A review of population-based prevalence studies of physical activity in adults in the Asia-Pacific region

Background  

Physical activity (PA) surveillance is an important component of non-communicable disease risk factor monitoring, and occurs through national and international surveillance systems. This review identifies population PA estimates for adults in the Asia-Pacific region, and examines variation in trends and prevalence rates obtained using different PA measures.     

Completeness of hepatitis,brucellosis, syphilis,measles and HIV/AIDS surveillance in Izmir,Turkey

Background  

According to the surveillance system in Turkey, most diseases are notified only by clinicians, without involving laboratory notification. It is assumed that a considerable inadequacy in notifications exists; however, this has not been quantified by any researcher. Our aim was to evaluate the completeness of communicable disease surveillance in the province of Izmir, Turkey for the year of 2003 by means of estimating the incidences of diseases.     

Using Ontario's "Telehealth" health telephone helpline as an early-warning system: a study protocol

Background  

The science of syndromic surveillance is still very much in its infancy. While a number of syndromic surveillance systems are being evaluated in the US, very few have had success thus far in predicting an infectious disease event. Furthermore, to date, the majority of syndromic surveillance systems have been based primarily in emergency department settings, with varying levels of enhancement from other data sources. While research has been done on the value of telephone helplines on health care use and patient satisfaction, very few projects have looked at using a telephone helpline as a source of data for syndromic surveillance, and none have been attempted in Canada. The notable exception to this statement has been in the UK where research using the national NHS Direct system as a syndromic surveillance tool has been conducted.     

Spatial analysis of campylobacter infection in the Canadian province of Manitoba

Background  

The study describes population level variations in campylobacter incidence within the Canadian province of Manitoba, and the relationship to sociodemographic and landscape related characteristics. Using data derived from the Manitoba Health Public Health Branch communicable disease surveillance database, the study applied a number of spatial and ecological techniques to visualize, explore and model campylobacter incidence for the years 1996 to 2004. Analytical techniques used in the study included spatial smoothing, the spatial scan statistic, the Gini coefficient, and Poisson regression analysis.     

Developing effective chronic disease interventions in Africa: insights from Ghana and Cameroon

Background  

Africa faces an urgent but 'neglected epidemic' of chronic disease. In some countries stroke, hypertension, diabetes and cancers cause a greater number of adult medical admissions and deaths compared to communicable diseases such as HIV/AIDS or tuberculosis. Experts propose a three-pronged solution consisting of epidemiological surveillance, primary prevention and secondary prevention. In addition, interventions must be implemented through 'multifaceted multi-institutional' strategies that make efficient use of limited economic and human resources. Epidemiological surveillance has been prioritised over primary and secondary prevention. We discuss the challenge of developing effective primary and secondary prevention to tackle Africa's chronic disease epidemic through in-depth case studies of Ghanaian and Cameroonian responses.     

美国疾病预防控制中心和世界卫生组织传染病监测系统评价策略分析

目的 对比分析美国疾病预防控制中心(CDC)及WHO的监测系统评价方案,探讨适合中国的传染病监测系统评价策略.方法 系统收集美国CDC及WHO历年来提出的各版本监测系统评价方案,分析其主要思想和对中国的适用性;以现况分析和可行性分析探讨适合中国的传染病监测系统评价策略.结果 美国CDC提出的评价方案适于评价专病监测系统,重在对系统特征进行分析.WHO提出的评价方案适于评价国家或区域的整体监测体系,重在对系统功能进行分析.中国现阶段开展的监测系统评价多应用了特征评价的思想,也已初步具备功能评价的条件.结论 现阶段制定传染病监测系统评价策略时应参考美国CDC及WHO的各版本监测方案,并结合中国国情加以制定.     

Globalization and local response to epidemiological overlap in 21st century Ecuador

Background  

Third World countries are confronted by a complex overlay of two sets of health problems. Traditional maladies, including communicable diseases, malnutrition, and environmental health hazards coexist with emerging health challenges, including cardiovascular disease, cancer, and increasing levels of obesity. Using Ecuador as an example, this paper proposes a conceptual framework for linking epidemiologic overlap to emerging social structures and processes at the national and global levels.     

