Enhanced surveillance during a public health emergency in a resource-limited setting: Experience from a large dengue outbreak in Solomon Islands, 2016-17.
Enhanced surveillance during a public health emergency in a resource-limited setting: Experience from a large dengue outbreak in Solomon Islands, 2016-17.
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DOI：
10.1371/journal.pone.0198487
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Kolbe A
中科院分区：
文献类型：
--
作者：
Craig AT;Joshua CA;Sio AR;Teobasi B;Dofai A;Dalipanda T;Hardie K;Kaldor J;Kolbe A
2016年8月至2017年4月，所罗门群岛经历了该国有记录以来规模最大、持续时间最长的登革热疫情，共有12,329例疑似病例，877人住院治疗，16人死亡。我们对相关数据和文件进行了回顾性分析，并进行了关键知情人访谈，以确认事件，并调查在低资源国家环境中，在公共卫生紧急事件期间加强和扩大数据收集的症状监测的适应性。虽然疫情迅速消耗了可用的公共和临床资源，但我们发现当局能够扩大传统的基于症状的国家预警监测系统，以支持事件期间增加的信息需求，这表明该系统的灵活性和更广泛的症状监测。扩大规模方面的挑战包括：提高技能和协助以前没有所需任务经验的工作人员;管理大量数据;在疫情爆发期间保持数据质量;协调常规和强化监测数据，并保持对其他疾病的监测;提供对应对规划最有用的信息;以及管理工作人员疲劳。所罗门群岛与该区域其他国家沿着，仍然容易受到登革热和其他传染病爆发的影响。确保监测系统强大并能够适应紧急情况下不断变化的需求，应成为卫生保护的优先事项。
Between August-2016 and April-2017, Solomon Islands experienced the largest and longest-running dengue outbreak on record in the country, with 12,329 suspected cases, 877 hospitalisations and 16 deaths. We conducted a retrospective review of related data and documents, and conducted key informant interviews to characterise the event and investigate the adaptability of syndromic surveillance for enhanced and expanded data collection during a public health emergency in a low resource country setting. While the outbreak quickly consumed available public and clinical resources, we found that authorities were able to scale up the conventional national syndrome-based early warning surveillance system to support the increased information demands during the event demonstrating the flexibility of the system and syndromic surveillance more broadly. Challenges in scaling up included upskilling and assisting staff with no previous experience of the tasks required; managing large volumes of data; maintaining data quality for the duration of the outbreak; harmonising routine and enhanced surveillance data and maintaining surveillance for other diseases; producing information optimally useful for response planning; and managing staff fatigue. Solomon Islands, along with other countries of the region remains vulnerable to outbreaks of dengue and other communicable diseases. Ensuring surveillance systems are robust and able to adapt to changing demands during emergencies should be a health protection priority.
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