation of Sever Respiratory Illness Sentinel Surveillance System in Yemen (Preprint)

10.2196/preprints.27621 ◽

2021 ◽

Author(s):

Ghamdan Gamal Alkholidy ◽

Labiba Saeed Anam ◽

Ali Ali Al Mahaqri ◽

Yousef S. Khader

Keyword(s):

Data Quality ◽

Surveillance System ◽

Respiratory Illness ◽

Control Measures ◽

Cdc Guidelines ◽

Control And Prevention ◽

Prevention And Control Measures ◽

And Control ◽

Severe Acute Respiratory Illness ◽

Structured Questionnaire

BACKGROUND The national Severe Acute Respiratory Illness surveillance system in Yemen was established in 2010 to monitor SARI occurrence in humans and provide a foundation for detecting SARI outbreaks. OBJECTIVE To ensure that the objectives of the national surveillance are being met, this study aimed to determine the level of usefulness and assess the performance of the SARI surveillance system in Yemen. METHODS The updated Centers for Disease Control and Prevention (CDC) guidelines were used for the purpose of evaluation. Related documents and reports were reviewed. Data were collected from four central-level managers and stakeholders, and from ten focal points at four Sentinel sites using semi-structured questionnaire. For each attribute, the score percent was calculated and ranked as the following: very poor (≤ 20 %), poor (>20-≤ 40%), average (>40-≤ 60%), good (>60-≤80 %) and excellent (>80 %). RESULTS As rated by the evaluators, SARI surveillance system achieved its targets. The system attributes flexibility (percent score: 86%) and acceptability (percent score: 82%) were rated as excellent, and simplicity (percent score: 74%) and stability (percent score: 75%) were rated as good. The percent score of timeliness was 23% in 2018, indicating poor timeliness. The overall data quality percent score of SARI system was 98.5%. Despite its many strengths, the SARI system has some weakness in that it depends on irregular external financial support. CONCLUSIONS Overall, the SARI surveillance system was useful in estimating morbidity and mortality, monitoring the trend of disease, stimulating researches to inform prevention and control measures. SARI surveillance system was excellent in flexibility, acceptability and data quality. Its simplicity and stability were good; its timeliness was poor. It is recommended to expand the system and engage private sites in SARI surveillance, establish an electronic database at central and peripheral levels, and provide the lab with the reagents needed for confirmation.

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Evaluation of the Influenza Sentinel Surveillance System in the Democratic Republic of Congo, 2012-2015

10.21203/rs.2.10330/v1 ◽

2019 ◽

Author(s):

Pélagie Diambalula Babakazo ◽

Joelle Kabamba-Tshilobo ◽

Emile Okitolonda Wemakoy ◽

Léopold Lubula ◽

Léonie Kitoko Manya ◽

...

Keyword(s):

Data Quality ◽

Surveillance System ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Sentinel Surveillance ◽

World Health ◽

Influenza Surveillance ◽

Surveillance Systems ◽

Republic Of Congo ◽

Sentinel Surveillance System

Abstract Background The World Health Organization recommends periodic evaluations of influenza surveillance systems to identify areas for improvement and provide evidence of data reliability for policymaking. However, data about the performance of established influenza surveillance systems are limited in Africa, including in the Democratic Republic of Congo (DRC). Methods We used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza sentinel surveillance system (ISSS) in DRC during 2012-2015. The performance of the system was evaluated using eight surveillance attributes: (i) data quality and completeness for key variables, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability and (viii) utility. For each attribute, specific indicators were developed and described using quantitative and qualitative methods. Scores for each indicator were as follows: <60% weak performance; 60-79% moderate performance; ≥80% good performance. Results During 2012-2015, we enrolled and tested 4,339 patients with influenza-like illness (ILI) and 2,869 patients with severe acute respiratory illness (SARI) from 11 sentinel sites situated in 5 of 11 provinces. Influenza viruses were detected in 446 (10.3%) samples from patients with ILI and in 151 (5.5%) samples from patients with SARI with higher detection during December-May. Data quality and completeness was >90% for all evaluated indicators. Other strengths of the system were timeliness, representativeness, simplicity, stability and utility that scored >70% each. Flexibility and acceptability had moderate to week performance. It was reported that the ISSS contributed to: (i) a better understanding of the epidemiology, circulating patterns and proportional contribution of influenza virus among patients with ILI or SARI; (ii) acquisition of new key competences related to influenza surveillance and diagnosis; and (iii) continuous education of surveillance staff and clinicians at sentinel sites about influenza. However, due to limited resources no actions were undertaken to mitigate the impact of seasonal influenza epidemics. Conclusions The system performed overall satisfactorily and provided reliable and timely data about influenza circulation in DRC. The simplicity of the system contributed to its stability. A better use of the available data could be made to inform and promote prevention interventions especially among the most vulnerable groups.

