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Atkins N, Harikar M, Duggan K, Zawiejska A, Vardhan V, Vokey L, Dozier M, de los Godos EF, Mcswiggan E, Mcquillan R, Theodoratou E, Shi T. What are the characteristics of participatory surveillance systems for influenza-like-illness? J Glob Health 2023; 13:04130. [PMID: 37856769 PMCID: PMC10587643 DOI: 10.7189/jogh.13.04130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Background Seasonal influenza causes significant morbidity and mortality, with an estimated 9.4 million hospitalisations and 290 000-650 000 respiratory related-deaths globally each year. Influenza can also cause mild illness, which is why not all symptomatic persons might necessarily be tested for influenza. To monitor influenza activity, healthcare facility-based syndromic surveillance for influenza-like illness is often implemented. Participatory surveillance systems for influenza-like illness (ILI) play an important role in influenza surveillance and can complement traditional facility-based surveillance systems to provide real-time estimates of influenza-like illness activity. However, such systems differ in designs between countries and contexts, making it necessary to identify their characteristics to better understand how they fit traditional surveillance systems. Consequently, we aimed to investigate the performance of participatory surveillance systems for ILI worldwide. Methods We systematically searched four databases for relevant articles on influenza participatory surveillance systems for ILI. We extracted data from the included, eligible studies and assessed their quality using the Joanna Briggs Critical Appraisal Tools. We then synthesised the findings using narrative synthesis. Results We included 39 out of 3797 retrieved articles for analysis. We identified 26 participatory surveillance systems, most of which sought to capture the burden and trends of influenza-like illness and acute respiratory infections among cohorts with risk factors for influenza-like illness. Of all the surveillance system attributes assessed, 52% reported on correlation with other surveillance systems, 27% on representativeness, and 21% on acceptability. Among studies that reported these attributes, all systems were rated highly in terms of simplicity, flexibility, sensitivity, utility, and timeliness. Most systems (87.5%) were also well accepted by users, though participation rates varied widely. However, despite their potential for greater reach and accessibility, most systems (90%) fared poorly in terms of representativeness of the population. Stability was a concern for some systems (60%), as was completeness (50%). Conclusions The analysis of participatory surveillance system attributes showed their potential in providing timely and reliable influenza data, especially in combination with traditional hospital- and laboratory led-surveillance systems. Further research is needed to design future systems with greater uptake and utility.
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Affiliation(s)
- Nadege Atkins
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
- Joint first authorship
| | - Mandara Harikar
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
- Joint first authorship
| | - Kirsten Duggan
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Agnieszka Zawiejska
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Vaishali Vardhan
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Laura Vokey
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Marshall Dozier
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Emma F de los Godos
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
- Equal contribution
| | - Emilie Mcswiggan
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ruth Mcquillan
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
- Equal contribution
| | - Evropi Theodoratou
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- UNCOVER (Usher Network for COVID-19 Evidence Reviews) Usher Institute, University of Edinburgh, Edinburgh, UK
- Equal contribution
| | - Ting Shi
- Center for Population Health Sciences, Usher Institute, University of Edinburgh, Scotland, UK
- Equal contribution
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Belazi S, Olsen SJ, Brown C, Green HK, Mook P, Nguyen-Van-Tam J, Penttinen P, Lansbury L. Spotlight influenza: Laboratory-confirmed seasonal influenza in people with acute respiratory illness: a literature review and meta-analysis, WHO European Region, 2004 to 2017. ACTA ACUST UNITED AC 2021; 26. [PMID: 34596019 PMCID: PMC8485580 DOI: 10.2807/1560-7917.es.2021.26.39.2000343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Across the World Health Organization European Region, there are few estimates of the proportion of people seeking medical care for influenza-like illness or acute respiratory infections and who have laboratory-confirmed seasonal influenza infection. Methods We conducted a meta-analysis of data extracted from studies published between 2004 and 2017 and from sentinel data from the European surveillance system (TESSy) between 2004 and 2018. We pooled within-season estimates by influenza type/subtype, setting (outpatient (OP)/inpatient (IP)) and age group to estimate the proportion of people tested who have laboratory-confirmed and medically-attended seasonal influenza in Europe. Results In the literature review, the pooled proportion for all influenza types was 33% (95% confidence interval (CI): 30–36), higher among OP 36% (95% CI: 33–40) than IP 24% (95% CI: 20–29). Pooled estimates for all influenza types by age group were: 0–17 years, 26% (22–31); 18–64 years, 41% (32–50); ≥ 65 years, 33% (27–40). From TESSy data, 33% (31–34) of OP and 24% (21–27) of IP were positive. The highest proportion of influenza A was in people aged 18–64 years (22%, 16–29). By subtype, A(H1N1)pdm09 was highest in 18–64 year-olds (16%, 11–21%) whereas A(H3N2) was highest in those ≥ 65 years (10%, 2–22). For influenza B, the highest proportion of infections was in those aged 18–64 years (15%, 9–24). Conclusions Laboratory-confirmed influenza accounted for approximately one third of all acute respiratory infections for which medical care was sought during the influenza season.
