scholarly journals The importance of age-specific data in routine syndromic surveillance

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Roger Morbey ◽  
Alex J. Elliot ◽  
Gillian E. Smith

ObjectiveTo investigate whether aberration detection methods for syndromicsurveillance would be more useful if data were stratified by age band.IntroductionWhen monitoring public health incidents using syndromicsurveillance systems, Public Health England (PHE) uses the ageof the presenting patient as a key indicator to further assess theseverity, impact of the incident, and to provide intelligence on thelikely cause. However the age distribution of cases is usually notconsidered until after unusual activity has been identified in the all-ages population data. We assessed whether monitoring specific agegroups contemporaneously could improve the timeliness, specificityand sensitivity of public health surveillance.MethodsFirst, we examined a wide range of health indicators from the PHEsyndromic surveillance systems to identify for further study thosewith the greatest seasonal variation in the age distribution of cases.Secondly, we examined the identified indicators to ascertain whetherany age bands consistently lagged behind other age bands. Finally,we applied outbreak detection methods retrospectively to age specificdata, identifying periods of increased activity that were only detectedor detected earlier when age-specific surveillance was used.ResultsSeasonal increases in respiratory indicators occurred first inyounger age groups, with increases in children under 5 providingearly warning of subsequent increases occurring in older age groups.Also, we found age specific indicators improved the specificity ofsurveillance using indicators relating to respiratory and eye problems;identifying unusual activity that was less apparent in the all-agespopulation.ConclusionsRoutine surveillance of respiratory indicators in young childrenwould have provided early warning of increases in older age groups,where the burden on health care usage, e.g. hospital admissions, isgreatest. Furthermore this cross-correlation between ages occurredconsistently even though the age distribution of the burden ofrespiratory cases varied between seasons. Age specific surveillancecan improve sensitivity of outbreak detection although all-agesurveillance remains more powerful when case numbers are low.

2019 ◽  
Vol 35 (17) ◽  
pp. 3110-3118
Author(s):  
Angela Noufaily ◽  
Roger A Morbey ◽  
Felipe J Colón-González ◽  
Alex J Elliot ◽  
Gillian E Smith ◽  
...  

Abstract Motivation Public health authorities can provide more effective and timely interventions to protect populations during health events if they have effective multi-purpose surveillance systems. These systems rely on aberration detection algorithms to identify potential threats within large datasets. Ensuring the algorithms are sensitive, specific and timely is crucial for protecting public health. Here, we evaluate the performance of three detection algorithms extensively used for syndromic surveillance: the ‘rising activity, multilevel mixed effects, indicator emphasis’ (RAMMIE) method and the improved quasi-Poisson regression-based method known as ‘Farrington Flexible’ both currently used at Public Health England, and the ‘Early Aberration Reporting System’ (EARS) method used at the US Centre for Disease Control and Prevention. We model the wide range of data structures encountered within the daily syndromic surveillance systems used by PHE. We undertake extensive simulations to identify which algorithms work best across different types of syndromes and different outbreak sizes. We evaluate RAMMIE for the first time since its introduction. Performance metrics were computed and compared in the presence of a range of simulated outbreak types that were added to baseline data. Results We conclude that amongst the algorithm variants that have a high specificity (i.e. >90%), Farrington Flexible has the highest sensitivity and specificity, whereas RAMMIE has the highest probability of outbreak detection and is the most timely, typically detecting outbreaks 2–3 days earlier. Availability and implementation R codes developed for this project are available through https://github.com/FelipeJColon/AlgorithmComparison Supplementary information Supplementary data are available at Bioinformatics online.


2019 ◽  
Vol 24 (11) ◽  
Author(s):  
A Septfons ◽  
T Goronflot ◽  
B Jaulhac ◽  
V Roussel ◽  
S De Martino ◽  
...  

Background: Lyme borreliosis (LB) is the most frequent vector-borne disease in France. Since 2009, surveillance of LB is conducted by a sentinel network of general practitioners (GPs). This system, in conjunction with the national hospitalisation database was used to estimate the incidence and describe the characteristics of LB in France. Aim: To describe the estimated incidence and trends in GP consultations and hospital admissions for LB in France and identify risk groups and high-incidence regions. Results: From 2011 to 2016, the mean yearly incidence rate of LB cases was 53 per 100,000 inhabitants (95% CI: 41–65) ranging from 41 in 2011 to 84 per 100 000 in 2016. A mean of 799 cases per year were hospitalised with LB associated diagnoses 2005–16. The hospitalisation incidence rate (HIR) ranged from 1.1 cases per 100,000 inhabitants in 2005 to 1.5 in 2011 with no statistically significant trend. We observed seasonality with a peak during the summer, important inter-regional variations and a bimodal age distribution in LB incidence and HIR with higher incidence between 5 and 9 year olds and those aged 60 years. Erythema migrans affected 633/667 (95%) of the patients at primary care level. Among hospitalised cases, the most common manifestation was neuroborreliosis 4,906/9,594 (51%). Conclusion: Public health strategies should focus on high-incidence age groups and regions during the months with the highest incidences and should emphasise prevention measures such as regular tick checks after exposure and prompt removal to avoid infection.


