Infection Control in Nursery Schools and Schools Using a School Absenteeism Surveillance System

Early Detection and Monitoring of Gastrointestinal Infections Using Syndromic Surveillance: A Systematic Review

The underreporting of laboratory-reported cases of community-based gastrointestinal (GI) infections poses a challenge for epidemiologists understanding the burden and seasonal patterns of GI pathogens. Syndromic surveillance has the potential to overcome the limitations of laboratory reporting through real-time data and more representative population coverage. This systematic review summarizes the utility of syndromic surveillance for early detection and surveillance of GI infections. Relevant articles were identified using the following keyword combinations: 'early warning', 'detection', 'gastrointestinal activity', 'gastrointestinal infections', 'syndrome monitoring', 'real-time monitoring', 'syndromic surveillance'. In total, 1820 studies were identified, 126 duplicates were removed, and 1694 studies were reviewed. Data extraction focused on studies reporting the routine use and effectiveness of syndromic surveillance for GI infections using relevant GI symptoms. Eligible studies (n = 29) were included in the narrative synthesis. Syndromic surveillance for GI infections has been implemented and validated for routine use in ten countries, with emergency department attendances being the most common source. Evidence suggests that syndromic surveillance can be effective in the early detection and routine monitoring of GI infections; however, 24% of the included studies did not provide conclusive findings. Further investigation is necessary to comprehensively understand the strengths and limitations associated with each type of syndromic surveillance system.

Nursery school absenteeism surveillance system and infection control measures in nursery schools

INTRODUCTION

The Nursery School Absenteeism Surveillance System (NSASSy), which includes 40% of all nursery schools in Japan, has a degree of effectiveness that is difficult to prove: nursery schools and areas without NSASSy cannot be evaluated for their incidence of infectious diseases as precisely as those with NSASSy. Instead, we examine nursery school countermeasures against infectious diseases by considering the endogeneity bias of NSASSy.

METHOD

After sending questionnaires to 500 Tokyo metropolitan and nearby nursery schools in November 2022, we received their responses through the end of 2022. Questionnaires asked about infection control measures of nursery schools: (1) cooperation with public health centers; (2) cooperation with staff; (3) cooperation with children's parents; (4) precautions among children; (5) countermeasure systems; (6) precaution systems; (7) recording of health conditions of children; (8) usefulness of studying while students; and (9) usefulness of training at nursery schools. Ordered probit with inverse probability weighted adjustment was used as the estimation procedure. The explanatory variable was a dummy variable for using NSASSy. Probability in weight was estimated using the first-step probit for NSASSy. Explanatory variables were a dummy variable for publicly funded nursery schools and a dummy variable for local governments that had adopted NSASSy.

RESULTS

We analyzed 193 nursery schools. NSASSy was negative and associated significantly with (3) cooperation with children's parents and (7) recording of health conditions of children. These countermeasures were more likely to have been taken by NSASSy nursery schools.

[Perceived needs regarding school health care]

BACKGROUND AND OBJECTIVE

Changes in infant morbidity require adaptations to preserve their proper development and academic performance. The objective of this study was to know the perceived needs of teachers, pediatricians and pediatric nurses regarding the training of schools to deal with emergences related to chronic pathology and accidents.

METHOD

Cross-sectional study using an ad hoc validated questionnaire on digital support (Google Forms) that included sociodemographic variables and a structured survey that collected information on chronic pathology, health care and safety in case of emergency in the school.

RESULTS

Data from 266 questionnaires (134 teachers, 132 pediatricians and pediatric nurses) were analyzed. 73.9% of the teachers stated that they have had students with chronic pathology during the last year and 45.5% confirmed the existence of protocols for their assistance, although 68.7% did not receive specific training for their care. 25% of pediatricians and nurses stated that the parents of children with chronic disease always notify the schools and 17.4% stated that they knew about the existence of specific protocols. 35.6% collaborated in training related to specific pathology or emergencies in schools, with a greater predominance of primary health care (P<.001). 50.7% of the pediatricians and 79.7% of the nurses stated as a medium-high priority the need to have a school nurse in the centers.

CONCLUSIONS

The health care of students with chronic diseases in schools can be improved for teachers, pediatricians and pediatric nurses, considering the figure of school nurse as the main improvement measure.

Cost-effectiveness analysis of (Nursery) School Absenteeism Surveillance System

BACKGROUND

Our earlier report reported that the (Nursery) School Absenteeism Surveillance System ((N)SASSy) can decrease numbers of patients. This study evaluates (N)SASSy's cost-effectiveness.

METHODS

A social perspective is taken for economic evaluation. For simplicity, 8,000 yen is assumed for direct medical costs. We assume the home health care duration to be 6 days, with 30 000 yen as the indirect opportunity cost of family nursing. Benefit-cost ratios are used as indicators of cost-effectiveness.

RESULTS

By multiplying the disease burden per patient by the reduced number of patients, the (N)SASSy effect was estimated as 206.9 billion yen, with 95% confidence interval of [67.3,346.6] billion yen. The total cost attributable to (N)SASSy throughout Japan is expected to be 2.63 billion yen. The benefit-cost ratio is expected to be approximately 60.

CONCLUSIONS

The estimated benefit-cost ratio is much higher than that for the routine immunization of children.