ISDS Conference

Numerous studies have demonstrated a causal relationship between human papillomavirus (HPV) and cervical cancer1. By 2007 two vaccines targeting HPV were available in the United States. Both vaccines have shown close to 100% efficacy against HPV types 16 and 18, the cause of 70% of all cervical cancers2. It is hypothesized that with routine vaccination the prevalence of HPV and HPV-associated cancers should decline3. A need exists for surveillance with national coverage2. The purpose of this study is to present a method to estimate rate of change of high-risk HPV in the United States since 2004 in women using national reference laboratory data.

Objective

To establish and evaluate an HPV surveillance protocol and determine the rate of change of high-risk HPV in the United States since 2004 using archived reference laboratory data.

The importance of providing information on epidemic prone diseases in a timely and complete manner cannot be over-emphasized. In many countries WDSS form a core component of national health system notification and response plans. Countries are required to establish WDSS for diseases that have demonstrated ability to cause serious public health impact and spread rapidly across geographic regions. Ministries of Health, the World Health Organisation (WHO) and other sector ministries rely on accurate and timely information to ensure an effective response. Zimbabwe MOHCW's WDSS is a critical component of the health management information system (HMIS). At least fourteen diseases and public health events that include non-specific diarrheal disease, cholera, malaria, vaccine preventable diseases, snake and dog bites have been reported through the system. Due to an unstable macro-economic environment, Zimbabwe's WDSS has struggled with incomplete and delayed reporting from facilities to the district and national level. According to WHO both timeliness and completeness of data were oscillating below 40% since 2005 through 2011. The MOHCW has measured timeliness as a proportion of facility reports received at the national office every Wednesday, completeness of the national report as a proportion of facilities contributing to the report. Rural facilities have reported challenges in transmitting data to the next administrative level. In December 2010, only 8.8% of rural health facilities had a functional fixed-line telephone and only 11.3% had a functional VHF radio. We document the processes in revitalizing the Zimbabwe, MOHCW's WDSS in the period 2009 -2013.

Objective

Documentation of the processes in revitalizing the Zimbabwe, Ministry of Health and Child Welfare (MOHCW)'s weekly disease surveillance system (WDSS) in the period 2009 -2013.

Civil Registration System (CRS) in India has been in vogue for more than 100 years now. The Registration of Births and Deaths Act, 1969 came into force in 1970. Even after 4 decades of the enactment of the Act, there are wide inter-state and intra-state variations. Our study is on Andhra Pradesh (AP), a South Indian state with a population of 84.6 million (Census of India, 2011) wherein the birth and death registrations varies from 23.2% - 148.6% registrations. We conducted an analysis of four (2007 - 2010) years civil registration data of AP.

Objective

1. To assess the district wise reporting and registrations of births and deaths in AP from 2007 - 2010. 2. To make an urban vs. rural comparison of proportions of these registrations. 3. To identify factors influencing civil registration in AP and steps for strengthening CRS.

In 2003, the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia estimated that approximately 1 million people in the United States were living with HIV/AIDS, and that approximately 25% these were undiagnosed and unaware of their HIV infection. For many such patients the emergency department may be the only part of the health care system that is utilized. In 2006, the CDC revised their recommendations for HIV testing in a variety of care settings including the emergency department (ED). Early identification and treatment improves survival for patients with HIV. Earlier testing programs including those provided in the ED may lead to earlier detection and further reduction in the transmission of HIV in the United States. (1,2,3,4,5) High risk patients should recieve screening for HIV and those patients who have a lab test for GC/chlamydia represent a high risk patient popualtion.(4) While the ED is a frequent health care access point for patients seeking evaluation for sexually transmitted diseases, ED providers may not be following guidlines for HIV testing in high risk patients.

Objective

To assess compliance with CDC and USPSTF guidelines for HIV testing in a regional cohort of emergency departments.

In 2003, the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia estimated that approximately 1 million people in the United States were living with HIV/AIDS, and that approximately 25% these were undiagnosed and unaware of their HIV infection. For many such patients the emergency department may be the only part of the health care system that is utilized. In 2006, the CDC revised their recommendations for HIV testing in a variety of care settings including the emergency department (ED). Early identification and treatment improves survival for patients with HIV. Earlier testing programs including those provided in the ED will lead earlier detection and further reduction in the transmission of HIV in the United States. (1,2,3) The analysis was focused on ED providersÕ knowledge and attitudes towards routine HIV testing, perceived barriers to HIV testing.

Objective:

To evaluate ED staff attitudes and potential barriers towards ED based POC HIV testing in an urban academic ED prior to implementing an ED based POC HIV test.

