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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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Hammond A, Kim JJ, Sadler H, Vandemaele K. Influenza surveillance systems using traditional and alternative sources of data: A scoping review. Influenza Other Respir Viruses 2022; 16:965-974. [PMID: 36073312 DOI: 10.1111/irv.13037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE While the World Health Organization's recommendation of syndromic sentinel surveillance for influenza is an efficient method to collect high-quality data, limitations exist. Aligned with the Research Recommendation 1.1.2 of the WHO Public Health Research Agenda for Influenza-to identify reliable complementary influenza surveillance systems which provide real-time estimates of influenza activity-we performed a scoping review to map the extent and nature of published literature on the use of non-traditional sources of syndromic surveillance data for influenza. METHODS We searched three electronic databases (PubMed, Web of Science, and Scopus) for articles in English, French, and Spanish, published between January 1 2007 and January 28 2022. Studies were included if they directly compared at least one non-traditional with a traditional influenza surveillance system in terms of correlation in activity or timeliness. FINDINGS We retrieved 823 articles of which 57 were included for analysis. Fifteen articles considered electronic health records (EHR), 11 participatory surveillance, 10 online searches and webpage traffic, seven Twitter, five absenteeism, four telephone health lines, three medication sales, two media reporting, and five looked at other miscellaneous sources of data. Several articles considered more than one non-traditional surveillance method. CONCLUSION We identified eight categories and a miscellaneous group of non-traditional influenza surveillance systems with varying levels of evidence on timeliness and correlation to traditional surveillance systems. Analyses of EHR and participatory surveillance systems appeared to have the most agreement on timeliness and correlation to traditional systems. Studies suggested non-traditional surveillance systems as complements rather than replacements to traditional systems.
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Affiliation(s)
- Aspen Hammond
- Global Influenza Programme, World Health Organization, Geneva, Switzerland
| | - John J Kim
- Global Influenza Programme, World Health Organization, Geneva, Switzerland.,School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Holly Sadler
- Global Influenza Programme, World Health Organization, Geneva, Switzerland
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Concordance between the Clinical Diagnosis of Influenza in Primary Care and Epidemiological Surveillance Systems (PREVIGrip Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031263. [PMID: 35162284 PMCID: PMC8835369 DOI: 10.3390/ijerph19031263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 02/05/2023]
Abstract
Introduction: Health authorities use different systems of influenza surveillance. Sentinel networks, which are recommended by the World Health Organization, provide information on weekly influenza incidence in a monitored population, based on laboratory-confirmed cases. In Catalonia there is a public website, DiagnostiCat, that publishes the number of weekly clinical diagnoses at the end of each week of disease registration, while the sentinel network publishes its reports later. The objective of this study was to determine whether there is concordance between the number of cases of clinical diagnoses and the number of confirmed cases of influenza, in order to evaluate the predictive potential of a clinical diagnosis-based system. Methods: Population-based ecological time series study in Catalonia. The period runs from the 2010–2011 to the 2018–2019 season. The concordance between the clinical diagnostic cases and the confirmed cases was evaluated. The degree of agreement and the concordance were analysed using Bland–Altman graphs and intraclass correlation coefficients. Results: There was greater concordance between the clinical diagnoses and the sum of the cases confirmed outside and within the sentinel network than between the diagnoses and the confirmed sentinel cases. The degree of agreement was higher when influenza rates were low. Conclusions: There is concordance between the clinical diagnosis and the confirmed cases of influenza. Registered clinical diagnostic cases could provide a good alternative to traditional surveillance, based on case confirmation. Cases of clinical diagnosis of influenza may have the potential to predict the onset of annual influenza epidemics.
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Liu D, Mitchell L, Cope RC, Carlson SJ, Ross JV. Elucidating user behaviours in a digital health surveillance system to correct prevalence estimates. Epidemics 2020; 33:100404. [PMID: 33002805 DOI: 10.1016/j.epidem.2020.100404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 08/12/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022] Open
Abstract
Estimating seasonal influenza prevalence is of undeniable public health importance, but remains challenging with traditional datasets due to cost and timeliness. Digital epidemiology has the potential to address this challenge, but can introduce sampling biases that are distinct to traditional systems. In online participatory health surveillance systems, the voluntary nature of the data generating process must be considered to address potential biases in estimates. Here we examine user behaviours in one such platform, FluTracking, from 2011 to 2017. We build a Bayesian model to estimate probabilities of an individual reporting in each week, given their past reporting behaviour, and to infer the weekly prevalence of influenza-like-illness (ILI) in Australia. We show that a model that corrects for user behaviour can substantially affect ILI estimates. The model examined here elucidates several factors, such as the status of having ILI and consistency of prior reporting, that are strongly associated with the likelihood of participating in online health surveillance systems. This framework could be applied to other digital participatory health systems where participation is inconsistent and sampling bias may be of concern.