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Affiliation(s)
- Sara Belazi
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
| | | | | | | | - Piers Mook
- WHO Regional Office for Europe, Copenhagen, Denmark
| | - Jonathan Nguyen-Van-Tam
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Louise Lansbury
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom
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Chasqueira MJ, Paixão P, Rodrigues ML, Piedade C, Caires I, Palmeiro T, Botelho MA, Santos M, Curran M, Guiomar R, Pechirra P, Costa I, Papoila A, Alves M, Neuparth N. Respiratory infections in elderly people: Viral role in a resident population of elderly care centers in Lisbon, winter 2013-2014. Int J Infect Dis 2018; 69:1-7. [PMID: 29391246 PMCID: PMC7110569 DOI: 10.1016/j.ijid.2018.01.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 01/15/2018] [Accepted: 01/17/2018] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE The aim of this study was to analyze the etiology and clinical consequences of viral respiratory infections in 18 elderly care centers (ECC) in Lisbon, which housed a total of 1022 residents. METHODS Nasopharyngeal swabs were collected whenever an elderly had symptoms of acute respiratory infections (ARI). PCR and RT-PCR were performed for influenza A/B, human parainfluenza virus 1-4, adenovirus, human metapneumovirus (HMPV), respiratory syncytial virus (RSV), rhinovirus, enterovirus, human coronavirus and human Bocavirus (HBoV). Array cards for atypical bacteria were also used in severe cases. RESULTS In total, 188 episodes of ARI were reported, being rhinovirus the most frequently detected (n=53), followed by influenza A(H3) (n=19) and HBoV (n=14). Severe infections were reported in 19 patients, 11 of which were fatal, Legionela pneumophila, rhinovirus, HMPV and RSV associated with these fatalities. Nine influenza strains were analyzed, all antigenically dissimilar from vaccine strain 2013/14. "Age", "HMPV" and "Respiratory disease" showed an association with severe infection. CONCLUSIONS In this study an etiologic agent could be found in 60% of the acute respiratory episodes. These data provides information about the circulating viruses in ECC and highlights the importance of searching both viruses and atypical bacteria in severe ARI.
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Affiliation(s)
- Maria-Jesus Chasqueira
- NOVA Medical School-Faculdade de Ciências Médicas, Campo Mártires da Pátria, 130, 1169-056 Lisboa, Portugal.
| | - Paulo Paixão
- Centro de Estudos de Doenças Crónicas, CEDOC, NOVA Medical School-Faculdade de Ciências Médicas, CEDOC I, Rua do Instituto Bacteriológico, n.°s 5, 5-A e 5-B, 1150-190 Lisboa, Portugal.
| | - Maria-Lúcia Rodrigues
- NOVA Medical School-Faculdade de Ciências Médicas, Campo Mártires da Pátria, 130, 1169-056 Lisboa, Portugal.
| | - Cátia Piedade
- NOVA Medical School-Faculdade de Ciências Médicas, Campo Mártires da Pátria, 130, 1169-056 Lisboa, Portugal.
| | - Iolanda Caires
- Centro de Estudos de Doenças Crónicas, CEDOC, NOVA Medical School-Faculdade de Ciências Médicas, CEDOC I, Rua do Instituto Bacteriológico, n.°s 5, 5-A e 5-B, 1150-190 Lisboa, Portugal.
| | - Teresa Palmeiro
- Centro de Estudos de Doenças Crónicas, CEDOC, NOVA Medical School-Faculdade de Ciências Médicas, CEDOC I, Rua do Instituto Bacteriológico, n.°s 5, 5-A e 5-B, 1150-190 Lisboa, Portugal.
| | - Maria-Amalia Botelho
- Centro de Estudos de Doenças Crónicas, CEDOC, NOVA Medical School-Faculdade de Ciências Médicas, CEDOC I, Rua do Instituto Bacteriológico, n.°s 5, 5-A e 5-B, 1150-190 Lisboa, Portugal.
| | - Madalena Santos
- Hospital Curry Cabral, Centro Hospitalar de Lisboa Central, Rua da Beneficência n.° 8, 1069-166 Lisboa, Portugal.
| | - Martin Curran
- Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0QQ, UK.
| | - Raquel Guiomar
- Laboratório Nacional de Referência para o Vírus da Gripe, Instituto Nacional de Saúde Ricardo Jorge, Av. Padre Cruz, 1600 Lisboa, Portugal.
| | - Pedro Pechirra
- Laboratório Nacional de Referência para o Vírus da Gripe, Instituto Nacional de Saúde Ricardo Jorge, Av. Padre Cruz, 1600 Lisboa, Portugal.
| | - Inês Costa
- Laboratório Nacional de Referência para o Vírus da Gripe, Instituto Nacional de Saúde Ricardo Jorge, Av. Padre Cruz, 1600 Lisboa, Portugal.
| | - Ana Papoila
- Epidemiology and Statistics, Research Unit, Centro Hospitalar de Lisboa Central, EPE, Rua José António Serrano, 1150-199 Lisboa, Portugal; CEAUL, Departamento de Bioestatística e Informática, NOVA Medical School-Faculdade de Ciências Médicas, CEDOC I, Rua do Instituto Bacteriológico, n.°s 5, 5-A e 5-B, 1150-190 Lisboa, Portugal.
| | - Marta Alves
- Epidemiology and Statistics, Research Unit, Centro Hospitalar de Lisboa Central, EPE, Rua José António Serrano, 1150-199 Lisboa, Portugal.
| | - Nuno Neuparth
- Centro de Estudos de Doenças Crónicas, CEDOC, NOVA Medical School-Faculdade de Ciências Médicas, CEDOC I, Rua do Instituto Bacteriológico, n.°s 5, 5-A e 5-B, 1150-190 Lisboa, Portugal.
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