Evaluation of a method for issuing warnings pre-epidemics and epidemics in Japan by infectious diseases surveillance.
Evaluation of a method for issuing warnings pre-epidemics and epidemics in Japan by infectious diseases surveillance.
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DOI：
10.2188/jea.14.33
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发表时间：
2004-03
影响因子：
4.7
通讯作者：
Nagai M
中科院分区：
文献类型：
--
作者：
Murakami Y;Hashimoto S;Taniguchi K;Osaka K;Fuchigami H;Nagai M
背景：已经开发出简单的方法，利用传染病监测数据对小区域的流行前和流行进行预警。如果每个哨点医疗机构每周的病例指数大于规定值，则发出疫情预警。疫情预警是指在接下来的四个星期内发布疫情预警。虽然这些方法在日本常规用于监测，但仍有待验证。方法：采用1999-2001财年流感样疾病和12种儿科疾病的传染病监测数据进行分析。我们检查了警告的频率、警告出现前后指数的时间变化，以及流行前警告的敏感性、特异性和阳性预测值。结果：对于大多数调查的疾病，发出警告的周数比例在 0% 到 10% 之间。在包括流感样疾病在内的多种疾病中，我们观察到该指数在警告前后出现快速上升和逐渐下降的情况。流感样疾病的流行前预警的敏感性、特异性和阳性预测值分别为90.4%、93.7%和23.9%，儿科疾病（水痘、风疹、麻疹和流行性腮腺炎）的敏感性、特异性和阳性预测值分别为25.1-54.2%、86.1-99.2%和2.5-20.8%。结论：研究表明，用于确定是否发布流行病警报的方法对于某些疾病（包括流感样疾病）是令人满意的，但对于其他几种疾病可能需要改进。
BACKGROUND: Simple methods have been developed to warn of pre-epidemics and epidemics in small areas using data of infectious diseases surveillance. Epidemic warnings are made if the index of cases per week per sentinel medical institution is greater than a defined value. A pre-epidemic warning means that an epidemic warning will be given in the following four weeks. While the methods are used routinely for surveillance in Japan, they remain to be validated. METHODS: Infectious diseases surveillance data of influenza-like illness and 12 pediatric diseases in the fiscal year between 1999 and 2001 were used in the analysis. We examined the frequency of warnings, temporal changes in the index before and after the onset of a warning, and the sensitivity, specificity, and positive predictive value of pre-epidemic warnings. RESULTS: For the majority of the diseases investigated, the proportion of weeks in which a warning was issued ranged between 0% and 10%. In several diseases including influenza-like illness, we observed a rapid increase and gradual decrease in the index before and after a warning. The sensitivity, specificity, and positive predictive value of a pre-epidemic warning were 90.4%, 93.7% and 23.9% for influenza-like illness, and ranged between 25.1-54.2%, 86.1-99.2%, and 2.5-20.8% for the pediatric diseases (chickenpox, rubella, measles, and mumps), respectively. CONCLUSIONS: The study showed that the methods used for determining whether or not to issue an epidemic warning were satisfactory in some diseases, including influenza-like illness, and may need to be improved in several other diseases.