2014 ◽  
Vol 143 (10) ◽  
pp. 2018-2042 ◽  
Author(s):  
V. RODRÍGUEZ-PRIETO ◽  
M. VICENTE-RUBIANO ◽  
A. SÁNCHEZ-MATAMOROS ◽  
C. RUBIO-GUERRI ◽  
M. MELERO ◽  
...  

SUMMARYIn this globalized world, the spread of new, exotic and re-emerging diseases has become one of the most important threats to animal production and public health. This systematic review analyses conventional and novel early detection methods applied to surveillance. In all, 125 scientific documents were considered for this study. Exotic (n = 49) and re-emerging (n = 27) diseases constituted the most frequently represented health threats. In addition, the majority of studies were related to zoonoses (n = 66). The approaches found in the review could be divided in surveillance modalities, both active (n = 23) and passive (n = 5); and tools and methodologies that support surveillance activities (n = 57). Combinations of surveillance modalities and tools (n = 40) were also found. Risk-based approaches were very common (n = 60), especially in the papers describing tools and methodologies (n = 50). The main applications, benefits and limitations of each approach were extracted from the papers. This information will be very useful for informing the development of tools to facilitate the design of cost-effective surveillance strategies. Thus, the current literature review provides key information about the advantages, disadvantages, limitations and potential application of methodologies for the early detection of new, exotic and re-emerging diseases.


2017 ◽  
Vol 38 (4) ◽  
pp. 162
Author(s):  
Fiona J May

Culture independent diagnostic tests (CIDT) for detection of pathogens in clinical specimens have become widely adopted in Australian pathology laboratories. Pathology laboratories are the primary source of notification of pathogens to state and territory surveillance systems. Monitoring and analysis of surveillance data is integral to guiding public health actions to reduce the incidence of disease and respond to outbreaks. As with any change in testing protocol, the advantages and disadvantages of the change from culture based testing to culture independent testing need to be weighed up and the impact on surveillance and outbreak detection assessed. This article discusses the effect of this change in testing on surveillance and public health management of pathogens in Australia, with specific focus on gastrointestinal pathogens.


2007 ◽  
Vol 56 (4) ◽  
pp. 533-537 ◽  
Author(s):  
Yu-Chi Lin ◽  
Shu-Man Yao ◽  
Jer-Jea Yan ◽  
Ying-Yan Chen ◽  
Chuen-Sheue Chiang ◽  
...  

In Taiwan, routine pertussis immunization has been implemented for more than 40 years and a low incidence of pertussis was maintained until an 80-fold increase in cases occurred in 1992. The unexpected increase emphasized the significance of pertussis. This study evaluated a total of 2452 reported cases of pertussis during 1993–2004 and surveillance data on incidence, age distribution and seasonality. The highest morbidity was in infants aged <1 year, and upward trends in the incidence of pertussis were significant for infants aged <1 year and adolescents aged 10–14 years. The highest mean number of cases was observed in August and upward trends were in colder months. This study indicates that the epidemiology of pertussis may have been changed by waning immunity in Taiwan. Increased surveillance activities, especially in older age groups, and additional booster doses of acellular pertussis vaccine for children aged 6–8 years and adolescents/young adults aged 15–20 years are necessary to control and prevent pertussis.


Author(s):  
Tonći Grgurinović ◽  
Joško Sindik

Numerous studies show that wide range of anthropological characteristics and health indicators significantly affects the success in football. Therefore, constant monitoring of these indicators provides to the coaches the information useful for the planning of the training process, adjusted to concrete athletes. This study explores selected morphological, physiological characteristics and health (MPH) indicators of adult football players of various levels of sporting excellence. The aim of the study was to determine the differences in MPH indicators, as well as their correlation, stratified according to the age group of the athletes. The different profiles of players were identified, in relation to selected MPH indicators. A sample of 813 male players is examined, 362 in the age group 17-30 years (M±SD 21.48±3.51) and 451 aged over 30 years (43.84±9.17), from Zagreb football clubs, included in medical examination at the Clinic for Occupational Health and Sport. Several differences in MPH are found between two age groups, mainly in direction more desirable features in younger age group. The results provide important information for planning training, but also for health prevention measures.


