Mortality

Monitoring of long-term infectious disease mortality trends is of great value to national public health systems both in estimation of the efficacy of preventive programs, and in development of the new strategies of preventive measures. In the developed countries, there are a number of studies with long-term time series of infectious disease mortality analysis in epidemiological and historical aspects. Our research was based on the work by Armstrong GL, Conn LA and Pinner RW, 1999. Literature review revealed that such analysis has been never carried out in Ukraine up to now.

Objective: The aim of our work is to determine the main trends and structure in infectious disease mortality in Ukraine over the last 50 years.

The number of overdose deaths involving illicit opioids such as heroin and illicitly-manufactured fentanyl (IMF) is now higher than deaths involving prescription opioids. Adolescents misusing prescription opioids are more likely to use heroin. Although nonmedical use of prescription opioids (NUPO) among adolescents is decreasing, there is still relatively high prevalence of this behavior. Such high prevalence, along with the evolving epidemiology of the drug overdose epidemic as well as the association between NUPO and heroin use, signal that NUPO in adolescents is still an important issue. Understanding the interrelationships between NUPO and illicit opioid use in adolescents can inform prevention efforts. The purpose of this study is to: 1) present the magnitude of the drug overdose problem in adolescents, 2) compare the prevalence of heroin use and injection drug use (IDU) between students reporting NUPO and those not reporting NUPO, and 3) determine whether a dose-response relationship exists between these behaviors among adolescents. This information will be beneficial when focusing on adolescents at risk for heroin use by helping to determine whether any NUPO is associated with heroin use or if such risk is only noted at a higher frequency of NUPO behavior.

Objective: Given the evolving opioid overdose epidemic, we examined the interrelationships between nonmedical use of prescription opioids and illicit opioid use in adolescents.

Influenza is a serious disease that seasonality causes substantial but varying morbidity and mortality. In Taiwan, estimates of the influenza mortality burden were based on post-hoc analyses of national mortality statistics and not available until at least six months after the corresponding epidemic. Timely monitoring and early detection of influenza-associated excess mortality can guide antiviral or vaccine interventions and help healthcare capacity planning. Beginning April 2009, Taiwan Centers for Disease Control has been collaborating with the Department of Health Office of Statistics to develop an automated system for real-time pneumonia and influenza (P&I) mortality surveillance.

Objective 

To develop and evaluate a nationwide automated system for early detection of aberrations and real-time monitoring of P&I mortality in Taiwan.

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.

Beginning on March 13, 2011, ACDC experienced an unusual increase in reported bacterial meningitis cases in Los Angeles (LA) County. Early in the investigation, there were few epidemiological links between the cases. Three cases were homeless; two resided at the same Skid Row shelter in downtown LA. ACDC assessed its syndromic surveillance databases to help gauge the scope of the outbreak and detect potentially overlooked cases.

Objective

To describe the complementary usage of electronic emergency department (ED) data, Coroner deaths, and 911 dispatch call center data in a bacterial meningitis outbreak.

The mortality monitoring system was initiated in August 2009 during the influenza A(H1N1) pandemic. It is a collaboration between the Centre for Infectious Disease Control (CIb) and Statistics Netherlands. The system monitors nation-wide reported number of deaths (population: 16.8 million) from all causes, as cause of death information is not available real-time. Data is received from Statistics Netherlands by weekly emails.

Objective

Weekly numbers of deaths are monitored to increase the capacity to deal with unusual (disease) events such as pandemic influenza, other infections and non-infectious incidents. The monitoring information can potentially be used to track and estimate the impact of an outbreak on all cause mortality.

Crude mortality could be valuable for infectious disease surveillance if available in a complete and timely fashion. Syndromic surveillance with weekly deaths has been demonstrated to be useful in France. Such data can be of use for detecting, and tracking the impact, of unusual health events (e.g. pandemic influenza) or other unexpected or unknown events of infectious nature. To evaluate whether these aims can be achieved with crude mortality monitoring in the Netherlands, we investigated trends in death notifications and we tested whether retrospective crude mortality trends, at different days of delay, reflect known trends in infectious pathogens that are associated with death (such as influenza).

Objective

To evaluate the potential of mortality data in the Netherlands for real-time surveillance of infectious events.

Crude mortality could be valuable for infectious disease surveillance if available in a complete and timely fashion. Such data can be of used for detecting, and tracking the impact of unusual health events (e.g. pandemic influenza) or other unexpected or unknown events of infectious nature.

To evaluate whether these goals can be achieved with crude mortality monitoring in the Netherlands, a pilot study was set up in 2008 in which death counts were received from Statistics Netherlands. 

The aims of this pilot are: 1) Setting up communication and data transmission. 2) Calculating expected mortality counts (depending on the season) and a prediction interval. 3) Detecting deviations in mortality counts above the threshold. 4) Comparing such deviations (and lags hereof) with other public health information (such as sentinel influenza-like-illness surveillance, and web-based selfreported ILI). 4) Evaluating the additional value of such a system for infectious disease public health.

Objective

To evaluate the potential use of mortality data in the Netherlands for real-time surveillance of infectious disease events through a pilot study.

Four waves of pandemic influenza from 1918-1920 in New York City caused ~40,000 deaths, primarily of young-adults and children. The explosiveness of the autumn 1918 wave has led many to believe that in the event of a similar pandemic today early detection and intervention strategies may not be effective. Recent historical studies of the 1918 pandemic, however, provide evidence of controllable transmissibility, of a limited early wave4, and of social distancing measures significantly reducing pandemic impact in many US cities. Importantly, mitigation efforts initiated after the beginning of community-wide transmission (even up to the point of 3-6% of a population being infected) significantly reduced the total impact in 1918.

Objective

In response to an Institute of Medicine report recommending community-based pandemic influenza mitigation strategies be informed by surveillance and disease modeling, we aimed to assess the feasibility of using emergency department data to identify model derived threshold triggers for initiating intervention efforts in the event of a 1918-like pandemic.