scholarly journals A regional approach for the influenza surveillance in France

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Marc Ruello ◽  
Camille Pelat ◽  
Céline Caserio-Schönemann ◽  
Anne Fouillet ◽  
Isabelle Bonmarin ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
National Level ◽  
Health Agency ◽  
Data Sources ◽  
Outbreak Detection ◽  
Detection Methods ◽  
Influenza Surveillance ◽  
Time Step ◽  
Statistical Results

ObjectiveTo describe the results of the new organization of influenzasurveillance in France, based on a regional approach.IntroductionIn France, until winter 2014-2015, management and preventiveactions for the control of the flu epidemic were implemented whenthe national incidence of influenza-like illness (ILI) consultationsin general practice was over an epidemic threshold. The 2014-2015influenza epidemic had a major public health impact, particularly inthe elderly, and caused a severe overloading of the health care system,in particular emergency departments (ED) [1]. The epidemic alertemitted by the French National Public Health Agency at the nationallevel was too late for the hospitals to prepare themselves in manyregions.After a national feedback organized in April 2015 with allpartners involved in influenza surveillance and management, it wasrecommended to improve influenza surveillance in France following3 axes: 1) regionalize surveillance so that healthcare structures canadapt to the particular situation of their region; 2) use a pre-epidemicalert level for better anticipating the outbreak; 3) use multiple datasources and multiple outbreak detection methods to strengthen thedetermination of influenza alert level.MethodsA user-friendly web application was developed to provide commondata visualizations and statistical results of outbreak detectionmethods to all the epidemiologists involved in influenza surveillanceat the national level or in the 15 regional units of our agency [2].It relies on 3 data sources, aggregated on a weekly time step: 1) theproportion of ILI among all coded attendances in the ED participatingto the OSCOUR Network [3] ; 2) the proportion of ILI among allcoded visits made by emergency general practitioners (GPs) workingin the SOS Médecins associations [3]; 3) the incidence rate of ILIestimated from a sample of sentinel GPs [4].For each region each week, 3 statistical outbreak detection methodswere applied to the 3 data sources, generating 9 results that werecombined to obtain a weekly regional influenza alarm level. Basedon this alarm level and on other information (e.g.virological data),the epidemiologists then determined the epidemiological status ofeach region as either 1) epidemic-free, 2) in pre/post epidemic or 3)epidemic.The R software was used for programming algorithms and buildingthe web interface (package shiny).ResultsThe epidemiological status of influenza at the regional level wascommunicated through maps published in the weekly influenzareports of the Agency throughout the surveillance season [5].In week 2016-W03, Brittany was the first French region to declarethe influenza epidemic, with nine other regions in pre-epidemic alert.The epidemic then spread over the whole mainland territory. The peakof the epidemic was declared in week 11, the end in week 16.ConclusionsThis regional multi-source approach has been made possible bythe sharing of data visualizations and statistical results through a webapplication. This application helped detecting early the epidemicstart and allowed a reactive communication with the regionalhealth authorities in charge of the organization of health care, themanagement and the setting up of the appropriate preventivemeasures.

scholarly journals Improving regional influenza surveillance through a combination of automated outbreak detection methods: the 2015/16 season in France

2017 ◽  
Vol 22 (32) ◽  
Author(s):  
Camille Pelat ◽  
Isabelle Bonmarin ◽  
Marc Ruello ◽  
Anne Fouillet ◽  
Céline Caserio-Schönemann ◽  
...  
Keyword(s):  
Public Health ◽  
General Practitioners ◽  
National Level ◽  
Health Agency ◽  
Public Health Agency ◽  
Data Sources ◽  
Outbreak Detection ◽  
Detection Methods ◽  
Influenza Epidemic ◽  
National Public Health

The 2014/15 influenza epidemic caused a work overload for healthcare facilities in France. The French national public health agency announced the start of the epidemic – based on indicators aggregated at the national level – too late for many hospitals to prepare. It was therefore decided to improve the influenza alert procedure through (i) the introduction of a pre-epidemic alert level to better anticipate future outbreaks, (ii) the regionalisation of surveillance so that healthcare structures can be informed of the arrival of epidemics in their region, (iii) the standardised use of data sources and statistical methods across regions. A web application was developed to deliver statistical results of three outbreak detection methods applied to three surveillance data sources: emergency departments, emergency general practitioners and sentinel general practitioners. This application was used throughout the 2015/16 influenza season by the epidemiologists of the headquarters and regional units of the French national public health agency. It allowed them to signal the first influenza epidemic alert in week 2016-W03, in Brittany, with 11 other regions in pre-epidemic alert. This application received positive feedback from users and was pivotal for coordinating surveillance across the agency’s regional units.

