Establishing a National Syndromic Surveillance  System among Asylum Seekers

ObjectiveFacing challenges to establish a new national syndromicsurveillance system in the Netherlands for infectious diseases amongasylum seekers.IntroductionMost European countries are facing a continuous increased influxof asylum seekers [1]. Poor living conditions in crowded shelters andrefugee camps increase the risk for - outbreaks of - infectious diseasesin this vulnerable population. In line with ECDC recommendations[2], we aim to improve information on infectious diseases amongasylum seekers by establishing a new syndromic surveillance systemin the Netherlands. This system will complement the notifiabledisease system for infectious diseases.The aim of the syndromic surveillance system is to improve thedetecting of outbreaks of infectious diseases in asylum seekers’centres in an early stage of development to be able to take adequateand timely measures to prevent further spread, and to collectinformation on the burden of infection within this population.MethodsPrimary health care for asylum seekers in the Netherlands isorganized nationally by the Asylum Seekers Health Centre, withgeneral practitioners providing care in each reception centre. Generalpractitioners (GPs) act as gatekeepers for specialized, secondaryhealth care and the GP is the first professional to consult for healthproblems. Therefore, electronic health records (EHR) kept by GPsprovide a complete picture of this population. These EHRs containdata on diagnoses/symptoms and treatment of asylum seekers, usingthe International Classification of Primary Care (ICPC). This data isrecorded routinely, as part of the health care process. During summer2016, about 30,000 asylum seekers were housed in about 60 receptioncentres across the Netherlands.ResultsThe governance structure was layed down in a collaborationagreement between the Asylum Seekers Health Centre, the nationalinstitute of public health RIVM and NIVEL. To ensure privacy ofthe asylum seekers, a privacy protocol has been drawn, taking intoaccount strict privacy regulations in the Netherlands. The informationsystem provider of the health care centre developed an extraction toolthat automatically generates weekly data extracts from the electronichealth records system to a Trusted Third Party (TTP). Beforetransferring the data to NIVEL, the TTP removes directly identifyingpatient information, indirectly identifying information like date ofbirth is replaced by quarter and year, and the personal identificationnumber is replaced by a pseudonym. At NIVEL, all data is storedin a relational database, from which weekly research extracts aregenerated for infectious disease surveillance at RIVM after applyinga second pseudonymisation step (two-way pseudonimisation) [3].First data extracts are being expected mid-October 2016, after whichdata quality will be evaluated. Weekly, or daily, consultations rateswill be calculated based on the number of cases meeting predefineddefinitions, stratified by immigration centre, age group, sex andnationality. Numerators will be based on the number of populationhoused in the immigration centres.ConclusionsWith the cooperation of a national health care centre, providingprimary care to asylum seekers housed at several locations, and theinformation system provider of the health care centre, EHRs can beused for syndromic surveillance, taking into account strict privacyregulations. The new surveillance system will be evaluated after oneyear, focusing on data quality, usefulness, and the added value aboveto the notification of diseases.

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Risk factors associated with the incidence of self-reported COVID-19-like illness: Data from a web-based syndromic surveillance system in the Netherlands

Epidemiology and Infection ◽

10.1017/s0950268821001187 ◽

2021 ◽

pp. 1-20

Author(s):

Scott A McDonald ◽

Cees C van den Wijngaard ◽

Cornelia CH Wielders ◽

Ingrid HM Friesema ◽

Loes Soetens ◽

...

Keyword(s):

Risk Factors ◽

The Netherlands ◽

Surveillance System ◽

Syndromic Surveillance ◽

Web Based ◽

Syndromic Surveillance System ◽

Factors Associated

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Scabies epidemiology in health care centers for refugees and asylum seekers in Greece

10.1101/2022.01.10.22268996 ◽

2022 ◽

Author(s):

Christina Louka ◽

Emmanouil Logothetis ◽

Daniel Engelman ◽

Eirini Samiotaki-Logotheti ◽

Spyros Pournaras ◽

...

Keyword(s):

Public Health ◽

Health Care ◽

Infectious Diseases ◽

Surveillance System ◽

Asylum Seekers ◽

Respiratory Infections ◽

Early Stage ◽

Epidemiological Data ◽

Health Concern ◽

Refugees And Asylum Seekers

Background Scabies is a global health concern disproportionally affecting vulnerable population such as refugees and asylum seekers. Greece is a main geographical point of entry in Europe for refugees, but epidemiological data on scabies in this population is scarce. We aimed to evaluate the epidemiology of scabies, including trends over the study period. Methodology/Principal findings Data were collected from June, 2016 to July, 2020, using the surveillance system of the Greek National Public Health Organization. Staff at health centers for refugees/asylum seekers compiled daily reports on scabies and other infectious diseases. Observed proportional morbidity for scabies was calculated using consultations for scabies as a proportion of total consultations. There were a total of 13118 scabies cases over the study period. Scabies was the third most frequently observed infectious disease in refugees/asylum seekers population after respiratory infections and gastroenteritis without blood in the stool. The scabies monthly observed proportional morbidity varied between 0.3% (August 2017) to 5.6% (January 2020). Several outbreaks were documented during the study period. An increasing number of cases was observed from October 2019 until the end of the study period, with a peak of 1663 cases in January 2020, related to an outbreak at one center. Spearman correlation test between the number of reported scabies cases and time confirmed an increasing trend (ρ=0.67). Conclusions/Significance Scabies is one of the most frequently reported infectious diseases by health care workers in refugee/asylum seekers centers in Greece. Consultations for scabies increased over time and there were several outbreaks. The current surveillance system effectively detects new cases in an early stage. Public health interventions, including mass drug administration, should be considered to reduce the burden of scabies in refugee/migrant populations.

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Utility of a Syndromic Surveillance System to Identify Disease Outbreaks with Reportable Disease Data

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v6i1.5197 ◽

2014 ◽

Vol 6 (1) ◽

Author(s):

Carrie Eggers ◽

Janet Hamilton ◽

Richard Hopkins

Keyword(s):

Infectious Diseases ◽

Positive Predictive Value ◽

Predictive Value ◽

Surveillance System ◽

Syndromic Surveillance ◽

Disease Outbreaks ◽

Syndromic Surveillance System ◽

Using Data

The sensitivity and predictive value of a surveillance system (ESSENCE-FL) originally designed for syndromic data to identify possible outbreak activity using data from a reportable disease system was examined. ESSENCE-FL-generated alerts were compared with confirmed outbreak activity for different infectious diseases over a 52-week period. Results showed that although overall sensitivity of the system to detect outbreak activity was fairly low, the positive predictive value was relatively high. This evaluation concludes that the application of reportable disease data within the ESSENCE-FL syndromic surveillance system is useful for prompting users of possible outbreak activity that warrants further inquiry.

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