Early-warning health and process indicators for sentinel surveillance in Madagascar 2007-2011.
Early-warning health and process indicators for sentinel surveillance in Madagascar 2007-2011.
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DOI：
10.5210/ojphi.v6i3.5400
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发表时间：
2014
影响因子：
--
通讯作者：
Richard V
中科院分区：
文献类型：
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作者：
Rajatonirina S;Rakotomanana F;Randrianasolo L;Razanajatovo NH;Andriamandimby SF;Ravolomanana L;Randrianarivo-Solofoniaina AE;Reynes JM;Piola P;Finlay-Vickers A;Heraud JM;Richard V
背景：流行病对资源匮乏的国家构成重大威胁，而用于早期发现和应对的监测工具往往不足。 2007年，马达加斯加建立了哨点监测系统，旨在快速识别潜在的发热或腹泻综合症流行病并发出警报。我们通过对高质量数据的及时分析，呈现了该系统构建五年来的健康和过程指标，展示了时空趋势、预警信号检测能力和过程评估。方法：马达加斯加哨点监测网络目前基于从 34 个初级卫生中心收集的发烧和腹泻综合征数据，并通过手机短信传输每天报告。马达加斯加巴斯德研究所每天都会分析数据，以便能够更快地发出警报，并使用综合过程指标（及时性、数据质量）来监控系统。结果：从 2007 年到 2011 年，报告了 917,798 次访问。发热综合征约占每年就诊的 11%，但观察到的趋势因年份和哨点地点而异。 2007年至2011年，共确认21起疫情警报。然而，数据传输存在延迟（2008 年 88% 在 24 小时内传输；2011 年为 67%），每周传输用于有效性控制的表格百分比从 2007 年的 99.9% 下降到 2011 年的 63.5%。结论：哨点监测计划应同时考虑流行病学指标和过程指标。它还必须受到监测的主要目的和当地因素的控制，例如医护人员的动机和电信基础设施。系统的定期改进需要永久性的评价指标。
Background: Epidemics pose major threats in resource-poor countries, and surveillance tools for their early detection and response are often inadequate. In 2007, a sentinel surveillance system was established in Madagascar, with the aim of rapidly identifying potential epidemics of febrile or diarrhoeal syndromes and issuing alerts. We present the health and process indicators for the five years during which this system was constructed, showing the spatiotemporal trends, early-warning sign detection capability and process evaluation through timely analyses of high-quality data. Methods: The Malagasy sentinel surveillance network is currently based on data for fever and diarrhoeal syndromes collected from 34 primary health centres and reported daily via the transmission of short messages from mobile telephones. Data are analysed daily at the Institut Pasteur de Madagascar to make it possible to issue alerts more rapidly, and integrated process indicators (timeliness, data quality) are used to monitor the system. Results: From 2007 to 2011, 917,798 visits were reported. Febrile syndromes accounted for about 11% of visits annually, but the trends observed differed between years and sentinel sites. From 2007 to 2011, 21 epidemic alerts were confirmed. However, delays in data transmission were observed (88% transmitted within 24 hours in 2008; 67% in 2011) and the percentage of forms transmitted each week for validity control decreased from 99.9% in 2007 to 63.5% in 2011. Conclusion: A sentinel surveillance scheme should take into account both epidemiological and process indicators. It must also be governed by the main purpose of the surveillance and by local factors, such as the motivation of healthcare workers and telecommunication infrastructure. Permanent evaluation indicators are required for regular improvement of the system.