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Affiliation(s)
- Dennis Liu
- School of Mathematical Sciences, The University of Adelaide, North Terrace, Adelaide, SA 5015, Australia; ARC Centre of Excellence for Mathematical and Statistical Frontiers (ACEMS), Australia.
| | - Lewis Mitchell
- School of Mathematical Sciences, The University of Adelaide, North Terrace, Adelaide, SA 5015, Australia; ARC Centre of Excellence for Mathematical and Statistical Frontiers (ACEMS), Australia
| | - Robert C Cope
- Biological Data Science Institute, The Australian National University, Canberra, ACT 2601, Australia
| | - Sandra J Carlson
- Hunter New England Population Health, Wallsend, NSW 2287, Australia
| | - Joshua V Ross
- School of Mathematical Sciences, The University of Adelaide, North Terrace, Adelaide, SA 5015, Australia; ARC Centre of Excellence for Mathematical and Statistical Frontiers (ACEMS), Australia
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Guerra J, Acharya P, Barnadas C. Community-based surveillance: A scoping review. PLoS One 2019; 14:e0215278. [PMID: 30978224 PMCID: PMC6461245 DOI: 10.1371/journal.pone.0215278] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/31/2019] [Indexed: 12/22/2022] Open
Abstract
Background Involving community members in identifying and reporting health events for public health surveillance purposes, an approach commonly described as community-based surveillance (CBS), is increasingly gaining interest. We conducted a scoping review to list terms and definitions used to characterize CBS, to identify and summarize available guidance and recommendations, and to map information on past and existing in-country CBS systems. Methods We searched eight bibliographic databases and screened the worldwide web for any document mentioning an approach in which community members both collected and reported information on health events from their community for public health surveillance. Two independent reviewers performed double blind screening and data collection, any discrepancy was solved through discussion and consensus. Findings From the 134 included documents, several terms and definitions for CBS were retrieved. Guidance and recommendations for CBS were scattered through seven major guides and sixteen additional documents. Seventy-nine unique CBS systems implemented since 1958 in 42 countries were identified, mostly implemented in low and lower-middle income countries (79%). The systems appeared as fragmented (81% covering a limited geographical area and 70% solely implemented in a rural setting), vertical (67% with a single scope of interest), and of limited duration (median of 6 years for ongoing systems and 2 years for ended systems). Collection of information was mostly performed by recruited community members (80%). Interpretation While CBS has already been implemented in many countries, standardization is still required on the term and processes to be used. Further research is needed to ensure CBS integrates effectively into the overall public health surveillance system.
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Affiliation(s)
- José Guerra
- World Health Organization (WHO), Lyon, France
- * E-mail:
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6
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Guerrisi C, Turbelin C, Souty C, Poletto C, Blanchon T, Hanslik T, Bonmarin I, Levy-Bruhl D, Colizza V. The potential value of crowdsourced surveillance systems in supplementing sentinel influenza networks: the case of France. Euro Surveill 2018; 23:1700337. [PMID: 29945696 PMCID: PMC6152237 DOI: 10.2807/1560-7917.es.2018.23.25.1700337] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 02/15/2018] [Indexed: 11/20/2022] Open
Abstract
IntroductionParticipatory surveillance systems provide rich crowdsourced data, profiling individuals and their health status at a given time. We explored the usefulness of data from GrippeNet.fr, a participatory surveillance system, to estimate influenza-related illness incidence in France. Methods: GrippeNet.fr is an online cohort since 2012 averaging ca. 5,000 weekly participants reporting signs/symptoms suggestive of influenza. GrippeNet.fr has flexible criteria to define influenza-related illness. Different case definitions based on reported signs/symptoms and inclusions of criteria accounting for individuals' reporting and participation were used to produce influenza-related illness incidence estimates, which were compared to those from sentinel networks. We focused on the 2012/13 and 2013/14 seasons when two sentinel networks, monitoring influenza-like-illness (ILI) and acute respiratory infections (ARI) existed in France. Results: GrippeNet.fr incidence estimates agreed well with official temporal trends, with a higher accuracy for ARI than ILI. The influenza epidemic peak was often anticipated by one week, despite irregular participation of individuals. The European Centre for Disease Prevention and Control ILI definition, commonly used by participatory surveillance in Europe, performed better in tracking ARI than ILI when applied to GrippeNet.fr data. Conclusion: Evaluation of the epidemic intensity from crowdsourced data requires epidemic and intensity threshold estimations from several consecutive seasons. The study provides a standardised analytical framework for crowdsourced surveillance showing high sensitivity in detecting influenza-related changes in the population. It contributes to improve the comparability of epidemics across seasons and with sentinel systems. In France, GrippeNet.fr may supplement the ILI sentinel network after ARI surveillance discontinuation in 2014.