scholarly journals Cross-national comparisons of health indicators require standardized definitions and common data sources

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Hanna Tolonen ◽  
Jaakko Reinikainen ◽  
Päivikki Koponen ◽  
Hanna Elonheimo ◽  
Luigi Palmieri ◽  
...  
Keyword(s):  
Health Care ◽  
National Level ◽  
International Health ◽  
Health Indicators ◽  
Data Sources ◽  
Similar Data ◽  
Prevention And Health Promotion ◽  
Using Data ◽  
Obesity Hypertension

Abstract Background Health indicators are used to monitor the health status and determinants of health of the population and population sub-groups, identify existing or emerging health problems which would require prevention and health promotion activities, help to target health care resources in the most adequate way as well as for evaluation of the success of public health actions both at the national and international level. The quality and validity of the health indicator depends both on available data and used indicator definition. In this study we will evaluate existing knowledge about comparability of different data sources for definition of health indicators, compare how selected health indicators presented in different international databases possibly differ, and finally, present the results from a case study from Finland on comparability of health indicators derived from different data sources at national level. Methods For comparisons, four health indicators were selected that were commonly available in international databases and available for the Finnish case study. These were prevalence of obesity, hypertension, diabetes, and asthma in the adult populations. Our evaluation has three parts: 1) a scoping review of the latest literature, 2) comparison of the prevalences presented in different international databases, and 3) a case study using data from Finland. Results Literature shows that comparability of estimated outcomes for health indicators using different data sources such as self-reported questionnaire data from surveys, measured data from surveys or data from administrative health registers, varies between indicators. Also, the case study from Finland showed that diseases which require regular health care visits such as diabetes, comparability is high while for health outcomes which can remain asymptomatic for a long time such as hypertension, comparability is lower. In different international health related databases, country specific results differ due to variations in the used data sources but also due to differences in indicator definitions. Conclusions Reliable comparison of the health indicators over time and between regions within a country or across the countries requires common indicator definitions, similar data sources and standardized data collection methods.

FluHMM: A simple and flexible Bayesian algorithm for sentinel influenza surveillance and outbreak detection

2018 ◽  
Vol 28 (6) ◽  
pp. 1826-1840 ◽  
Author(s):  
Theodore Lytras ◽  
Kassiani Gkolfinopoulou ◽  
Stefanos Bonovas ◽  
Baltazar Nunes
Keyword(s):  
Public Health ◽  
Public Health Practice ◽  
R Package ◽  
Sentinel Surveillance ◽  
Surveillance Data ◽  
Outbreak Detection ◽  
Influenza Surveillance ◽  
Bayesian Algorithm ◽  
Public Health Action ◽  
Health Action

Timely detection of the seasonal influenza epidemic is important for public health action. We introduce FluHMM, a simple but flexible Bayesian algorithm to detect and monitor the seasonal epidemic on sentinel surveillance data. No comparable historical data are required for its use. FluHMM segments a typical influenza surveillance season into five distinct phases with clear interpretation (pre-epidemic, epidemic growth, epidemic plateau, epidemic decline and post-epidemic) and provides the posterior probability of being at each phase for every week in the period under surveillance, given the available data. An alert can be raised when the probability that the epidemic has started exceeds a given threshold. An accompanying R package facilitates the application of this method in public health practice. We apply FluHMM on 12 seasons of sentinel surveillance data from Greece, and show that it achieves very good sensitivity, timeliness and perfect specificity, thereby demonstrating its usefulness. We further discuss advantages and limitations of the method, providing suggestions on how to apply it and highlighting potential future extensions such as with integrating multiple surveillance data streams.

scholarly journals The preventive health care act and the future forum public health in Germany

