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Tejiokem MC, Barry A, Ratovoson R, Yambiyo B, Hamidou Lazoumar R, Herrant M, Madaha E, Richard V. African countries from the Pasteur Network reexamine their syndromic sentinel surveillance system associated with household contact within the AFROSCREEN program. Front Public Health 2024; 11:1292435. [PMID: 38249384 PMCID: PMC10796548 DOI: 10.3389/fpubh.2023.1292435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024] Open
Abstract
Surveillance to better detect and respond to new pathogens remains a major challenge for global public health. The Pasteur Network recently held a brainstorming workshop located in Cameroon attended by Pasteur epidemiological teams from Niger, Central African Republic (CAR), Cameroon, Senegal, and Madagascar to discuss how the Pasteur Network in Africa could use the lessons of COVID-19 to set-up a pilot sentinel surveillance scheme given its expertise and involvement during the pandemic. The possibility of coupling sentinel syndromic and biological surveillance already implemented for influenza surveillance with the recent sequencing capacity put in place by the AFROSCREEN program prompted us to consider strengthening surveillance tools to target "Pathogen X" detection in Africa. The perspective project provided by the Pasteur Network teams and shared with other partners of the AFROSCREEN program will target strengthening of the diagnosis of severe acute respiratory infections (IRAS) and the surveillance of IRAS, the evaluation of the impact of SARS-CoV-2 on the epidemiology of IRAS, and the addition of the detection of new pathogens, called "Pathogen X," based on sequencing capacity and epidemiological criteria from One Health approaches.
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Affiliation(s)
| | | | - Rila Ratovoson
- Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Brice Yambiyo
- Institut Pasteur de Bangui, Bangui, Central African Republic
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Guillot C, Bouchard C, Aenishaenslin C, Berthiaume P, Milord F, Leighton PA. Criteria for selecting sentinel unit locations in a surveillance system for vector-borne disease: A decision tool. Front Public Health 2022; 10:1003949. [PMID: 36438246 PMCID: PMC9686450 DOI: 10.3389/fpubh.2022.1003949] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/10/2022] [Indexed: 11/11/2022] Open
Abstract
Objectives With vector-borne diseases emerging across the globe, precipitated by climate change and other anthropogenic changes, it is critical for public health authorities to have well-designed surveillance strategies in place. Sentinel surveillance has been proposed as a cost-effective approach to surveillance in this context. However, spatial design of sentinel surveillance system has important impacts on surveillance outcomes, and careful selection of sentinel unit locations is therefore an essential component of planning. Methods A review of the available literature, based on the realist approach, was used to identify key decision issues for sentinel surveillance planning. Outcomes of the review were used to develop a decision tool, which was subsequently validated by experts in the field. Results The resulting decision tool provides a list of criteria which can be used to select sentinel unit locations. We illustrate its application using the case example of designing a national sentinel surveillance system for Lyme disease in Canada. Conclusions The decision tool provides researchers and public health authorities with a systematic, evidence-based approach for planning the spatial design of sentinel surveillance systems, taking into account the aims of the surveillance system and disease and/or context-specific considerations.
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Affiliation(s)
- Camille Guillot
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada,Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'île-de-Montréal (CReSP), Montréal, QC, Canada,*Correspondence: Camille Guillot
| | - Catherine Bouchard
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, St. Hyacinthe, QC, Canada
| | - Cécile Aenishaenslin
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Philippe Berthiaume
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, St. Hyacinthe, QC, Canada
| | - François Milord
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Patrick A. Leighton
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada,Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'île-de-Montréal (CReSP), Montréal, QC, Canada
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Bellocchio F, Carioni P, Lonati C, Garbelli M, Martínez-Martínez F, Stuard S, Neri L. Enhanced Sentinel Surveillance System for COVID-19 Outbreak Prediction in a Large European Dialysis Clinics Network. Int J Environ Res Public Health 2021; 18:9739. [PMID: 34574664 PMCID: PMC8472609 DOI: 10.3390/ijerph18189739] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/09/2021] [Accepted: 09/11/2021] [Indexed: 12/23/2022]
Abstract
Accurate predictions of COVID-19 epidemic dynamics may enable timely organizational interventions in high-risk regions. We exploited the interconnection of the Fresenius Medical Care (FMC) European dialysis clinic network to develop a sentinel surveillance system for outbreak prediction. We developed an artificial intelligence-based model considering the information related to all clinics belonging to the European Nephrocare Network. The prediction tool provides risk scores of the occurrence of a COVID-19 outbreak in each dialysis center within a 2-week forecasting horizon. The model input variables include information related to the epidemic status and trends in clinical practice patterns of the target clinic, regional epidemic metrics, and the distance-weighted risk estimates of adjacent dialysis units. On the validation dates, there were 30 (5.09%), 39 (6.52%), and 218 (36.03%) clinics with two or more patients with COVID-19 infection during the 2-week prediction window. The performance of the model was suitable in all testing windows: AUC = 0.77, 0.80, and 0.81, respectively. The occurrence of new cases in a clinic propagates distance-weighted risk estimates to proximal dialysis units. Our machine learning sentinel surveillance system may allow for a prompt risk assessment and timely response to COVID-19 surges throughout networked European clinics.
