Michigan system for opioid overdose surveillance

Community rapid response may reduce opioid overdose harms, but is hindered by the lack of timely data. To address this need, we created and evaluated the Michigan system for opioid overdose surveillance (SOS). SOS integrates suspected fatal overdose data from Medical Examiners (MEs), and suspected non-fatal overdoses (proxied by naloxone administration) from the Michigan Emergency Medical Services (EMS) into a web-based dashboard that was developed with stakeholder feedback. Authorised stakeholders can view approximate incident locations and automated spatiotemporal data summaries, while the general public can view county-level summaries. Following Centers for Disease Control and Prevention (CDC) surveillance system evaluation guidelines, we assessed simplicity, flexibility, data quality, acceptability, sensitivity, positive value positive (PVP), representativeness, timeliness and stability of SOS. Data are usually integrated into SOS 1-day postincident, and the interface is updated weekly for debugging and new feature addition, suggesting high timeliness, stability and flexibility. Regarding representativeness, SOS data cover 100% of EMS-based naloxone adminstrations in Michigan, and receives suspected fatal overdoses from MEs covering 79.1% of Michigan’s population, but misses those receiving naloxone from non-EMS. PVP of the suspected fatal overdose indicator is nearly 80% across MEs. Because SOS uses pre-existing data, added burden on MEs/EMS is minimal, leading to high acceptability; there are over 300 authorised SOS stakeholders (~6 new registrations/week) as of this writing, suggesting high user acceptability. Using a collaborative, cross-sector approach we created a timely opioid overdose surveillance system that is flexible, acceptable, and is reasonably accurate and complete. Lessons learnt can aid other jurisdictions in creating analogous systems.

Correction to: Using a hepatitis B surveillance system evaluation in Fujian, Hainan, and Gansu provinces to improve data quality and assess program effectiveness, China, 2015

An amendment to this paper has been published and can be accessed via the original article.

An Evaluation of the Adverse Events Following Immunization Surveillance System: A Case of the Oral Cholera Vaccine Mass Campaign, Chimanimani and Chipinge Districts, Zimbabwe, 2019.

Background: Three cases of adverse events following immunization (AEFI), in Chimanimani and Chipinge districts, were notified during their oral cholera vaccine (OCV) mass campaigns post-Cyclone Idai. However, the coverage survey uncovered 93 AEFI cases. We determined the reasons for the AEFI surveillance system under-reporting and assessed performance of the systemMethods: We conducted a surveillance system evaluation using the updated CDC guidelines for surveillance system evaluation. Fifty-seven health workers and 50 community members were randomly selected from 39 health facilities. We reviewed completed AEFI reporting forms to check for data quality, simplicity, completeness, and timeliness of the system. We used questionnaires to determine HCWs and community’s knowledge on the operations of the surveillance system. We used a health facility checklist to assess the system’s stability. Data were analysed to generate means and frequencies. Three-point Likert scales were used to rate health worker knowledge on the AEFI system. Results: Reasons for under-reporting were community’s poor knowledge, perceiving adverse events as minor issues and fear of being blamed for causing adverse events by health workers. The community had poor knowledge with 27/50 (54%) answering at least one out of three questions correctly. The system had a low sensitivity of 3% and was unstable, 24/39 (62%) of the facilities relied on public transport.Conclusion: Community’s poor knowledge on AEFI, occurrence of mild adverse events and fear of being blamed led to under-reporting. The system was neither stable nor sensitive. Community sensitization on AEFI were thus improved.

The epidemiology of chlamydia, gonorrhoea and syphilis in Portugal: where do we go from now?

Chlamydia (CT), gonorrhoea (NG) and syphilis (TP) infections are rising and have an important burden in the EU/EEA. This study aims to describe the epidemiology of these infections in Portugal, between 2015 and 2018, in order to set a baseline for the recently created National Strategy for STI Control and to generate hypothesis on areas for improvement. We analysed data from the national system of epidemiological surveillance (SINAVE®) and described all probable and confirmed cases of CT, NG and TP notified in Portugal between January 1st, 2015 and December 31st, 2018.This reports the overall case evolution as well as specific characteristics of different groups. Throughout the analysed 4-year period there were 1267 cases of CT, 1917 of NG and 3240 of TP (probable and confirmed). Of CT cases, 70% (n = 891) occurred in males, 66.3% (n = 840) in people aged 18-35, 52.9% (n = 670) in heterosexuals and 42.9% (n = 543) in men who have sex with men (MSM). Of NG cases, 87.9% (n = 1686) were males, 90.8% (n = 1741) were <45 years-old and 51.2% (n = 982) were MSM. Of TP cases, 76.0% (n = 2462) were males, 64.8% (n = 2101) were <45 years-old, 41.1% (n = 1333) were heterosexuals and MSM accounted for 39.9% (n = 1294). The notified cases have doubled from 2015 to 2018 (1159 to 2354) and tripled in MSM (440 to 1312), with a 7.9, 4.1 and 1.6-fold increase in CT, NG and TP, respectively. For each infection, symptomatic cases contributed to 42.9% (CT), 14.6% (NG) and 81.9% (TP) of the overall. In similarity to European trends, CT, NG and TP infections seem to be rising in Portugal. Changes in patient behaviour, clinical practice, screenings, settings of diagnosis and notification should be further explored to better understand this trend, including clinical features. From our results, MSM and people aged <45 should be prioritised within the National Strategy for STI Control. A surveillance system evaluation could be considered for sensitivity and usefulness. Key messages The number of chlamydia, gonorrhoea and syphilis reported cases in Portugal raised in the four-year period between 2015 and 2018, with MSM accounting for 54.6% (1312/2403) of the cases in 2018. This sets up a baseline to guide the adoption of specific measures and the prioritisation of interventions. MSM should be given special attention when addressing new prevention strategies.

Measles surveillance system Evaluation in Benishangul Gumuz, Mandura woreda, Ethiopia in 2018

Objective The main objective of this study is to Evaluate measles surveillance system in Benishangul Gumuz, Mandura woreda, Ethiopia in 2018. Result The weekly reporting rates of the health facilities over the past 52 weeks of 2018 were >80% timeliness and completeness as show below by line graph for health posts. All the weekly surveillance reports were sent to the next level via report format and telephone. Mandura Woreda administration has made major progress in tackling the spread of measles. The overall structural set up of the surveillance system in creation of responsible unit /focal person of Public Health Emergency Management at each district and health facility level is good.