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
F De Bock ◽  
Y Shajanian Zarneh ◽  
S Matusall
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Promotion ◽  
Health System ◽  
Public Health System ◽  
National Level ◽  
Preventive Health Care ◽  
Preventive Health ◽  
Life Course Perspective ◽  
Bottom Up

Abstract The public health system in Germany, similar to education and cultural affairs, is characterised by the federal structure. It is mainly regulated and decided at the state and municipal level, and not primarily at the national level. The preventive health care act (The Act to Strengthen Health Promotion and Preventive Health Care) (2015) underlines the setting-based approach of health promotion and takes a life course perspective by recommending goals of growing up healthy, living and working healthy and healthy ageing. The act formulates broad recommendations for prevention and health promotion at the national level, that in turn take on concrete forms in mandatory framework agreements at the federal state level with uniform health objectives. On the whole, the key objective of the act is to improve preventive health care and general health promotion. Also the financing of the act by the mandatory health insurance is a special feature and at the same time a novelty. At the same time a bottom-up project has been recently launched with the aim to develop a public health strategy in Germany. The project future forum public health (ZfPH) is a platform for public health professionals, researchers and students following incorporated concepts of policy analysis as well as methods that will ensure participation, transparency and transferability of the results into policy and practice. Over the next three years, ZfPH’s steering group will moderate a participatory process, including stakeholders from public health practice and research as well as policy makers. In an evidence-based approach, they will first analyse the current state of Germany’s public health system before developing concrete policy recommendations for a coherent and efficient public health system. The presentation will give a short overview over the German public health system and the preventive health care act, its structure and the achievements as well as the bottom-up project future forum public health.

scholarly journals Assessment of Nutrition Information System Using Health Metrics Network Framework

2015 ◽  
Vol 10 (1) ◽  
pp. 1 ◽  
Author(s):  
Mochamad Iqbal Nurmansyah ◽  
Catur Rosidati ◽  
Riastuti Kusuma Wardani ◽  
Badra Al-Aufa
Keyword(s):  
Health Care ◽  
Information System ◽  
Vitamin A ◽  
National Level ◽  
Health Information System ◽  
Health Resources ◽  
Health Agency ◽  
Integrated Health Care ◽  
Nutrition Information ◽  
Integrated Health

Nutrition Information System (NIS) developed by Heath Ministry’s Nutritional Development Directorate since 2011 covers data of toddler assessment in integrated health care, malnutrition case, coverages of Fe tablet among pregnant mothers, iodized salt consumption, vitamin A distribution and exclusive breastfeeding. This study aimed to assess NIS performance in South Tangerang City Health Agency using WHO’s Health Metrics Network 2008 framework. NIS is national level information system with gradual reporting mechanism starting from 508 districts/cities to 34 provinces ended at national level. Eight districts/cities over Banten Province have conducted NIS. This study had six informants namely nutrition section, health resources and health information system section, two nutrition duties and two integrated health care workers. Data was collected on January - April 2013 using interview, observation and document analysis guidelines. Data analysis used interpretation analysis. The result showed no any policy and training implemented regarding nutrition surveillance. Monitoring activity was already conducted. Facilities were adequate, but the maintenance was deficient. There are six nutritional development indicators according to MDGs. Data grouping and dictionaries were available. Data reporting was conducted every month. Graphics and maps were used for presenting data. The data served was used for monitoring and making a decision on nutritional development programs at integrated health care, primary health care and health agency levels. Generally, NIS implementation in South Tangerang City. Health agency was already adequate.Penilaian Sistem Informasi Gizi Menggunakan Kerangka Health MetricsNetworkSistem informasi gizi (Sigizi) dikembangkan oleh Direktorat Bina Gizi Kementerian Kesehatan sejak 2011. Data Sigizi mencakup data penimbangan balita di posyandu, kasus gizi buruk, cakupan pemberian tablet Fe pada ibu hamil, konsumsi garam beryodium, pemberian vitamin A, dan ASI eksklusif. Penelitian ini bertujuan untuk mengukur kinerja pengelolaan Sigizi di Dinas Kesehatan Kota Tangerang Selatan menggunakan kerangka Health Metrics Network yang dikeluarkan oleh WHO tahun 2008. Sigizi merupakan sistem informasi yang diaplikasikan pada tingkat nasional dengan mekanisme pelaporan berjenjang, dari 508 kabupaten/kota menuju 34 provinsi dan bermuara di tingkat nasional. Di Provinsi Banten, terdapat delapan kabupaten/kota yang menjalankan Sigizi. Informan penelitian berjumlah enam orang, yaitu seksi gizi, seksi sumber daya kesehatan dan sistem informasi kesehatan, dua tenaga pelaksana gizi, dan dua kader posyandu. Pengumpulan data dilakukan Januari – April 2013 menggunakan pedoman wawancara, observasi, dan telaah dokumen. Analisis interpretasi digunakan dalam menganalisis data. Hasil penelitian menunjukan belum ada kebijakan serta pelatihan mengenai pengawasan gizi. Kegiatan pemantauan telah dilakukan. Sarana dinilai cukup, namun terdapat kekurangan dalam upaya perawatannya. Terdapat enam indikator dalam pembinaan gizi yang mengacu pada MDGs. Terdapat pengelompokan dan kamus data. Pelaporan data dilakukan setiap bulan. Grafik dan peta digunakan untuk menyajikan data. Data yang tersedia digunakan untuk pemonitoran dan pengambilan keputusan dalam kegiatan pembinaan gizi, baik di tingkat posyandu, puskesmas maupun dinkes. Secara umum, pelaksanaan Sigizi di Dinas Kesehatan Kota Tangerang Selatan telah memadai.

