Evaluation of Syndromic Surveillance

Informal surveillance systems like HealthMap are effective at the early detection of outbreaks. However, reliance on informal sources such as news media makes the efficiency of these systems vulnerable to newsroom constraints, namely high-profile disease events drawing reporting resources at the expense of other potential outbreaks and diminished staff over weekends and holidays. To our knowledge, this effect on informal or syndromic surveillance systems has yet to be studied.

Objective

Reporting about large public health events may reduce effective disease surveillance by syndromic or informal surveillance systems. The goal is to determine to what extent this problem exists and characterize situations in which it is likely to occur.

The Biological Threat Reduction Program (BTRP) of the U.S. Defense Threat Reduction Agency (DTRA) delivers interventions to enhance surveillance of especially dangerous pathogens of both humans and animals within countries of the former Soviet Union. The program targets the different stages at which threats or their impact can be reduced, for example via i) the reduction of exposure to threats, or ii) measures for the containment of the threat. The program delivers training on surveillance-related subjects through regular events attended by representatives of the Ministry of Agriculture of Uzbekistan (UZ). This provides an opportunity to capture data and conduct simple interventions on specific subjects amenable to basic evaluation. Given the sensitive nature of pathogen-specific data, we focus on non-disease-specific interventions leading to the reduction of exposure to and release of any given hazard. Here we present an opportunistic approach for capturing data, at no additional cost, to assess i) baseline awareness of on-farm biosecurity measures among UZ veterinary officials and ii) the impact of training on their awareness of biosecurity. We also discuss the conceptual design of a study to assess on-farm biosecurity practices in UZ.

Objective

To describe approaches to the evaluation of surveillance-related efforts in resource-limited countries. Here we present an opportunistic approach to measure the success of efforts to improve on-farm biosecurity in Uzbekistan, leading to a reduction of generic threats to animal disease transmission.

Syndromic surveillance of health care data such as the International Classification of Diseases, Ninth Revision (ICD-9), codes related to Influenza-Like-Illness (ILI), was used to track the progression of the 2009 Fall Novel H1N1 Outbreak in the Madison area. Early studies focused on prediction of an outbreak, however further investigation of patient resource utilization would be helpful in developing an action plan for addressing community and patient needs during future outbreaks. There is a paucity of research comparing emergency department (ED) and urgent care utilization rates during the 2009 Novel H1N1 Pandemic, though there is regional data suggesting that urgent care centers bore a larger portion of the burden of H1N1 influenza than emergency departments. Furthermore, one group found that ILI related phone calls to urgent care centers predicted influenza outbreak at least one week ahead of peaks in the ILI hospital care consultation rates. ED data on its own has proven useful for public health disease surveillance and many studies group urgent care and ED care together. The literature is lacking subgroup analysis of these two very different care environments. Understanding the correlation between urgent care and ED utilization rates will provide a more in depth understanding of the stress that the 2009 Fall Novel H1N1 placed on community resources in our geographic region.

Objective

To compare the proportion of patients presenting with ILI to urgent care centers versus the ED during the 2009 Fall Novel H1N1 Outbreak.

Cardiothoracic surgery quality improvement is a core value of healthcare provision. In order to improve quality of care, information on key indicators needs to be systematically collected and maintained.In 2006, thecardiothoracic department at AgaKhan University developed an infrastructure that would enable us to answer the more challenging research queries in cardiac surgery practice. The resulting electronic cardiothoracic database is based on the European Association of Cardiothoracic Surgeons database and the Society of Thoracic Surgeons database.While, it is currently used only at Aga Khan University, it has the potential to become a multicenter database.

Objective

To assess the impact of database development and maintenance on clinical practice and quality of care.

Distribute is a national emergency department syndromic surveillance project developed by the International Society for Disease Surveillance (ISDS) for influenza-like-illness (ILI) that integrates data from existing state and local public health department surveillance systems. The Distribute is a national emergency department syndromic surveillance project developed by the International Society for Disease Surveillance (ISDS) for influenza-like-illness (ILI) that integrates data from existing state and local public health department surveillance systems. The Distribute project provides graphic comparisons of both ILI-related clinical visits across jurisdictions and a national picture of ILI. Unlike other surveillance systems, Distribute is designed to work solely with summarized (aggregated) data which cannot be traced back to the un-aggregated 'raw' data. This and the distributed, voluntary nature of the project create some unique data quality issues, with considerable site to site variability. Together with the ISDS, the University of Washington has developed processes and tools to address these challenges, mirroring work done by others in the Distribute community.

Objective

The goal of this session will be to briefly present two methods for comparing aggregate data quality and invite continued discussion on data quality from other surveillance practitioners, and to present the range of data quality results across participating Distribute sites.

