Evaluating Oregon's occupational public health surveillance system based on the CDC updated guidelines

[Evaluation of the Viral Hemorrhagic Fever Surveillance System in the Assaba region, Mauritania (2020-2022)]

Introduction

Several arboviral diseases have been known to be endemic (e.g., Crimean-Congo hemorrhagic fever, Rift Valley fever) or are emerging (dengue fever, chikungunya, O'nyong-nyong) in human populations in Mauritania, while others have become rare in recent years (e.g. yellow fever). Moreover, domestic animals, especially cattle, camels, goats, and sheep, are also known to be infected with some of these arboviruses (e.g. Crimean-Congo hemorrhagic fever, Rift Valley fever). For these reasons, viral hemorrhagic fever surveillance in Mauritania is part of the Integrated Disease Surveillance and Response (IDSR). However, limited information is available on the efficacy of the viral hemorrhagic fever surveillance system in the Assaba region of Mauritania. The aim of the present study was to assess the performance of the surveillance system, in particular its general utility, simplicity, flexibility, acceptability, and reactivity.

Methods

A descriptive cross-sectional study was conducted from July to August 2022 in the Assaba region with the objective of evaluating the characteristics of the system by interviewing key actors involved in the surveillance of viral hemorrhagic fevers, with a focus on Rift Valley fever and Crimean-Congo hemorrhagic fever, using questionnaires developed following the guidelines of the Centers for Disease Control and Prevention (Atlanta, Georgia, USA). Data from 2020-2022 on viral hemorrhagic fevers from the National Institute of Public Health laboratory were analyzed. Medians, interquartile ranges, and proportions were calculated using Epi Info® 7.2.5.0 and Excel® 2021.

Results

The questionnaire was answered by all twenty-six persons involved in the viral hemorrhagic fever surveillance system in Assaba region. The majority of survey respondents found the system to be useful (51%), simple (63%), acceptable (46%), responsive (64%), and flexible (46%). An analysis of the data revealed a positive predictive value of 28% for Rift Valley Fever. The weekly distribution of cases within the wilaya indicates that the moughataa of Kiffa recorded the highest number of cases in September, with a notable weekly peak during that month in 2020. According to the analysis of the National Institute of Public Health database, cases of viral hemorrhagic fevers were promptly handled. Survey responses and database analysis revealed issues related to data quality and data management mechanisms. These limitations in the surveillance system are likely to be due to insufficient resources and training of the personnel, in particular with regards to data collection and management, which in turn led to incomplete or missing data and invalid data entry. These weak points can be ascribed, at least in part, to financial constraints and inadequate attribution of priority to arboviral diseases. Despite these limitations, disease data generated by the surveillance system were generally reliable.

Conclusion

The viral hemorrhagic fever surveillance system in the Assaba region adheres to the organization and functioning of the national viral hemorrhagic fever surveillance system, which is part of the IDSR. The characteristics of utility, simplicity, responsiveness, and flexibility of the viral hemorrhagic fever surveillance system are good, but acceptability and flexibility need further improvement. The earlier the first arboviral human or animal cases are detected, the more likely an active intervention can be organized in response to the emerging epidemic or epizootic and prevent the spread of the disease. An efficient viral surveillance system is the key to reducing the negative impact of arboviral diseases in Assaba region.

Assessing health human resource structure at Urumqi's center for disease control and prevention

By conducting an in-depth investigation and analysis of the health human resource framework within the Urumqi Center for Disease Control and Prevention (CDC), this study aims to offer valuable insights for the objective assessment and future enhancement of its talent development endeavors. A questionnaire survey was administered, followed by a descriptive analysis, involving the healthcare professionals affiliated with the Urumqi Center for CDC. The Urumqi Center for CDC exhibited a lower compilation number than its on-duty personnel count. When compared to county (district) level, the municipal level CDC displayed a higher educational attainment, a more favorable title distribution, and a younger workforce demographic. The human resource count in both Urumqi's city and county (district) level CDCs has decreased, but the relative numbers have improved, indicating enhanced quality and a younger workforce. The municipal-level CDC boasts a superior human resource structure compared to the county (district) level, with better fairness in population distribution by area than geography. Allocation equity within the central urban area is higher than in distant urban areas, highlighting regional disparities as a significant factor.

An in-depth review of the UNICEF NutriDash platform, lessons learnt and future perspectives: a mixed-methods study

OBJECTIVES

Robust data on nutrition are essential to realise the right to nutrition for every child. Created in 2009, UNICEF's Nutrition Dashboard (NutriDash) collects nutrition programme information from 125 countries. An in-depth review of NutriDash was conducted to understand its strengths and identify key actions to increase its effectiveness and efficiency.