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
Keyword(s):  
Public Health ◽  
Hospital Admissions ◽  
Age Distribution ◽  
Age Groups ◽  
Health Indicators ◽  
Older Age ◽  
Outbreak Detection ◽  
Detection Methods ◽  
Surveillance Systems ◽  
Wide Range

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.

scholarly journals Economic Burden of Public Health Care Was Higher Than That of Hospitalization and Treatment Associated With COVID-19 in China

2020 ◽  
Author(s):  
Xiaohua Liang ◽  
Lun Xiao ◽  
Xue-Li Yang ◽  
Xue-Fei Zhong ◽  
Peng Zhang ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
National Level ◽  
Emerging Infectious Diseases ◽  
Medical Costs ◽  
Public Health Care ◽  
Chinese Government ◽  
Direct Medical Costs ◽  
Epidemiological Surveys ◽  
The Cost

Abstract Background: During the coronavirus disease 2019 (COVID-19) pandemic, it is essential to evaluate the socioeconomic burden imposed on the Chinese health care system.Methods: We prospectively collected information from the Center for Disease Control and Prevention and the designated hospitals to determine the cost of public health care and hospitalization due to COVID-19. We estimated the resource use and direct medical costs per confirmed case and the costs associated with public health care per thousand people at the national level.Results: The average costs per case for specimen collection and nucleic acid testing (NAT) were $29.49 and $53.44, respectively, while the average cost of NAT for high-risk populations was $297.94 per capita. The average costs per thousand people for epidemiological surveys, disinfectant, health education and centralized isolation were $49.54, $247.01, $90.22 and $543.72, respectively. A single hospitalization for COVID-19 in China cost an average of $3,792.69 ($2,754.82-$5,393.76) in direct medical costs incurred only during hospitalization, while the total costs associated with hospitalization were estimated to have reached nearly $31,229.39 million in China as of 20 May 2020. The cost of public health care ($6.81 billion) was 20 times that of hospitalization.Conclusions: This study highlights the magnitude of resources needed to control the COVID-19 pandemic and treat COVID-19 cases. Public health measures implemented by the Chinese government have been valuable with regard to reducing the infection rate and may be cost-effective ways to control emerging infectious diseases.

scholarly journals Cross-national Comparisons of Health Indicators Require Standardized Definitions and Common Data Sources

2021 ◽  
Author(s):  
Hanna Tolonen ◽  
Jaakko Reinikainen ◽  
Päivikki Koponen ◽  
Hanna Elonheimo ◽  
Luigi Palmieri ◽  
...  
Keyword(s):  
Health Care ◽  
National Level ◽  
International Health ◽  
Health Indicators ◽  
Data Sources ◽  
Similar Data ◽  
Prevention And Health Promotion ◽  
Using Data ◽  
Obesity Hypertension