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Affiliation(s)
- Caroline Guerrisi
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Clément Turbelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Cécile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Chiara Poletto
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Thomas Hanslik
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
- UFR des sciences de la santé Simone-Veil, Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
- AP-HP, Service de Médecine Interne, Hôpital Ambroise Paré, Boulogne Billancourt, France
| | - Isabelle Bonmarin
- Department of infectious diseases, Public Health France, Saint-Maurice, France
| | - Daniel Levy-Bruhl
- Department of infectious diseases, Public Health France, Saint-Maurice, France
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Paris, France
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7
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Cowling BJ, Xu C, Tang F, Zhang J, Shen J, Havers F, Wendladt R, Leung NH, Greene C, Iuliano AD, Shifflett P, Song Y, Zhang R, Kim L, Chen Y, Chu DK, Zhu H, Shu Y, Yu H, Thompson MG. Cohort profile: the China Ageing REespiratory infections Study (CARES), a prospective cohort study in older adults in Eastern China. BMJ Open 2017; 7:e017503. [PMID: 29092901 PMCID: PMC5695487 DOI: 10.1136/bmjopen-2017-017503] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/24/2017] [Accepted: 08/29/2017] [Indexed: 12/19/2022] Open
Abstract
PURPOSE This study was established to provide direct evidence on the incidence of laboratory-confirmed influenza virus and respiratory syncytial virus (RSV) infections in older adults in two cities in Jiangsu Province, China, and the potential impact of acute respiratory infections on frailty. PARTICIPANTS The cohort was enrolled in Suzhou and Yancheng, two cities in Jiangsu Province in Eastern China. Between November 2015 and March 2016, we enrolled 1532 adults who were 60-89 years of age, and collected blood samples along with baseline data on demographics, general health, chronic diseases, functional status and cognitive function through face-to-face interviews using a standardised questionnaire. Participants are being followed weekly throughout the year to identify acute respiratory illnesses. We schedule home visits to ill participants to collect mid-turbinate nasal and oropharyngeal swabs for laboratory testing and detailed symptom information for the acute illness. Regular follow-up including face-to-face interviews and further blood draws will take place every 6-12 months. FINDINGS TO DATE As of 3 September 2016, we had identified 339 qualifying acute respiratory illness events and 1463 (95%) participants remained in the study. Laboratory testing is ongoing. FUTURE PLANS We plan to conduct laboratory testing to estimate the incidence of influenza virus and RSV infections in older adults. We plan to investigate the impact of these infections on frailty and functional status to determine the association of pre-existing immune status with protection against influenza and RSV infection in unvaccinated older adults, and to assess the exposure to avian influenza viruses in this population.