Modern public health surveillance systems have great potential for improving public health. However, evaluating the performance of surveillance systems is challenging because examples of baseline disease distribution in the population are limited to a few years of data collection. Agent-based simulations of infectious disease transmission in highly detailed synthetic populations can provide unlimited realistic baseline data.

Objective

To create, implement, and test a flexible methodology to generate detailed synthetic surveillance data providing realistic geo-spatial and temporal clustering of baseline cases.

One goal of the Biological Threat Reduction Program of the US Defense Threat Reduction Agency is the enhancement of surveillance of especially dangerous pathogens of both humans and animals within countries of the former Soviet Union. One of the diseases of interest to the program is brucellosis, which is a life-threatening condition and constitutes a major health and economic challenge around the world. This is also true for Uzbekistan (UZ), where brucellosis is endemic in a number of regions. In the Samarqand region of UZ, for example, studies have reported a 9.3%, and 3.6% seroprevalence for humans and farm animals respectively.The lack of awareness about brucellosis in at-risk populations, shepherds, veterinarians and people who handle raw milk, is believed to significantly contribute to the spread of disease from animals to humans. Here we suggest mechanisms to evaluate awareness about the disease and the impact of an educational intervention in at-risk groups.

Objective

To outline the mechanism of a pilot educational brucellosis prevention program among selected high- risk groups in an endemic region of Uzbekistan.

In the last decade, the scope of public health (PH) surveillance has grown, and biosurveillance capacity has expanded in Duval County. In 2004, the Duval County Health Department (DCHD) implemented a standalone syndromic surveillance (SS) system which required the manual classification and entry of emergency department (ED) chief complaints by hospital staff. At that time, this system, in conjunction with other external systems (e.g. CDC ILInet, FluStar, NRDM) were used to conduct surveillance for health events. Recommendations from a 2007 ISDS panel were used to strengthen surveillance within Duval County. Later that year, the Florida DOH moved to a statewide SS system and implemented ESSENCE which has been expanded to include 1) ED record data from 176 hospitals (8 within Duval County); 2) Reportable disease case records from Merlin; 3) Florida Poison Information Network consultations; and, 4) Florida Office of Vital Statistics death records (1). ESSENCE has subsequently become a platform for rapid data analysis, mapping, and visualization across several data sources (1). As a result, ESSENCE has improved business processes within DCHD well beyond the initial scope of event detection. These improvements have included 1) expansion of the ability to create visualizations (e.g. epi-curves, charts, and maps); 2) reduction in the time required to produce reports (e.g. newsletters, media responses); 3) reduction in staff training needs; and 4) augmentation of epidemiology processes (e.g. active case finding, emergency response, quality improvement (QI)), and closing the PH surveillance loop.

Objective

This paper reviews the evolution of biosurveillance in Duval County, FL and characterizes the subsequent improved execution of epidemiology functions as a result of the implementation of the Early Notification of Community-based Epidemics (ESSENCE) system.

Outbreaks of Avian influenza (AI) in poultry were first reported in Nigeria in 2006 (1). The only human case was reported in 2007 (1). The epizootics of AI among poultry and wild birds and subsequent risk to human health highlighted the need to detect influenza viruses with pandemic potential and for establishment of Influenza Sentinel Surveillance (ISS) System. This is to aid the description of the the epidemiology and burden of seasonal human influenza, to provide information for public health decision making, for program planning and preparedness and to serve as an early warning for outbreaks of Avian or pandemic flu. Also, to characterize and monitor trends in illnesses and deaths attributable to SARI (2). Lagos State University Teaching Hospital (LASUTH) is one of the 4 sites for ISS in Nigeria and started functioning in 2009.

Objective

To analyze the Lagos site of the National Influenza Sentinel Surveillance (NISS) system and to determine the viruses responsible for Influenza-like illnesses (ILI) and Severe Acute Respiratory Infection (SARI).

This study assessed the performance of the core function activities (CFA) of the Communicable Disease Surveillance system and response (CDSs) existing in Gazera State. The first assessment of disease surveillance being conducted in the area during 2008-2009. The assessment findings facilitate the identification of exact areas for improvement and consequently was used in surveillance system improvement as well as a baseline for future reform plans (1). Communicable diseases in Gazera State continue to be the leading cause of morbidity and mortality (2). The State was one of the states that experienced epidemics of serious diseases such as Acute Watery Diarrhoea, Cerebro-spinal Meningitis, Rift valley Fever..etc. During the last decade, the state has witnessed more than twenty epidemics resulting in high morbidity and mortalities, as reported in 2006-2007(1). This was coupled with struggling health services and health information system and this was stated in the Federal Ministry of Health (FMOH) annual report 2008 (2).

Objective

The aim of this study is to assess the impact of staff qualification and training on the performance of Core Function Activities (CFA) Of Communicable Disease Surveillance System in Gazera State, Sudan.