Abstract Background Health indicators are used to monitor the health status and determinants of health of the population and population sub-groups, identify existing or emerging health problems which would require prevention and health promotion activities, help to target health care resources in the most adequate way as well as for evaluation of the success of public health actions both at the national and international level. The quality and validity of the health indicator depends both on available data and used indicator definition. In this study we will evaluate existing knowledge about comparability of different data sources for definition of health indicators, compare how selected health indicators presented in different international databases possibly differ, and finally, present the results from a case study from Finland on comparability of health indicators derived from different data sources at national level. Methods For comparisons, four health indicators were selected that were commonly available in international databases and available for the Finnish case study, were selected. These were prevalence of obesity, hypertension, diabetes, and asthma in the adult populations. Our evaluation has three parts: 1) a scoping review of the latest literature, 2) comparison of the prevalences presented in different international databases, and 3) a case study using data from Finland.Results Literature shows that comparability of estimated outcomes for health indicators using different data sources such as self-reported questionnaire data from surveys, measured data from surveys or data from administrative health registers, varies between indicators. Also, the case study from Finland showed that diseases which require regular health care visits such as diabetes, comparability is high while for health outcomes which can remain asymptomatic for a long time such as hypertension, comparability is lower. In different international health related databases, country specific results differ due to variations in the used data sources but also due to differences in indicator definitions.Conclusions Reliable comparison of the health indicators over time and between regions within a country or across the countries requires common indicator definitions, similar data sources and standardized data collection methods.

scholarly journals Can innovative digital collaborations help overcome barriers to intersectoral collaboration?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Nordström ◽  
B Kumar
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Systems ◽  
Local Level ◽  
National Level ◽  
Migrant Health ◽  
Intersectoral Collaboration ◽  
Professional Networks ◽  
Care Systems

Abstract Issue Health in all policies is desirable, but moving from the silos approach is a challenge for health care systems. New health policies require more cooperation and broader collaboration between governmental, private and volunteer sector, as well as across professions. Though it is key to implementation of national policies and long-term public health work at the local level, intersectoral collaboration remains elusive. Professionals working with public health and migrant health across Norway often work independently of each other and other sectors. Description of the Problem Evaluation of the Norwegian network for migrant friendly hospitals showed that with the opportunity to meet and share experiences, participants used the new knowledge and network in developing their practice and organisation of services. They experienced greater support to challenge status quo in their institutions. However, fear of making the network “too big to handle” is a barrier to creating intersectoral network. In a recent survey (2017), health personnel ask for digital solutions for finding resources and support in their practice to give better health care to immigrant patients. Results The newly (2020) knowledge HUB part of JAHEE actions brings stakeholders together at the local, regional and national level, ensuring access to the same knowledge, increase evidence based decisions among stakeholders when choosing interventions on the local, regional and national level, including sharing of good practices and promising initiatives at a national level so that they can be replicated. Lessons Professional networks that are coordinated and collaborative are important for development of services and implementation of measures for migrant health. However, expanding them across sectors and fields may create challenges. Combining sectoral networks with a common digital platform may overcome some of these challenges. Key messages Exploiting the potential of collaborative digital solutions may help overcome some barriers to intersectoral approach to migrant health. Coordinated collaborative professional networks can support the participants in developing their practice and organisation of services for migrants.

scholarly journals Outbreak Prediction: Aggregating Evidence Through Multivariate Surveillance

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Flavie Vial ◽  
Wei Wei ◽  
Leonhard Held
Keyword(s):  
Public Health ◽  
Animal Health ◽  
Surveillance Data ◽  
Data Sources ◽  
Outbreak Detection ◽  
Develop Model ◽  
Valuable Alternative ◽  
Detection Systems ◽  
Predictive Methods ◽  
Nature Experience

Since there is often different information contained in observations from different data sources, outbreak detection systems should be multivariate by nature. Experience from public health shows that, in reality they often fail to achieve acceptable sensitivity while retaining manageable false alert rates. A valuable alternative to classical "outbreak detection" is "outbreak prediction" based on suitably selected model. We think that such an approach is particularly promising for multivariate surveillance. We propose to use Swiss multivariate surveillance data to develop model-based predictive methods which can be used to inform decisions about animal health.

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