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Affiliation(s)
- Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, Li Ka Shing Faculty of Medicine, School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Cuiling Xu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, Li Ka Shing Faculty of Medicine, School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
- Chinese National Influenza Center, National Institute for Viral Disease Control and Prevention, Collaboration Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Fenyang Tang
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, China
| | - Jun Zhang
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Jinjin Shen
- Yancheng Center for Disease Prevention and Control, Yancheng, China
| | - Fiona Havers
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Nancy Hl Leung
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, Li Ka Shing Faculty of Medicine, School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Carolyn Greene
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Ying Song
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ran Zhang
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lindsay Kim
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yuyun Chen
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, Li Ka Shing Faculty of Medicine, School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Daniel Kw Chu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, Li Ka Shing Faculty of Medicine, School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Huachen Zhu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, Li Ka Shing Faculty of Medicine, School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Yuelong Shu
- Chinese National Influenza Center, National Institute for Viral Disease Control and Prevention, Collaboration Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
- Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mark G Thompson
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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8
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Guerrisi C, Turbelin C, Blanchon T, Hanslik T, Bonmarin I, Levy-Bruhl D, Perrotta D, Paolotti D, Smallenburg R, Koppeschaar C, Franco AO, Mexia R, Edmunds WJ, Sile B, Pebody R, van Straten E, Meloni S, Moreno Y, Duggan J, Kjelsø C, Colizza V. Participatory Syndromic Surveillance of Influenza in Europe. J Infect Dis 2017; 214:S386-S392. [PMID: 28830105 DOI: 10.1093/infdis/jiw280] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The growth of digital communication technologies for public health is offering an unconventional means to engage the general public in monitoring community health. Here we present Influenzanet, a participatory system for the syndromic surveillance of influenza-like illness (ILI) in Europe. Through standardized online surveys, the system collects detailed profile information and self-reported symptoms volunteered by participants resident in the Influenzanet countries. Established in 2009, it now includes 10 countries representing more than half of the 28 member states of the European Union population. The experience of 7 influenza seasons illustrates how Influenzanet has become an adjunct to existing ILI surveillance networks, offering coherence across countries, inclusion of nonmedically attended ILI, flexibility in case definition, and facilitating individual-level epidemiological analyses generally not possible in standard systems. Having the sensitivity to timely detect substantial changes in population health, Influenzanet has the potential to become a viable instrument for a wide variety of applications in public health preparedness and control.
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Affiliation(s)
- Caroline Guerrisi
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique
| | - Clément Turbelin
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique
| | - Thierry Blanchon
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique
| | - Thomas Hanslik
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique.,Assistance Publique Hopitaux de Paris, Service de Medecine Interne, Hopital Ambroise Pare, Boulogne Billancourt
| | - Isabelle Bonmarin
- Department of infectious diseases, Public Health France, Saint-Maurice, France
| | - Daniel Levy-Bruhl
- Department of infectious diseases, Public Health France, Saint-Maurice, France
| | | | | | | | | | | | - Ricardo Mexia
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | | | | | | | | | - Sandro Meloni
- Institute for Biocomputation and Physics and Complex Systems, University of Zaragoza, Spain
| | - Yamir Moreno
- Institute for Biocomputation and Physics and Complex Systems, University of Zaragoza, Spain
| | - Jim Duggan
- College of Engineering and Informatics, National University of Ireland, Galway
| | | | - Vittoria Colizza
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique.,Institute for Scientific Interchange, Turin, Italy
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9
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PINI A, MERK H, CARNAHAN A, GALANIS I, VAN STRATEN E, DANIS K, EDELSTEIN M, WALLENSTEN A. High added value of a population-based participatory surveillance system for community acute gastrointestinal, respiratory and influenza-like illnesses in Sweden, 2013-2014 using the web. Epidemiol Infect 2017; 145:1193-1202. [PMID: 28137317 PMCID: PMC5426337 DOI: 10.1017/s0950268816003290] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/22/2016] [Accepted: 12/14/2016] [Indexed: 11/07/2022] Open
Abstract
In 2013-2014, the Public Health Agency of Sweden developed a web-based participatory surveillance system, Hӓlsorapport, based on a random sample of individuals reporting symptoms weekly online, to estimate the community incidence of self-reported acute gastrointestinal (AGI), acute respiratory (ARI) and influenza-like (ILI) illnesses and their severity. We evaluated Hӓlsorapport's acceptability, completeness, representativeness and its data correlation with other surveillance data. We calculated response proportions and Spearman correlation coefficients (r) between (i) incidence of illnesses in Hӓlsorapport and (ii) proportions of specific search terms to medical-advice website and reasons for calling a medical advice hotline. Of 34 748 invitees, 3245 (9·3%) joined the cohort. Participants answered 81% (139 013) of the weekly questionnaires and 90% (16 351) of follow-up questionnaires. AGI incidence correlated with searches on winter-vomiting disease [r = 0·81, 95% confidence interval (CI) 0·69-0·89], and ARI incidence correlated with searches on cough (r = 0·77, 95% CI 0·62-0·86). ILI incidence correlated with the web query-based estimated incidence of ILI patients consulting physicians (r = 0·63, 95% CI 0·42-0·77). The high response to different questionnaires and the correlation with other syndromic surveillance systems suggest that Hӓlsorapport offers a reasonable representation of AGI, ARI and ILI patterns in the community and can complement traditional and syndromic surveillance systems to estimate their burden in the community.