METHODS

Adapting the Centres for Disease Control and Prevention updated guidelines for evaluating public health surveillance systems, a mixed-methods approach was used. A questionnaire was designed to capture information on key attributes of NutriDash and disseminated to UNICEF country offices for quantitative feedback on user experiences. Structured key informant interviews were held with internal and external stakeholders to gain qualitative perceptions on data generated from NutriDash. Analysis involved producing frequency distributions for the questionnaire data and performing thematic analyses on interview data.

RESULTS

A total of 53 respondents completed the questionnaire (42% response rate), representing 48 countries and good regional geographic representation. Most respondents (96%) worked in UNICEF country offices. The percentages of participants who agreed or strongly agreed with each attribute of the NutriDash system were as follows: acceptability: 71%, stability: 68%, simplicity; 63%, data quality: 60%, flexibility: 58% and usefulness: 43%. Internal and external stakeholders commented on the value of NutriDash; its use ranging from nutrition global trend monitoring for programme planning to producing reports and dashboards. Key themes derived from this review as areas for improvement included communication, access to data and data quality.

CONCLUSIONS

This review has identified key themes that will inform improvements to NutriDash and form a baseline for future periodic reviews to continuously enhance the system to improve availability of timely quality nutrition programme data. UNICEF will continue to engage with countries, key partners and governments to improve the NutriDash data value chain and ensure the right to nutrition for every child.

Evaluation of a technical advisory board for an occupational injury surveillance research project: A qualitative study

Background and Aims

Advisory boards play a key role in guiding and informing research programs, including occupational health surveillance. It is important to evaluate the effectiveness of these advisory boards. This report details the organization of the Risk Information System for Commercial (RISC) Fishing Technical Advisory Board (TAB), the approach taken to evaluate the TAB, and the results of the evaluation. The RISC TAB was formed to provide advice and recommendations to the study team and informed the development and use of the safety surveillance system.

Methods

The evaluation approach was informed by limited previous literature on advisory board assessments. This evaluation was conducted in Year 5 of the 6-year project. A review of the meeting notes, materials and correspondences, and study progress was conducted internally to document input from the board and associated actions. To obtain member perspectives, we surveyed the TAB and discussed it in a subsequent TAB meeting.

Results

The RISC Fishing TAB members constitute a wide variety of commercial fishing safety stakeholders. The internal analysis identified the main project aspects and 14 of the proposed changes from the TAB that have either been implemented or are in progress in the project. Ten of the 15 TAB members responded indicating a positive experience on board organization and conduct.

Conclusion

Evaluation of advisory boards is an essential part of a research program. A process is outlined in this report to inform future efforts to document measurable ways to inform projects based on advisory board feedback and reflections.

Enhancing global health security in Thailand: Strengths and challenges of initiating a One Health approach to avian influenza surveillance

Infectious disease surveillance systems support early warning, promote preparedness, and inform public health response. Pathogens that have human, animal, and environmental reservoirs should be monitored through systems that incorporate a One Health approach. In 2016, Thailand's federal government piloted an avian influenza (AI) surveillance system that integrates stakeholders from human, animal, and environmental sectors, at the central level and in four provinces to monitor influenza A viruses within human, waterfowl, and poultry populations. This research aims to describe and evaluate Thailand's piloted AI surveillance system to inform strategies for strengthening and building surveillance systems relevant to One Health. We assessed this surveillance system using the United States Centers for Disease Control and Prevention's (U.S. CDC) “Guidelines for Evaluating Public Health Surveillance Systems” and added three novel metrics: transparency, interoperability, and security. In-depth key informant interviews were conducted with representatives among six Thai federal agencies and departments, the One Health coordinating unit, a corporate poultry producer, and the Thai Ministry of Public Health-U.S. CDC Collaborating Unit. Thailand's AI surveillance system demonstrated strengths in acceptability, simplicity, representativeness, and flexibility, and exhibited challenges in data quality, stability, security, interoperability, and transparency. System efforts may be strengthened through increasing laboratory integration, improving pathogen detection capabilities, implementing interoperable systems, and incorporating sustainable capacity building mechanisms. This innovative piloted surveillance system provides a strategic framework that can be used to develop, integrate, and bolster One Health surveillance approaches to combat emerging global pathogen threats and enhance global health security.

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Infectious disease surveillance systems are often siloed by host, pathogen, and route of entry.

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Thailand initiated an Avian Influenza surveillance system and adopted a One Health model.

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The system is strongest in acceptability, simplicity, representativeness, and flexibility.

Understanding occupational safety and health surveillance: expert consensus on components, attributes and example measures for an evaluation framework

BACKGROUND

Occupational safety and health (OSH) surveillance systems track work-related fatalities, injuries and illnesses as well as the presence of workplace hazards and exposures to inform prevention efforts. Periodic evaluation is critical to the improvement of these systems to meet the demand for more timely, complete, accurate and efficient data processing and analysis. Despite the existence of general guidance for public health surveillance evaluation, no tailored guidance exists for evaluating OSH surveillance systems to date. This study utilized the Delphi technique to collect consensus among experts in the United States on surveillance elements (components, attributes and measures) to inform the development of a tailored evaluation framework.