美国疾病预防控制中心和世界卫生组织传染病监测系统评价策略分析

目的 对比分析美国疾病预防控制中心(CDC)及WHO的监测系统评价方案,探讨适合中国的传染病监测系统评价策略.方法 系统收集美国CDC及WHO历年来提出的各版本监测系统评价方案,分析其主要思想和对中国的适用性;以现况分析和可行性分析探讨适合中国的传染病监测系统评价策略.结果 美国CDC提出的评价方案适于评价专病监测系统,重在对系统特征进行分析.WHO提出的评价方案适于评价国家或区域的整体监测体系,重在对系统功能进行分析.中国现阶段开展的监测系统评价多应用了特征评价的思想,也已初步具备功能评价的条件.结论 现阶段制定传染病监测系统评价策略时应参考美国CDC及WHO的各版本监测方案,并结合中国国情加以制定.     

美国疾病预防控制中心和世界卫生组织传染病监测系统评价策略分析

目的 对比分析美国疾病预防控制中心(CDC)及WHO的监测系统评价方案,探讨适合中国的传染病监测系统评价策略.方法 系统收集美国CDC及WHO历年来提出的各版本监测系统评价方案,分析其主要思想和对中国的适用性;以现况分析和可行性分析探讨适合中国的传染病监测系统评价策略.结果 美国CDC提出的评价方案适于评价专病监测系统,重在对系统特征进行分析.WHO提出的评价方案适于评价国家或区域的整体监测体系,重在对系统功能进行分析.中国现阶段开展的监测系统评价多应用了特征评价的思想,也已初步具备功能评价的条件.结论 现阶段制定传染病监测系统评价策略时应参考美国CDC及WHO的各版本监测方案,并结合中国国情加以制定.     

A profile of the online dissemination of national influenza surveillance data

Background  

Influenza surveillance systems provide important and timely information to health service providers on trends in the circulation of influenza virus and other upper respiratory tract infections. Online dissemination of surveillance data is useful for risk communication to health care professionals, the media and the general public. We reviewed national influenza surveillance websites from around the world to describe the main features of surveillance data dissemination.     

An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective

Background  

Sub-Saharan African (SSA) countries are currently experiencing one of the most rapid epidemiological transitions characterized by increasing urbanization and changing lifestyle factors. This has resulted in an increase in the incidence of non-communicable diseases, especially cardiovascular disease (CVD). This double burden of communicable and chronic non-communicable diseases has long-term public health impact as it undermines healthcare systems.     

Conceptual framework of public health surveillance and action and its application in health sector reform

Background  

Because both public health surveillance and action are crucial, the authors initiated meetings at regional and national levels to assess and reform surveillance and action systems. These meetings emphasized improved epidemic preparedness, epidemic response, and highlighted standardized assessment and reform.     

Improving influenza surveillance in sub-Saharan Africa

Problem

Little is known about the burden of influenza in sub-Saharan Africa. Routine influenza surveillance is key to getting a better understanding of the impact of acute respiratory infections on sub-Saharan African populations.

Approach

A project known as Strengthening Influenza Sentinel Surveillance in Africa (SISA) was launched in Angola, Cameroon, Ghana, Nigeria, Rwanda, Senegal, Sierra Leone and Zambia to help improve influenza sentinel surveillance, including both epidemiological and virological data collection, and to develop routine national, regional and international reporting mechanisms. These countries received technical support through remote supervision and onsite visits. Consultants worked closely with health ministries, the World Health Organization, national influenza laboratories and other stakeholders involved in influenza surveillance

Local setting

Influenza surveillance systems in the target countries were in different stages of development when SISA was launched. Senegal, for instance, had conducted virological surveillance for years, whereas Sierra Leone had no surveillance activity at all.

Relevant changes

Working documents such as national surveillance protocols and procedures were developed or updated and training for sentinel site staff and data managers was organized.

Lessons learnt

Targeted support to countries can help them strengthen national influenza surveillance, but long-term sustainability can only be achieved with external funding and strong national government leadership.     