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Affiliation(s)
- Francesco Bellocchio
- Fresenius Medical Care Italia SpA, Palazzo Pignano, 26020 Lombardia, Italy; (F.B.); (P.C.); (M.G.)
| | - Paola Carioni
- Fresenius Medical Care Italia SpA, Palazzo Pignano, 26020 Lombardia, Italy; (F.B.); (P.C.); (M.G.)
| | - Caterina Lonati
- Center for Preclinical Research, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Mario Garbelli
- Fresenius Medical Care Italia SpA, Palazzo Pignano, 26020 Lombardia, Italy; (F.B.); (P.C.); (M.G.)
| | - Francisco Martínez-Martínez
- Santa Barbara Smart Health S. L., Parc Cientific Universitat id Valencia, Carrer del Catedràtic Agustín Escardino Benlloch, 9, 46980 Paterna, Spain;
| | - Stefano Stuard
- Fresenius Medical Care Deutschland GmbH, 61352 Bad Homburg, Germany;
| | - Luca Neri
- Fresenius Medical Care Italia SpA, Palazzo Pignano, 26020 Lombardia, Italy; (F.B.); (P.C.); (M.G.)
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Domínguez À, Soldevila N, Torner N, Martínez A, Godoy P, Rius C, Jané M. Usefulness of Clinical Definitions of Influenza for Public Health Surveillance Purposes. Viruses 2020; 12:v12010095. [PMID: 31947696 PMCID: PMC7019582 DOI: 10.3390/v12010095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/10/2020] [Accepted: 01/12/2020] [Indexed: 11/17/2022] Open
Abstract
This study investigated the performance of various case definitions and influenza symptoms in a primary healthcare sentinel surveillance system. A retrospective study of the clinical and epidemiological characteristics of the cases reported by a primary healthcare sentinel surveillance network for eleven years in Catalonia was conducted. Crude and adjusted diagnostic odds ratios (aDORs) and 95% confidence intervals (CIs) of the case definitions and symptoms for all weeks and epidemic weeks were estimated. The most predictive case definition for laboratory-confirmed influenza was the World Health Organization (WHO) case definition for ILI in all weeks (aDOR 2.69; 95% CI 2.42–2.99) and epidemic weeks (aDOR 2.20; 95% CI 1.90–2.54). The symptoms that were significant positive predictors for confirmed influenza were fever, cough, myalgia, headache, malaise, and sudden onset. Fever had the highest aDOR in all weeks (4.03; 95% CI 3.38–4.80) and epidemic weeks (2.78; 95% CI 2.21–3.50). All of the case definitions assessed performed better in patients with comorbidities than in those without. The performance of symptoms varied by age groups, with fever being of high value in older people, and cough being of high value in children. In patients with comorbidities, the performance of fever was the highest (aDOR 5.45; 95% CI 3.43–8.66). No differences in the performance of the case definition or symptoms in influenza cases according to virus type were found.
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Affiliation(s)
- Àngela Domínguez
- Departament de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain; (À.D.); (N.T.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (A.M.); (P.G.); (C.R.); (M.J.)
| | - Núria Soldevila
- Departament de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain; (À.D.); (N.T.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (A.M.); (P.G.); (C.R.); (M.J.)
- Correspondence:
| | - Núria Torner
- Departament de Medicina, Universitat de Barcelona, 08036 Barcelona, Spain; (À.D.); (N.T.)
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (A.M.); (P.G.); (C.R.); (M.J.)
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, 08005 Barcelona, Spain
| | - Ana Martínez
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (A.M.); (P.G.); (C.R.); (M.J.)
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, 08005 Barcelona, Spain
| | - Pere Godoy
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (A.M.); (P.G.); (C.R.); (M.J.)
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, 08005 Barcelona, Spain
- Institut de Recerca Biomèdica de Lleida, Universitat de Lleida, 25198 Lleida, Spain
| | - Cristina Rius
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (A.M.); (P.G.); (C.R.); (M.J.)
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
| | - Mireia Jané
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain; (A.M.); (P.G.); (C.R.); (M.J.)
