Sentinel surveillance system for early outbreak detection in Madagascar
Sentinel surveillance system for early outbreak detection in Madagascar
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DOI：
10.1186/1471-2458-10-31
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发表时间：
2010-01-21
影响因子：
4.5
通讯作者：
Richard, Vincent
中科院分区：
文献类型：
--
作者：
Randrianasolo, Laurence;Raoelina, Yolande;Richard, Vincent
背景资料：在印度洋爆发基孔肯雅热之后，卫生部指示建立必要的早期疫情检测系统。组织了一个疾病监测小组，包括马达加斯加巴斯德研究所，以建立一个以哨点综合征为基础的监测系统。该系统于2007年3月建立，每天将全国六个省的各种自愿全科医生的病人数据传送给IPM。我们描述的挑战和步骤，参与制定一个哨点监测系统和及时的信息，它提供了改善公共卫生decision-making.Methods：监测的基础上收集的数据从哨点全科医生（SGP）。SGP每周使用发给管理团队的表格报告每个新患者的性别、年龄、访视日期和时间以及症状。然而，该系统的独创之处在于，小额赠款方案还通过移动电话（加密短信），从星期一至星期五每天至少报告一次数据（发热病例、经快速检测证实的疟疾、流感、虫媒病毒综合征或疟疾病例数）。管理团队还可以通过移动的电话验证信息。结果：2008年，哨点监测系统包括13个卫生中心，并确定了5起疫情。在218，849次SGPs就诊中，12.2%与发热综合征有关。在这26，669例发热病例中，12.3%与登革热样发热有关，11.1%与流感样疾病有关，9.7%与经特定快速诊断测试证实的疟疾病例有关。结论：哨点监测系统是马达加斯加建立的第一个全国性实时监测系统。我们的研究结果应鼓励其他非洲国家发展自己的症状监测系统，及时发现传染病的爆发可能导致控制措施，限制其影响，并有助于防止未来的爆发。
Background: Following the outbreak of chikungunya in the Indian Ocean, the Ministry of Health directed the necessary development of an early outbreak detection system. A disease surveillance team including the Institut Pasteur in Madagascar (IPM) was organized to establish a sentinel syndromic-based surveillance system. The system, which was set up in March 2007, transmits patient data on a daily basis from the various voluntary general practitioners throughout the six provinces of the country to the IPM. We describe the challenges and steps involved in developing a sentinel surveillance system and the well-timed information it provides for improving public health decision-making.Methods: Surveillance was based on data collected from sentinel general practitioners (SGP). The SGPs report the sex, age, visit date and time, and symptoms of each new patient weekly, using forms addressed to the management team. However, the system is original in that SGPs also report data at least once a day, from Monday to Friday (number of fever cases, rapid test confirmed malaria, influenza, arboviral syndromes or diarrhoeal disease), by cellular telephone (encrypted message SMS). Information can also be validated by the management team, by mobile phone. This data transmission costs 120 ariary per day, less than US$1 per month.Results: In 2008, the sentinel surveillance system included 13 health centers, and identified 5 outbreaks. Of the 218,849 visits to SGPs, 12.2% were related to fever syndromes. Of these 26,669 fever cases, 12.3% were related to Dengue-like fever, 11.1% to Influenza-like illness and 9.7% to malaria cases confirmed by a specific rapid diagnostic test.Conclusion: The sentinel surveillance system represents the first nationwide real-time-like surveillance system ever established in Madagascar. Our findings should encourage other African countries to develop their own syndromic surveillance systems.Prompt detection of an outbreak of infectious disease may lead to control measures that limit its impact and help prevent future outbreaks.