Evaluation of the trends in the incidence of infectious diseases using the syndromic surveillance system, early warning and response unit, Mongolia, from 2009 to 2017: a retrospective descriptive multi-year analytical study

Comprehensive Vaccine-Preventable Disease Surveillance in the Western Pacific Region: A Literature Review on Integration of Surveillance Functions, 2000-2021

INTRODUCTION

A strategic framework for 2021-2030 developed by the World Health Organization (WHO) Regional Office for the Western Pacific emphasizes the need for high-quality and integrated vaccine-preventable disease (VPD) surveillance. We conducted a literature review to document the barriers, enabling factors, and innovations for integrating surveillance functions for VPDs and other communicable diseases in Western Pacific Region (WPR) countries.

METHODS

We searched published and gray literature on integrated VPD surveillance from 2000 to 2021. Articles in English, Spanish, or French were screened to identify those relating to VPD surveillance in a WPR country and not meeting defined exclusion criteria. We categorized articles using the 8 WHO surveillance support functions and abstracted data on the country; type of surveillance; and reported barriers, enabling factors, and best practices for integration.

RESULTS

Of the 3,137 references screened, 87 met the eligibility criteria. Of the 8 surveillance support functions, the proportion of references that reported integration related to the laboratory was 56%, followed by workforce capacity (54%), governance (51%), data management and use (47%), field logistics and communication (47%), coordination (15%), program management (13%), and supervision (9%). Several references noted fragmented systems and a lack of coordination between units as barriers to integration, highlighting the importance of engagement across public health units and between the public and private sectors. The literature also indicated a need for interoperable information systems and revealed the use of promising new technologies for data reporting and laboratory testing. In some WPR countries, workforce capacity was strengthened at all administrative levels by the implementation of integrated trainings on data monitoring and use and on laboratory techniques applicable to multiple VPDs.

CONCLUSION

This literature review supports integrating VPDs into broader communicable disease surveillance systems in WPR countries while ensuring that the minimal WHO-recommended standards for VPD surveillance are met.

Hospital admissions due to infectious and parasitic diseases in England and Wales between 1999 and 2019: an ecological study

Background

Infectious diseases continue to account for considerable illness and death worldwide, and emerging infectious diseases (EIDs) are a significant burden on global economies and public health. This study aimed to investigate the trends in infectious and parasitic disease (IPD) hospital admissions (HA) in England and Wales between 1999 and 2019.

Methods

This is an ecological study using publicly available data taken from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admission data were collected for the period between April 1999 to March 2019. IPDHA were identified using the tenth version of the International Statistical Classification of Diseases system, diagnostic codes (A00–B99). The trend in hospital admissions was assessed using a Poisson model.

Results

The overall annual number for IPD hospital admissions for various causes increased by 412.9%, from 151,336 in 1999 to 776,215 in 2019, representing an increase in hospital admission rate of 349.9% from 290.25 (95% CI 288.79–291.71) in 1999 to 1305.88 (95% CI 1303.00–1308.77) in 2019 per 100,000 persons: trend test, p < 0.01. The most common causes of infectious and parasitic disease hospital admissions were intestinal infectious diseases, other bacterial diseases, and other viral diseases, which accounted for 33.6, 27.5, and 23.8%, respectively. Patients aged 15 years and below accounted for 34.2% of the entire number of IPD hospital admissions, followed by the age group 15–59 years with 27.9%, the age group 75 years and above with 22.7%, and then the age group 60–74 years with 15.2%.

Conclusion

There was an increase in the hospital admission rate due to infectious diseases in the UK from 1999 to 2019. The most common causes of infectious and parasitic disease hospital admissions were intestinal infectious diseases, other bacterial diseases, and other viral diseases.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-022-07388-1.

Hygienic Condition of Different Water Sources in the Kharaa River Basin, Mongolia in the Light of a Rapid Warming Trend

Mongolia is a water-scarce land-locked country, and available water resources are utilized for multiple purposes including irrigation, food preparation, drinking water for livestock and people. Limited data availability on water hygiene means that the related risks to public health are only partially understood. This is particularly problematic due to the widespread use of unimproved water sources such as surface water and water from simple shallow wells. Based on two field surveys in the Kharaa River Basin in spring 2017 and 2018, we assessed the presence and quantity of total coliforms (TC), fecal coliforms (FC), and E. coli bacteria in surface waters and wells and investigated potential linkages between temperature and hygiene. In the Kharaa River and its tributaries, TC concentrations averaged at a most probable number of (MPN) of 754 ± 761 per 100 mL and FC concentrations at an MPN of 31 ± 33. Only small and non-significant correlations between coliform concentrations and temperature were identified. Coliforms concentrations in wells were lower (average MPN for TC: 550 ± 1286, and for FC 58 ± 253). There was considerable variation between wells, with moderate but significant correlations between temperature and bacterial counts. Low water temperatures in April and May (just above freezing to less than 6.5 °C in wells and 7.5 °C to 14.5 °C in the river system) and the positive correlations between temperature and coliform concentrations particularly for well samples indicate that further warming is likely to increase the risks of microbiological water pollution. In the future, this should be complemented by modeling at a watershed scale. This should include the consideration of a trend towards stronger rainfall events, changes in livestock density, and urban sewage treatment and discharge, which are other likely drivers of changes in water hygiene.

Incidence of Severe Chronic Neutropenia in South Korea and Related Clinical Manifestations: A National Health Insurance Database Study

Background and objectives: Severe chronic neutropenia (SCN) is a condition in which absolute neutrophil counts remain at a low level (under 500/µL) over months or years. Because of the rare onset of SCN, its epidemiology, prognosis, and clinical manifestations have not yet been fully understood. In particular, large-cohort studies in Asian countries are still insufficient. Therefore, in this study, national health insurance data was used to investigate the epidemiologic features and prognosis of SCN in South Korea. Materials and Methods: The data from the Health Insurance Review and Assessment database recorded between 1 January 2011 and 31 December 2015 were explored. SCN was defined based on the ICD-10 code, registry of benefit extension policy, and inclusion criteria of the study. After identifying patients with SCN, annual incidence and their co-morbidities were analyzed. Results: Among the initially identified patients with severe neutropenia (N = 2145), a total of 367 patients had SCN and were enrolled. The annual incidence rate of SCN ranged from 0.12 to 0.17 per 100,000 person-year (PY) during the study period. The highest incidence was observed in pediatric patients aged between 0 to 9 years (N = 156), followed by women in their fifties (N = 43). The total incidence rate was 0.17 in females and 0.12 in males (Relative risk (RR): 1.43, 95%, CI: 1.16–1.76). The most common accompanying condition was mild respiratory infection, but about 3.2% of patients progressed to hematologic malignancy after an average of 2.4 years. Conclusions: This nationwide population-based epidemiological study showed that incidence of SCN is higher in pediatrics and middle-aged women. As progression to hematologic malignancy was significantly higher in the age of in 45–49 years old, careful follow-up is necessary in this group. However, since this study lacks the molecular information, these finding need to be interpreted with great caution.