Integration of syndromic surveillance data into public health practice at state and local levels in North Carolina

Objectives

We sought to describe the integration of syndromic surveillance data into daily surveillance practice at local health departments (LHDs) and make recommendations for the effective integration of syndromic and reportable disease data for public health use.

Methods

Structured interviews were conducted with local health directors and communicable disease nursing staff from a stratified random sample of LHDs from May through September 2009. Interviews captured information on direct access to the North Carolina syndromic surveillance system and on the use of syndromic surveillance information for outbreak management, program management, and the creation of reports. We analyzed syndromic surveillance system data to assess the number of signals resulting in a public health response.

Results

Syndromic surveillance data were used for outbreak investigation (19% of respondents) and program management and report writing (43% of respondents); a minority reported use of both syndromic and reportable disease data for these purposes (15% and 23%, respectively). Receiving data from frequent system users was associated with using data for these purposes (p=0.016 and p=0.033, respectively, for syndromic and reportable disease data). A small proportion of signals (<25%) resulted in a public health response.

Conclusions

Use of syndromic surveillance data by North Carolina local public health authorities resulted in meaningful public health action, including both case investigation and program management. While useful, the syndromic surveillance data system was oriented toward sensitivity rather than efficiency. Successful incorporation of new surveillance data is likely to require systems that are oriented toward efficiency.Effective use of surveillance data is essential to good public health practice. In recent years, public health agencies have experienced a significant increase in the amount of data available for surveillance (e.g., data used for syndromic surveillance), and this increase is likely to continue. For example, the federal Health Information Technology for Economic and Clinical Health Act (HITECH Act) supports forwarding medical record data to public health agencies. Published work demonstrates that better data are needed for communicable disease surveillance; communicable disease reporting is not complete,¹ and many cases are reported later than is necessary for public health action.² While the medical record data that may be provided to public health have the potential to improve completeness and timeliness, these datasets are likely to have many records that are not usable for public health purposes.³ Furthermore, limited staff are available to review these data.^4,5 Effective use of these new data for public health surveillance will require efficient identification of and access to the usable data elements present in new datasets.The implementation of syndromic surveillance is an example of the incorporation of new data sources. Syndromic surveillance systems were established to facilitate early detection of events requiring a rapid response, such as outbreaks caused by bioterrorism agents. Events that may require public health intervention are identified using aberration detection algorithms and individual record review. Most states have a system of this type,⁶ and their value for public health event detection and characterization has been demonstrated.^6–10 Lessons learned from attempts to integrate syndromic data for public health surveillance and response can inform future management of new data.While syndromic surveillance data can be valuable to public health practice, the design of these systems frequently limits their use to jurisdictions with greater capacity. Alerts created by system algorithms are often of low positive predictive value,^11,12 and these systems can require a high level of staff time for detecting events that require public health action.⁸ Therefore, syndromic surveillance data are most commonly used by state and large city public health departments that have enough staff time for reviewing alerts and individual case records.^6,13,14 Although these data can be useful to health departments of all sizes, little is known about how best to make these data usable in situations with limited surveillance staff. The use of syndromic surveillance data in smaller population settings, such as most local health departments (LHDs), has not been described.North Carolina can provide an example of the integration of syndromic surveillance data into public health surveillance practice. Current electronic surveillance for communicable disease in the state includes a population-based syndromic surveillance system, the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT), and a population-based reportable communicable disease surveillance system, the North Carolina Electronic Disease Surveillance System (NC EDSS). Both syndromic and reportable disease data have been used for public health surveillance since 2006. NC DETECT use is the responsibility of syndromic surveillance staff, which includes two state-level epidemiologists and 11 hospital-based epidemiologists. All other public health agency staff may use NC DETECT. NC EDSS use is required for and restricted to staff responsible for communicable disease reporting at state and local levels.The objectives of this study were to quantitatively assess the use of syndromic surveillance data at state and local public health agencies in North Carolina, to describe how syndromic surveillance is incorporated into public health practice in the state, and to make recommendations for the effective integration of syndromic and reportable disease data for public health use.     

