Surveillance

Information about disease severity could help with both detection and situational awareness during outbreaks of acute respiratory infections (ARI). In this work, we use data from the EMR to identify patients with pneumonia, a key landmark of ARI severity. We asked if computerized analysis of the free-text of clinical notes or imaging reports could complement structured EMR data to uncover pneumonia cases.

Objective

To improve the surveillance for pneumonia using the free-text of electronic medical records (EMR).

Influenza is viral illness that affects mainly the nose, throat, bronchi and occasionally, the lungs. Influenza viruses have been an under-appreciated contributor to morbidity and mortality in Nigeria. They are a substantial contributor to respiratory disease burden in Nigeria and other developing countries. Nigeria started influenza sentinel surveillance in 2008 to inform disease control and prevention efforts.

Objective

To analyze Influenza surveillance data from 2009 to 2010 the Northern, Southern, and Western zones in Nigeria and determined co-morbidity factors associated with influenza in Nigeria.

Each year, influenza results in increased Emergency Department crowding which can be mitigated through early detection linked to an appropriate response. Although current surveillance systems, such as Google Flu Trends, yield near real-time influenza surveillance, few demonstrate ability to forecast impending influenza cases.

Objective

We sought to develop a practical influenza forecast model, based on real-time, geographically focused, and easy to access data, to provide individual medical centers with advanced warning of the number of influenza cases, thus allowing sufficient time to implement an intervention. Secondly, we evaluated how the addition of a real-time influenza surveillance system, Google Flu Trends, would impact the forecasting capabilities of this model.

Prostate cancer (PC) is the most common invasive cancer diagnosed among US men. The majority of PCs are organ-confined at diagnosis making them candidates for treatment using RAD, SURG, or other protocols. Several studies have provided preliminary evidence that radiation treatment of prostate cancer may increase subsequent rectal cancer risk (1-2). Data specifying type of RAD treatment of PC was not available for the study period.

Objective:

We sought to assess whether external beam radiation (RAD) treatment of prostate cancer, that exposes the rectum to ionizing radiation, was followed by increased hazards for rectal cancer, relative to prostatectomy (SURG).

 

Medical claims and EHR data sources offer the potential to ascertain disease and health risk behavior prevalence and incidence, evaluate the use of clinical services, and monitor changes related to public health interventions. Passage of the HITECH Act of 2009 supports the availability of standardized EHR data for use by public health officials to obtain actionable information. While full adoption of EHRs is still years away, there are presently publicly- and commerciallyavailable EHR and medical claims data sets that could enhance public health surveillance at a national, regional and state level. The purposes of this evaluation were to i.) demonstrate the feasibility of gaining access to such data, ii.) evaluate their ability to augment current surveillance activities by developing measures for twenty separate healthcare indicators (e.g., HIV screening), iii.) evaluate each data source across a set of criteria needed for an effective surveillance system, and iv.) assess the ability of the data sources to evaluate changes in healthcare utilization and preventive services that may be a result of the 2009 Health Reform legislation.

Objective:

To assess the utility of inpatient and ambulatory clinical data compiled by public and commercial sources to enhance the Centers for Disease Control and Prevention’s surveillance activities.

 

Cholera causes frequent outbreaks in Nigeria, resulting in mortality. In 2010 and 2011, 41,936 cases (case fatality rate [CFR]-4.1%) and 23,366 cases (CFR-3.2%) were reported (1). Reported cases in Nigeria by week 26, 2012 was 309 (CFR-1.29%) involving 20 Local Government Areas in 6 States. In Nigeria, there are currently eleven (11) States including Niger state at high risk for cholera/bloodless diarrhea outbreaks. In 2011, Niger state had 2472 cholera cases (CFR-2%) and 45,111 other diarrhea diseases cases, recorded in more than half of state Purpose of surveillance system is to ensure early detection of cholera and other diarrheal cases and to monitor trends towards evidencebased decision for management, prevention and control.

Objective:

To determine how the cholera and other diarrheal disease surveillance system in Niger state is meeting its surveillance objectives, to evaluate its performance and attributes and to describe its operation to make recommendations for improvement.

 

Antimicrobial prescriptions are a new data source available to the Veterans Health Administration (VHA) biosurveillance program. Little is known about whether antiviral or antibacterial prescription data correlates with influenza ICD-9-CM coded encounters. We therefore evaluated the utility and timeliness of antiviral and antibacterial utilization for influenza surveillance.

Uncertainty introduced by the selective identification of cases must be recognized and corrected for in order to accurately map the distribution of risk. Consider the problem of identifying geographic areas with increased risk of DRTB. Most countries with a high TB burden only offer drug sensitivity testing (DST) to those cases at highest risk for drug-resistance. As a result, the spatial distribution of confirmed DRTB cases under-represents the actual number of drug-resistant cases. Also, using the locations of confirmed DRTB cases to identify regions of increased risk of drug-resistance may bias results towards areas of increased testing. Since testing is neither done on all incident cases nor on a representative sample of cases, current mapping methods do not allow standard inference from programmatic data about potential locations of DRTB transmission.

Objective

Uncertainty regarding the location of disease acquisition, as well as selective identification of cases, may bias maps of risk. We propose an extension to a distance-based mapping method (DBM) that incorporates weighted locations to adjust for these biases. We demonstrate this method by mapping potential drug-resistant tuberculosis (DRTB) transmission hotspots using programmatic data collected in Lima, Peru.

In the South East Asia Region (SEAR), infectious disease continues to be a leading cause of death. SEAR countries, like Vietnam, are also at risk for outbreaks of emerging diseases due to high population density, proximity to animals and deforestation. Given Vietnam’s location in SEAR and its recurrent outbreaks of zoonotic diseases— timely surveillance in Vietnam is critical to global public health. Online news sources have been recognized as potential sources for early detection of emerging disease outbreaks, as was the case with SARS.  HealthMap, an innovative disease surveillance system developed at Boston Children’s Hospital, leverages the expediency of online news media by using text-mining technology to monitor and map global disease outbreaks reported by news sources.

Objective

To present the development of a surveillance system utilizing online Vietnamese language media sources to detect disease events in Vietnam and the South East Asian Region.