METHODS

A Delphi study approach with three survey rounds invited an expert panel to rate and comment on potential OSH surveillance evaluation framework elements, resulting in an optimal list of elements through the panel's consensus. Additionally, experts completed a review of OSH surveillance systems they worked with and answered questions regarding the development of an evaluation framework. Descriptive statistics of the ratings were compiled for the Delphi process. Major themes from experts' comments were further identified using content analysis to inform contextual information underlying their choices.

RESULTS

Fifty-four potential experts across the United States were contacted to participate in the Delphi study. Ten experts began the first survey round with eight then seven experts continuing in the subsequent rounds, respectively. A total of 64 surveillance components, 31 attributes, and 116 example measures were selected into the final list through panel consensus, with 134 (63.5%) reaching high consensus. Major themes regarding current OSH surveillance focused on resources and feasibility, data collection, flexibility, and the inter-relatedness among elements.

CONCLUSIONS

A Delphi process identified tailored OSH surveillance elements and major themes regarding OSH surveillance. The identified elements can serve as a preliminary guide for evaluating OSH surveillance systems. A more detailed evaluation framework is under development to incorporate these elements into a standard yet flexible approach to OSH surveillance evaluation.

Public health surveillance in the U.S. Department of Veterans Affairs: evaluation of the Praedico surveillance system

Background

Early threat detection and situational awareness are vital to achieving a comprehensive and accurate view of health-related events for federal, state, and local health agencies. Key to this are public health and syndromic surveillance systems that can analyze large data sets to discover patterns, trends, and correlations of public health significance. In 2020, Department of Veterans Affairs (VA) evaluated its public health surveillance system and identified areas for improvement.

Methods

Using the Centers for Disease Control and Prevention (CDC) Guidelines for Evaluating Public Health Surveillance Systems, we assessed the ability of the Praedico Surveillance System to perform public health surveillance for a variety of health issues and evaluated its performance compared to an enterprise data solution (VA Corporate Data Warehouse), legacy surveillance system (VA ESSENCE) and a national, collaborative syndromic surveillance platform (CDC NSSP BioSense).

Results

Review of system attributes found that the system was simple, flexible, and stable. Representativeness, timeliness, sensitivity, and Predictive Value Positive were acceptable but could be further improved. Data quality issues and acceptability present challenges that potentially affect the overall usefulness of the system.

Conclusions

Praedico is a customizable surveillance and data analytics platform built on big data technologies. Functionality is straightforward, with rapid query generation and runtimes. Data can be graphed, mapped, analyzed, and shared with key decision makers and stakeholders. Evaluation findings suggest that future development and system enhancements should focus on addressing Praedico data quality issues and improving user acceptability. Because Praedico is designed to handle big data queries and work with data from a variety of sources, it could be enlisted as a tool for interdepartmental and interagency collaboration and public health data sharing. We suggest that future system evaluations include measurements of value and effectiveness along with additional organizations and functional assessments.

Evaluating Oregon's occupational public health surveillance system based on the CDC updated guidelines

Background

The Oregon Occupational Public Health Program (OOPHP) monitors occupational health indicators (OHIs) to inform occupational safety and health (OSH) surveillance. In 2018, OOPHP evaluated the performance of the OSH surveillance system and identified areas for future improvement.

Methods

Following the Centers for Disease Control and Prevention (CDC) updated guidelines for evaluating public health surveillance systems, the OOPHP evaluation team engaged internal and external stakeholders using a mixed‐methods approach. Operational measures for ten surveillance attributes were developed. Multiple data collection methods resulted in credible evidence for evaluation conclusions. Analyses included summary statistics and qualitative analysis of interviews, a focus group, and online surveys.

Results

Twenty stakeholders took part in this evaluation, with an average participation rate of 55%. Results showed the Oregon OSH surveillance system was simple, flexible, and highly accepted by its stakeholders. Funding security presents challenges for stability. A lack of timeliness of OHIs, low relevance of OHIs to local OSH issues, and the system's ineffectual data dissemination all limit the usefulness of the OSH surveillance system. A review of key data sources for the system showed good data quality and predictive value positive, but relatively poor sensitivity and representativeness.

Conclusions

The evaluation team successfully adapted attributes and examples in the CDC guidelines to this Oregon OSH surveillance evaluation. The evaluation findings have informed the development of recommendations for improvements to OOPHP's OSH surveillance. Future research is needed to develop guidance specific to OSH surveillance evaluation.