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, 08005 Barcelona, Spain
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Kroll M, Phalkey R, Dutta S, Shukla S, Butsch C, Bharucha E, Kraas F. Involving private healthcare practitioners in an urban NCD sentinel surveillance system: lessons learned from Pune, India. Glob Health Action 2016; 9:32635. [PMID: 27760678 PMCID: PMC5071647 DOI: 10.3402/gha.v9.32635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/22/2016] [Accepted: 08/29/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite the rising impact of non-communicable diseases (NCDs) on public health in India, lack of quality data and routine surveillance hampers the planning process for NCD prevention and control. Current surveillance programs focus largely on communicable diseases and do not adequately include the private healthcare sector as a major source of care in cities. OBJECTIVE The objective of the study was to conceptualize, implement, and evaluate a prototype for an urban NCD sentinel surveillance system among private healthcare practitioners providing primary care in Pune, India. DESIGN We mapped all private healthcare providers in three selected areas of the city, conducted a knowledge, attitude, and practice survey with regard to surveillance among 258 consenting practitioners, and assessed their willingness to participate in a routine NCD surveillance system. In total, 127 practitioners agreed and were included in a 6-month surveillance study. Data on first-time diagnoses of 10 selected NCDs alongside basic demographic and socioeconomic patient information were collected onsite on a monthly basis using a paper-based register. Descriptive and regression analyses were performed. RESULTS In total, 1,532 incident cases were recorded that mainly included hypertension (n=622, 41%) and diabetes (n=460, 30%). Dropout rate was 10% (n=13). The monthly reporting consistency was quite constant, with the majority (n=63, 50%) submitting 1-10 cases in 6 months. Average number of submitted cases was highest among allopathic practitioners (17.4). A majority of the participants (n=104, 91%) agreed that the surveillance design could be scaled up to cover the entire city. CONCLUSIONS The study indicates that private primary healthcare providers (allopathic and alternate medicine practitioners) play an important role in the diagnosis and treatment of NCDs and can be involved in NCD surveillance, if certain barriers are addressed. Main barriers observed were lack of regulation of the private sector, cross-practices among different systems of medicine, limited clinic infrastructure, and knowledge gaps about disease surveillance. We suggest a voluntary augmented sentinel NCD surveillance system including public and private healthcare facilities at all levels of care.
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Affiliation(s)
- Mareike Kroll
- Institute of Geography, University of Cologne, Cologne, Germany;
| | - Revati Phalkey
- Institute of Geography, University of Cologne, Cologne, Germany
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
| | - Sayani Dutta
- Institute of Environment Education and Research, Bharati Vidyapeeth University, Pune, India
| | - Sharvari Shukla
- Symbiosis Institute of Health Sciences, Symbiosis International Institute, Pune, India
| | - Carsten Butsch
- Institute of Geography, University of Cologne, Cologne, Germany
| | - Erach Bharucha
- Institute of Environment Education and Research, Bharati Vidyapeeth University, Pune, India
| | - Frauke Kraas
- Institute of Geography, University of Cologne, Cologne, Germany
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Lunelli A, Rizzo C, Puzelli S, Bella A, Montomoli E, Rota MC, Donatelli I, Pugliese A. Understanding the dynamics of seasonal influenza in Italy: incidence, transmissibility and population susceptibility in a 9-year period. Influenza Other Respir Viruses 2013; 7:286-95. [PMID: 22694182 PMCID: PMC5779816 DOI: 10.1111/j.1750-2659.2012.00388.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Influenza surveillance systems have been established in many countries in the world, yielding timely information about the intensity and features of seasonal outbreaks. Such data have also been used to estimate epidemiological parameters and to evaluate the effect of factors on infection dynamics. However, little is known about the extent of under-reporting in surveillance data, and thus of the true influenza incidence in the population. DESIGN Through mathematical and statistical modelling, we analysed Italian epidemiological and virological surveillance data collected together with serological data derived from influenza vaccine clinical trials performed in Italy. RESULTS Depending on the season, the reporting rate estimates ranged between 20% and 33% of the total incidence with higher reporting rates in seasons dominated by A/H3N2 virus. Despite a generally higher number of individuals immune against A/H3N2 viruses, effective reproduction ratios were quite similar in all seasons varying between 1·2 and 1·4. We observed an age-dependent transmissibility for different subtypes: susceptible children were more likely than susceptible adults and elderly to get infected when A/H1N1 or B strains were circulating, while no clear age-dependence was found for A/H3N2. We also perform sensitivity analysis under different assumptions for vaccine effectiveness, generation time (GT) and model variants; we found that the overall results in predicted patterns were extremely similar, with a slightly better fit obtained with shorter GTs. CONCLUSIONS Our results provide relevant information on the influenza dynamics to fine-tune intervention strategies and for data collection improvement.
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MESH Headings
- Adolescent
- Adult
- Aged
- Child
- Child, Preschool
- Disease Outbreaks
- Female
- Humans
- Infant
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H3N2 Subtype/immunology
- Influenza A Virus, H3N2 Subtype/isolation & purification
- Influenza Vaccines/immunology
- Influenza, Human/epidemiology
- Influenza, Human/immunology
- Influenza, Human/prevention & control
- Influenza, Human/transmission
- Italy/epidemiology
- Male
- Middle Aged
- Models, Theoretical
- Seasons
- Sentinel Surveillance
- Young Adult
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Affiliation(s)
| | - Caterina Rizzo
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Siena, Italy
| | - Simona Puzelli
- Department of Infectious, Parasitic and Immune‐mediated Diseases, National Institute of Health, Rome, Italy
| | - Antonino Bella
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Siena, Italy
| | - Emanuele Montomoli
- Department of Physiopathology, Experimental Medicine and Public Health, University of Siena, Siena, Italy
| | - Maria C. Rota
- National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Siena, Italy
| | - Isabella Donatelli
- Department of Infectious, Parasitic and Immune‐mediated Diseases, National Institute of Health, Rome, Italy
| | - Andrea Pugliese
- Department of Mathematics, University of Trento, Trento, Italy
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