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Affiliation(s)
- A. PINI
- The Public Health Agency of Sweden, Stockholm, Sweden
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - H. MERK
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - A. CARNAHAN
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - I. GALANIS
- The Public Health Agency of Sweden, Stockholm, Sweden
| | | | - K. DANIS
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Santé Publique France, Public Health Agency, France
| | - M. EDELSTEIN
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - A. WALLENSTEN
- The Public Health Agency of Sweden, Stockholm, Sweden
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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10
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Intake of vitamin C, vitamin E, selenium, zinc and polyunsaturated fatty acids and upper respiratory tract infection-a prospective cohort study. Eur J Clin Nutr 2017; 71:450-457. [PMID: 28074891 DOI: 10.1038/ejcn.2016.261] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 10/06/2016] [Accepted: 11/21/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND/OBJECTIVES Antioxidants and polyunsaturated fatty acids (PUFAs) have a role in the human immune defense and may affect the susceptibility to upper respiratory tract infection (URTI). To examine dietary intake of vitamin C, vitamin E, selenium, zinc and PUFAs in relation to URTI incidence in a prospective cohort study. SUBJECTS/METHODS A total of 1533 Swedish women and men aged 25-64 years were followed for nine months during 2011-2012. Information on dietary intake was assessed through a web-based food frequency questionnaire, and events of URTI were self-reported prospectively as they occurred. Cox proportional hazards regression was applied to obtain incidence rate ratios with 95% confidence intervals. RESULTS The mean number of URTI events was 0.9 among all participants, 1.0 among women and 0.7 among men. In women, the incidence rate ratios (95% confidence interval) for high compared with low intake were 0.69 (0.55-0.88) for vitamin C, 0.77 (0.62-0.96) for vitamin E, 0.57 (0.39-0.83) for docosahexaenoic acid (DHA) and 0.80 (0.65-0.99) for arachidonic acid (AA). No association was found for selenium or zinc among women. In men, an increased URTI incidence was seen with medium vitamin E intake (1.42 (1.09-1.85)) and high zinc intake (1.50 (1.04-2.16)). No association was found for vitamin C, selenium or PUFAs among men. CONCLUSIONS We found an inverse association of URTI incidence among women for vitamin C, vitamin E, DHA and AA intake and a positive association among men for vitamin E and zinc intake. The observed gender differences warrant further investigation.
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van Noort SP, Codeço CT, Koppeschaar CE, van Ranst M, Paolotti D, Gomes MGM. Ten-year performance of Influenzanet: ILI time series, risks, vaccine effects, and care-seeking behaviour. Epidemics 2015; 13:28-36. [PMID: 26616039 DOI: 10.1016/j.epidem.2015.05.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 04/27/2015] [Accepted: 05/31/2015] [Indexed: 12/20/2022] Open
Abstract
Recent public health threats have propelled major innovations on infectious disease monitoring, culminating in the development of innovative syndromic surveillance methods. Influenzanet is an internet-based system that monitors influenza-like illness (ILI) in cohorts of self-reporting volunteers in European countries since 2003. We investigate and confirm coherence through the first ten years in comparison with ILI data from the European Influenza Surveillance Network and demonstrate country-specific behaviour of participants with ILI regarding medical care seeking. Using regression analysis, we determine that chronic diseases, being a child, living with children, being female, smoking and pets at home, are all independent predictors of ILI risk, whereas practicing sports and walking or bicycling for locomotion are associated with a small risk reduction. No effect for using public transportation or living alone was found. Furthermore, we determine the vaccine effectiveness for ILI for each season.
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Affiliation(s)
| | - Cláudia T Codeço
- Instituto Gulbenkian de Ciência, Oeiras, Portugal; Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Marc van Ranst
- Rega Institute for Medical Research, University of Leuven, Leuven, Belgium
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