We Can Have It All: Improved Surveillance Outcomes and Decreased Personnel Costs Associated With Electronic Reportable Disease Surveillance,North Carolina, 2010

Objectives. We assessed the timeliness, accuracy, and cost of a new electronic disease surveillance system at the local health department level. We describe practices associated with lower cost and better surveillance timeliness and accuracy.Methods. Interviews conducted May through August 2010 with local health department (LHD) staff at a simple random sample of 30 of 100 North Carolina counties provided information on surveillance practices and costs; we used surveillance system data to calculate timeliness and accuracy. We identified LHDs with best timeliness and accuracy and used these categories to compare surveillance practices and costs.Results. Local health departments in the top tertiles for surveillance timeliness and accuracy had a lower cost per case reported than LHDs with lower timeliness and accuracy ($71 and $124 per case reported, respectively; P = .03). Best surveillance practices fell into 2 domains: efficient use of the electronic surveillance system and use of surveillance data for local evaluation and program management.Conclusions. Timely and accurate surveillance can be achieved in the setting of restricted funding experienced by many LHDs. Adopting best surveillance practices may improve both efficiency and public health outcomes.Communicable disease reporting is central to public health surveillance, providing data to detect outbreaks and to describe disease trends.1 Over the past 10 years, communicable disease surveillance has transitioned from traditional paper-based disease reports to electronic reporting.2 All states have converted parts or all of their disease reporting to electronic systems, and most states now use an electronic system to enter and transmit case information at local and state public health agencies.3The transition to electronic reporting has resulted in corresponding modifications to surveillance practice, including changes in who enters and accesses communicable disease case data and how these data are entered at local and state health department levels.4–6 These and other changes have been described at the state level,3,7,8 but less information is available describing changes at the local level. Furthermore, there is little documented information on the cost or cost-effectiveness of electronic communicable disease surveillance systems at any level. Because funds for local public health are scarce and must be prioritized on the basis of costs and benefits, information about the costs of electronic disease surveillance is needed.In 2008, North Carolina implemented the North Carolina Electronic Disease Surveillance System (NC EDSS). The goal of this study was to describe the resources dedicated to communicable disease surveillance with NC EDSS at the local health department (LHD) level. We examined the cases reported before and after NC EDSS implementation and calculated personnel costs associated with communicable disease reporting with the NC EDSS system. Finally, we assigned LHDs composite scores on the basis of accuracy and timeliness of case reports, and compared costs and surveillance practices for LHDs with better and worse timeliness and accuracy.     

The burden of non communicable diseases in developing countries

Background  

By the dawn of the third millennium, non communicable diseases are sweeping the entire globe, with an increasing trend in developing countries where, the transition imposes more constraints to deal with the double burden of infective and non-infective diseases in a poor environment characterised by ill-health systems. By 2020, it is predicted that these diseases will be causing seven out of every 10 deaths in developing countries. Many of the non communicable diseases can be prevented by tackling associated risk factors.     

Proposal of a framework for evaluating military surveillance systems for early detection of outbreaks on duty areas

Background  

In recent years a wide variety of epidemiological surveillance systems have been developed to provide early identification of outbreaks of infectious disease. Each system has had its own strengths and weaknesses. In 2002 a Working Group of the Centers for Disease Control and Prevention (CDC) produced a framework for evaluation, which proved suitable for many public health surveillance systems. However this did not easily adapt to the military setting, where by necessity a variety of different parameters are assessed, different constraints placed on the systems, and different objectives required. This paper describes a proposed framework for evaluation of military syndromic surveillance systems designed to detect outbreaks of disease on operational deployments.     

Can current national surveillance systems in England and Wales monitor sexual transmission of hepatitis C among HIV-infected men who have sex with men?

Background  

Recent reports suggest an increase in sexually-transmitted hepatitis C infection among HIV-infected men who have sex with men (MSM) in European cities. We investigated whether current national surveillance systems in England and Wales (E&W) are able to monitor sexual transmission of hepatitis C infection among HIV-infected MSM.     

An agent-based approach for modeling dynamics of contagious disease spread

Background  

The propagation of communicable diseases through a population is an inherent spatial and temporal process of great importance for modern society. For this reason a spatially explicit epidemiologic model of infectious disease is proposed for a greater understanding of the disease's spatial diffusion through a network of human contacts.