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Clinical Predictors of Influenza in Young Children: The Limitations of “Influenza-Like Illness”

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/pis081 ◽

2012 ◽

Vol 2 (1) ◽

pp. 21-29 ◽

Cited By ~ 7

Author(s):

Nicholas T. Conway ◽

Zoe V. Wake ◽

Peter C. Richmond ◽

David W. Smith ◽

Anthony D. Keil ◽

...

Keyword(s):

Young Children ◽

Predictive Value ◽

Influenza Infection ◽

Diagnostic Testing ◽

Epidemiological Data ◽

Influenza Surveillance ◽

Surveillance Systems ◽

Clinical Predictors ◽

Influenza Like Illness ◽

Control And Prevention

Abstract Background Influenza-like illness (ILI) definitions have been infrequently studied in young children. Despite this, clinical definitions of ILI play an important role in influenza surveillance. This study aims to identify clinical predictors of influenza infection in children ≤5 years old from which age-specific ILI definitions are then constructed. Methods Children aged 6–59 months with a history of fever and acute respiratory symptoms were recruited in the Western Australia Influenza Vaccine Effectiveness (WAIVE) Study. Clinical data and per-nasal specimens were obtained from all children. Logistic regression identified significant predictors of influenza infection. Different ILI definitions were compared for diagnostic accuracy. Results Children were recruited from 2 winter influenza seasons (2008–2009; n = 944). Of 919 eligible children, 179 (19.5%) had laboratory-confirmed influenza infection. Predictors of infection included increasing age, lack of influenza vaccination, lower birth weight, fever, cough, and absence of wheeze. An ILI definition comprising fever ≥38°C, cough, and no wheeze had 58% sensitivity (95% confidence interval [CI], 50–66), 60% specificity (95% CI, 56–64), 26% positive predictive value (95% CI, 21–31), and 86% negative predictive value (95% CI, 82–89). The addition of other symptoms or higher fever thresholds to ILI definition had little impact. The Centers for Disease Control and Prevention definition of ILI (presence of fever [≥37.8°C] and cough and/or sore throat) was sensitive (92%; 95% CI, 86–95), yet lacked specificity (10%; 95% CI, 8–13) in this population. Conclusions Influenza-like illness is a poor predictor of laboratory-confirmed influenza infection in young children but can be improved using age-specific data. Incorporating age-specific ILI definitions and/or diagnostic testing into influenza surveillance systems will improve the accuracy of epidemiological data.

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Evaluation of the Kenya Livestock and Wildlife Syndromic Surveillance System for Rift Valley Fever, Narok County, Kenya, 2018-2019

10.21203/rs.3.rs-900525/v1 ◽

2021 ◽

Author(s):

Erenius Nakadio ◽

Samuel Kahariri ◽

Maurice Owiny

Keyword(s):

Data Quality ◽

Rift Valley ◽

Surveillance System ◽

Rift Valley Fever ◽

Participation Rate ◽

Categorical Variables ◽

Surveillance Systems ◽

Continuous Variables ◽

Valley Fever ◽

Syndromic Surveillance System

Abstract Background Rift Valley Fever (RVF) outbreaks in livestock have had a detrimental impact on livestock trade, animal breeding, and productivity. Routine evaluation and data analysis of surveillance systems ensure that health events are efficiently and effectively monitored. This study evaluated Kenya Livestock and Wildlife Surveillance System (KLWSS) and characterized RVF cases reported for Narok County. Methods We evaluated KLWSS from January 2018 to December 2019 using CDC guidelines for evaluating surveillance systems. Attributes of simplicity, flexibility, data quality, acceptability, representativeness, timeliness, stability, sensitivity, and predictive value positive were examined. A retrospective review of RVF surveillance data for Narok County was performed. Demographic and clinical variables were assessed. Data were cleaned in Ms. Excel and descriptive analysis was done using Epi Info 7. Categorical variables were summarized using frequencies and proportions while continuous variables were summarized using measures of central tendency and dispersion. Study authorization was granted by the Directorate of Veterinary Services. Results System was simple in structure and operation, accommodated upgrading of its application, data quality performance was 69.8%, stakeholder’s participation rate was 80% with 842 reports coming from six sub-counties and 30 wards. The median time between event occurrence and event reporting was two days (range one to six days). The system had been operational since 2018 with no reports of any unscheduled outages and downtimes. Suspected cases of RVF reported were 11% (95/842) of the reported cases. The livestock species affected were cattle 56% (53/95) and Sheep 44% (42/95). About 96% (91/95) of the suspected cases were in mixed livestock production systems. The common syndrome was abortions 74% (95/129) with Loita ward recording 97% (92/95) suspected RVF cases. All suspected cases were reported in March 2018. Conclusions The KLWSS system was found to be stable but with below-par performance in data quality. Improvement in data quality is required to ensure that the surveillance system is efficient and effective.

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