2009 ◽  
Vol 133 (6) ◽  
pp. 916-925 ◽  
Author(s):  
Vitali Sintchenko ◽  
Blanca Gallego

Abstract Context.—Traditional biothreat surveillance systems are vulnerable to incomplete and delayed reporting of public health threats. Objective.—To review current and emerging approaches to detection and monitoring of biothreats enabled by laboratory methods of diagnosis and to identify trends in the biosurveillance research. Data Sources.—PubMed (1995 to December 2007) was searched with the combined search terms “surveillance” and “infectious diseases.” Additional articles were identified by hand searching the bibliographies of selected papers. Additional search terms were “public health,” “disease monitoring,” “cluster,” “outbreak,” “laboratory notification,” “molecular,” “detection,” “evaluation,” “genomics,” “communicable diseases,” “geographic information systems,” “bioterrorism,” “genotyping,” and “informatics.” Publication language was restricted to English. The bibliographies of key references were later hand searched to identify articles missing in the database search. Three approaches to infectious disease surveillance that involve clinical laboratories are contrasted: (1) laboratory-initiated infectious disease notifications, (2) syndromic surveillance based on health indicators, and (3) genotyping based surveillance of biothreats. Advances in molecular diagnostics enable rapid genotyping of biothreats and investigations of genes that were not previously identifiable by traditional methods. There is a need for coordination between syndromic and laboratory-based surveillance. Insufficient and delayed decision support and inadequate integration of surveillance signals into action plans remain the 2 main barriers to efficient public health monitoring and response. Decision support for public health users of biosurveillance alerts is often lacking. Conclusions.—The merger of the 3 scientific fields of surveillance, genomics, and informatics offers an opportunity for the development of effective and rapid biosurveillance methods and tools.


2019 ◽  
Vol 147 ◽  
Author(s):  
J. A. Gómez ◽  
P. Wetzler Malbrán ◽  
G. Vidal ◽  
M. Seoane ◽  
N. D. Giglio

Abstract Among the different existing types of bacterial meningitis, the one caused by Neisseria meningitidis is the main presentation of invasive meningococcal disease (IMD). IMD is a significant public health concern and has a reported incidence rate in Argentina of 0.44 cases per 100 000 inhabitants in 2015. However, the actual incidence is thought to be higher as passive surveillance systems neither report nor identify 100% of all cases. The aim of this study is to develop an estimation of the burden of IMD in Argentina closer to reality by adjusting/correcting several limitations observed in the surveillance data available. A retrospective observational study has been performed using four Argentinean national databases recording the number of IMD cases and deaths, serogroups of N. meningitidis and ages, between 2007 to 2016. The reported data were adjusted to account for underreporting and to also integrate the cases missed due to well-known limitations associated with the diagnosis of N. meningitidis detection methods. Data were further analysed by serogroups of N. meningitidis and by age groups. After these adjustments, the potential numbers of IMD cases and IMD-related deaths are estimated to be 3.1 and 1.9 higher than reported, respectively. The study corrects the previous underestimation of the disease burden and provides expectedly more robust estimates aligned with international evidence and highlights the importance of active surveillance, with high-quality methods, for a better definition of preventive strategies against IMD in Argentina.


2019 ◽  
pp. 11-17
Author(s):  
E. A. Galova

Purpose of the study: to reveal characteristics of chronic viral hepatitis C (HCV) incidence in babies and preschoolers, schoolchildren, teenagers on the example of the Nizhny Novgorod region. Materials and methods. The article presents official epidemiological information on the incidence of HCV in children in the Nizhny Novgorod region in 1995–2015. Data statistical processing was performed with Statistica 7.0. soft ware package. Zero hypotheses were rejected at significance level of the corresponding statistical criterion p < 0,05. Results. The study revealed differences of HCV-epidemic process in infants and preschoolers, schoolchildren and teenagers. The incidence of HCV in children 0–6 years old and 15–17 years old is characterized by a lack of reduction and an uncertain prognosis (p < 0,05); the positive prognosis is possible in schoolchildren aged 7–14 years (p < 0,05). There was an increase of patients of younger age groups in the proportion, and decrease of cases frequency in children 7–14-year-olds. The authors identified that the viral hepatitis C incidence is correlate with the public health indicators and with the health care institutions activities; the correlations strength and correlations pattern is depend on age. The article presents a quantitative assessment of the relationship between the children HCV incidence in different age periods and the public health indicators and activities health institutions. Conclusions. In HCV-epidemic process in children at the present there is a redistribution of older and younger age groups role in its maintenance with the leading significance of the latter. Obtained results prove the significant contribution of HCV positive women of fertile age in the HCV- epidemic process in children at the present stage.


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