The U.S. Defense Threat Reduction Agency (DTRA) is funding multiple development efforts directed at enhanced platforms to support bio-surveillance analysts under their Bio-surveillance Ecosystem (BSVE) program. These efforts include well-integrated user interface systems and advanced algorithmic concepts to facilitate analysis of diverse, pertinent data sources including traditional bio-surveillance data sources as well as social media inputs. A central challenge in this development effort is a practical, effective, method to test these prototype systems. This presentation discusses a simulation-based testbed to allow quantitative evaluation of analytical methods through controlled injection of simulated outbreak-related information into test data streams.

Objective:

To develop a software toolset to serve as a flexible test environment for bio-surveillance systems by injecting controlled, simulation-based, data modifications into a variety of traditional and non-traditional bio-surveillance sources.

Brucellosis is one of the world'•s most widespread zoonosis. It is caused by gram-negative bacilli of the genus Brucella.It is a risk to those occupationally exposed to animals such as farmers, veterinarians, laboratorians and butchers and to the public through the consumption of contaminated unprocessed milk, milk products and meats.The epidemiology of Brucella infections involves complex mechanisms which vary according to the disease determinants. Previous studies in Kenya have reported a prevalence range of between 5% - 45% in livestock as well as over 20% in humans in selected regions1. Therefore, risk factors observed in a particular agro-ecological region cannot easily be extrapolated to another area with different ecological settings and husbandry practices. A strategy for brucellosis control would greatly benefit from detailed knowledge of local epidemiology. The available data on brucellosis is not adequate enough to inform an effective control process. Decision makers frequently apply different strategies according to the prevalence and epidemiology of the disease. People who interact with livestock on a regular basis are thought to be at an increased risk of contracting zoonoses including Brucellosis. Previous studies on Brucellosis have focused either on human or animal disease. The current study simultaneously investigated the linkage in sero-prevalence between humans and their animals within the same household at the same time.

Objective

We determined the sero-prevalence and risk factors for brucellosis in humans and their animals in Kajiado and Kiambu Counties of Kenya. We also examined the linkage between the sero-status of humans and that of their livestock.

The National Strategy for Biosurveillance defines biosurveillance as 'the process of gathering, integrating, interpreting, and communicating essential information related to all-hazards threats or disease activity affecting human, animal, or plant health to achieve early detection and warning, contribute to overall situational awareness of the health aspects of an incident, and to enable better decision-making at all levels.' However, the strategy leaves unanswered how 'essential information' is to be identified and integrated, or what the metrics qualify information as being 'essential'. Multi-Attribute Utility Theory (MAUT), a type of multi-criteria decision analysis, provides a structured approach that can offer solutions to this problem. While the use of MAUT has been demonstrated in a variety of fields, this method has never been applied to decision support in biosurveillance. We have developed a decision support analytic framework using MAUT that can facilitate identifying data streams for use in biosurveillance. We applied this framework to the problem of evaluating data streams for use in a global infectious disease surveillance system.

Objective

To describe how multi-criteria decision analysis can be applied to identifying essential biosurveillance information and demonstrate feasibility by applying it to prioritize data streams.

Monitoring trends of respiratory illnesses via syndromic surveillance in SC is performed on a daily basis. SC Syndromic Surveillance primarily utilizes emergency department data, and provides situational awareness regarding broad syndrome categories among hospitals in the state. Respiratory illnesses represent a significant public health burden, causing the second highest number of outbreaks reported in SC. Since syndromic surveillance can potentially serve as an earlier indicator of outbreaks,1 it is beneficial to assess seasonality of respiratory illnesses to identify illness clusters early to mobilize a rapid response.

Objective

To assess the temporal patterns of respiratory illnesses in South Carolina (SC) using syndromic surveillance emergency department (ED) data.

During the past decade, public health practitioners have implemented various new syndromic and other advanced surveillance systems to supplement their existing laboratory testing and disease surveillance toolkit. While much of the development and widespread implementation of these systems had been supported by public health preparedness funding, the reduction of these monies has greatly constrained the ability of public health agencies to staff and maintain these systems. The appearance of H3N2v and other novel influenza A viruses, requires agencies to carefully choose which systems will provide the most cost-effective data to support their public health practice. The global emergence of influenza A H7N9, Middle East Respiratory Syndrome Coronavirus (MERS-CoV), and other viruses associated with high mortality, emphasize the importance of maintaining vigilance for the presence of emerging disease.

Objective

To review approaches used by public health agencies for alerting health care providers and enhancing surveillance systems to identify the presence of novel respiratory disease and to characterize their recent experience in searching for globally emerging viruses.