Global capacity for emerging infectious disease detection
Global capacity for emerging infectious disease detection
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DOI：
10.1073/pnas.1006219107
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发表时间：
2010-12-14
影响因子：
11.1
通讯作者：
Brownstein, John S.
中科院分区：
文献类型：
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作者：
Chan, Emily H.;Brewer, Timothy F.;Brownstein, John S.
在国际上传播的新出现的传染病事件越来越多，如严重急性呼吸系统综合征（SARS）和2009年甲型H1N1流感大流行，突出表明需要改进全球疫情监测。预计，基于互联网的报告的激增，将加强沟通，改善监测和报告框架，特别是修订了2007年生效的世界卫生组织（世卫组织）《国际卫生条例》（2005年）。然而，对于疫情检测和传播过程是否以及如何随着时间的推移而实际发生变化，尚未进行全球性的定量评估。在这项研究中，我们分析了1996年至2009年世界卫生组织疾病暴发新闻报告的全部公共记录，以描述相对于估计的暴发开始日期，暴发发现和公众传播及时性的时空趋势。考克斯比例风险回归分析显示，总体而言，疫情发现的及时性每年提高7.3% [风险比（HR）= 1.073，95%CI（1.038; 1.110）]，公共沟通每年提高6.2% [HR = 1.062，95%CI（1.028; 1.096）]。然而，改善的程度因地理区域而异;世卫组织唯一一个具有统计学意义的区域（α = 0.05）西太平洋地区的疫情发现率有所提高[HR = 1.102/年，95% CI（1.008; 1.205）]，而东地中海[HR = 1.201/年，95% CI（1.066; 1.353）]和西太平洋地区[HR = 1.119/年，95% CI（1.025; 1.221）]的公众沟通有所改善。这些发现提供了定量的历史评估及时性传染病检测和疫情的公共报告。
The increasing number of emerging infectious disease events that have spread internationally, such as severe acute respiratory syndrome (SARS) and the 2009 pandemic A/H1N1, highlight the need for improvements in global outbreak surveillance. It is expected that the proliferation of Internet-based reports has resulted in greater communication and improved surveillance and reporting frameworks, especially with the revision of the World Health Organization's (WHO) International Health Regulations (IHR 2005), which went into force in 2007. However, there has been no global quantitative assessment of whether and how outbreak detection and communication processes have actually changed over time. In this study, we analyzed the entire WHO public record of Disease Outbreak News reports from 1996 to 2009 to characterize spatial-temporal trends in the timeliness of outbreak discovery and public communication about the outbreak relative to the estimated outbreak start date. Cox proportional hazards regression analyses show that overall, the timeliness of outbreak discovery improved by 7.3% [hazard ratio (HR) = 1.073, 95% CI (1.038; 1.110)] per year, and public communication improved by 6.2% [HR = 1.062, 95% CI (1.028; 1.096)] per year. However, the degree of improvement varied by geographic region; the only WHO region with statistically significant (alpha = 0.05) improvement in outbreak discovery was the Western Pacific region [HR = 1.102 per year, 95% CI (1.008; 1.205)], whereas the Eastern Mediterranean [HR = 1.201 per year, 95% CI (1.066; 1.353)] and Western Pacific regions [HR = 1.119 per year, 95% CI (1.025; 1.221)] showed improvement in public communication. These findings provide quantitative historical assessment of timeliness in infectious disease detection and public reporting of outbreaks.