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Kostkova P, Saigí-Rubió F, Eguia H, Borbolla D, Verschuuren M, Hamilton C, Azzopardi-Muscat N, Novillo-Ortiz D. Data and Digital Solutions to Support Surveillance Strategies in the Context of the COVID-19 Pandemic. Front Digit Health 2021; 3:707902. [PMID: 34713179 PMCID: PMC8522016 DOI: 10.3389/fdgth.2021.707902] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/30/2021] [Indexed: 12/23/2022] Open
Abstract
Background: In order to prevent spread and improve control of infectious diseases, public health experts need to closely monitor human and animal populations. Infectious disease surveillance is an established, routine data collection process essential for early warning, rapid response, and disease control. The quantity of data potentially useful for early warning and surveillance has increased exponentially due to social media and other big data streams. Digital epidemiology is a novel discipline that includes harvesting, analysing, and interpreting data that were not initially collected for healthcare needs to enhance traditional surveillance. During the current COVID-19 pandemic, the importance of digital epidemiology complementing traditional public health approaches has been highlighted. Objective: The aim of this paper is to provide a comprehensive overview for the application of data and digital solutions to support surveillance strategies and draw implications for surveillance in the context of the COVID-19 pandemic and beyond. Methods: A search was conducted in PubMed databases. Articles published between January 2005 and May 2020 on the use of digital solutions to support surveillance strategies in pandemic settings and health emergencies were evaluated. Results: In this paper, we provide a comprehensive overview of digital epidemiology, available data sources, and components of 21st-century digital surveillance, early warning and response, outbreak management and control, and digital interventions. Conclusions: Our main purpose was to highlight the plausible use of new surveillance strategies, with implications for the COVID-19 pandemic strategies and then to identify opportunities and challenges for the successful development and implementation of digital solutions during non-emergency times of routine surveillance, with readiness for early-warning and response for future pandemics. The enhancement of traditional surveillance systems with novel digital surveillance methods opens a direction for the most effective framework for preparedness and response to future pandemics.
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Affiliation(s)
- Patty Kostkova
- UCL Centre for Digital Public Health in Emergencies (dPHE), Institute for Risk and Disaster Reduction, University College London, London, United Kingdom
| | - Francesc Saigí-Rubió
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain.,Interdisciplinary Research Group on ICTs, Barcelona, Spain
| | - Hans Eguia
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain.,SEMERGEN New Technologies Working Group, Madrid, Spain
| | - Damian Borbolla
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States
| | - Marieke Verschuuren
- Division of Country Health Policies and Systems, Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Clayton Hamilton
- Division of Country Health Policies and Systems, Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Natasha Azzopardi-Muscat
- Division of Country Health Policies and Systems, Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - David Novillo-Ortiz
- Division of Country Health Policies and Systems, Regional Office for Europe, World Health Organization, Copenhagen, Denmark
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2
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Meier GC, Watkins J, McEwan P, Pockett RD. Resource use and direct medical costs of acute respiratory illness in the UK based on linked primary and secondary care records from 2001 to 2009. PLoS One 2020; 15:e0236472. [PMID: 32760071 PMCID: PMC7410242 DOI: 10.1371/journal.pone.0236472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 06/16/2020] [Indexed: 11/25/2022] Open
Abstract
Background Previous studies have shown that influenza is associated with a substantial healthcare burden in the United Kingdom (UK), but more studies are needed to evaluate the resource use and direct medical costs of influenza in primary care and secondary care. Methods A retrospective observational database study in the UK to describe the primary care and directly-associated secondary care resource use, and direct medical costs of acute respiratory illness (ARI), according to age, and risk status (NCT Number: 01521416). Patients with influenza, ARI or influenza-related respiratory infections during 9 consecutive pre-pandemic influenza peak seasons were identified by READ codes in the linked Clinical Practice Research Datalink (CPRD) and Hospital Episodes Statistics (HES) dataset. The study period was from 21st January 2001 to 31st March 2009. Results A total of 156,193 patients had ≥1 general practitioner (GP) episode of ARI, and a total of 82,204 patients received ≥1 GP prescription, at a mean of 2.5 (standard deviation [SD]: 3.0) prescriptions per patient. The total cost of GP consultations and prescriptions equated to £462,827 per year per 100,000 patients. The yearly cost of prescribed medication for ARI was £319,732, at an estimated cost of £11,596,350 per year extrapolated to the UK, with 40% attributable to antibiotics. The mean cost of hospital admissions equated to a yearly cost of £981,808 per 100,000 patients. The total mean direct medical cost of ARI over 9 influenza seasons was £21,343,445 (SD: £10,441,364), at £136.65 (SD: £66.85) per case. Conclusions Extrapolating to the UK population, for pre-pandemic influenza seasons from 2001 to 2009, the direct medical cost of ARI equated to £86 million each year. More studies are needed to assess the costs of influenza disease to help guide public health decision-making for seasonal influenza in the UK.
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Affiliation(s)
| | - John Watkins
- Public Health Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, Wales, United Kingdom
| | - Phil McEwan
- Swansea Centre for Health Economics, Swansea University, Swansea, Wales, United Kingdom
| | - Rhys D. Pockett
- Swansea Centre for Health Economics, Swansea University, Swansea, Wales, United Kingdom
- * E-mail:
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3
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Richard A, Müller L, Wisniak A, Thiabaud A, Merle T, Dietrich D, Paolotti D, Jeannot E, Flahault A. Grippenet: A New Tool for the Monitoring, Risk-Factor and Vaccination Coverage Analysis of Influenza-Like Illness in Switzerland. Vaccines (Basel) 2020; 8:vaccines8030343. [PMID: 32605076 PMCID: PMC7565003 DOI: 10.3390/vaccines8030343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/16/2020] [Accepted: 06/23/2020] [Indexed: 11/25/2022] Open
Abstract
Implemented in Switzerland in November 2016, Grippenet provides Internet-based participatory surveillance of influenza-like illness (ILI). The aim of this research is to test the feasibility of such a system and its ability to detect risk factors and to assess ILI-related behaviors. Participants filled in a web-based socio-demographic and behavioral questionnaire upon registration, and a weekly symptoms survey during the influenza season. ILI incidence was calculated weekly, and risk factors associated to ILI were analyzed at the end of each season. From November 2016 to May 2019, 1247 participants were included. The crossing of the Sentinel System (Sentinella) epidemic threshold was associated with an increase or decrease of Grippenet ILI incidence, within the same week or earlier. The number of active users varied according to ILI incidence. Factors associated with ILI were: ages 0–4 compared with 5–14 (adjusted odds ratio (AOR) 0.6, 95% confidence interval (CI) 0.19–0.99), 15–29 (AOR 0.29, 95% CI 0.15–0.60), and 65+ (AOR 0.38, 95% CI 0.16–0.93); female sex (male AOR 0.81, 95% CI 0.7–0.95); respiratory allergies (AOR 1.58, 95% CI 1.38–1.96), not being vaccinated (AOR 2.4, 95% CI 1.9–3.04); and self-employment (AOR 1.97, 95% CI 1.33–3.03). Vaccination rates were higher than those of the general population but not high enough to meet the Swiss recommendations. Approximately, 36.2% to 42.5% of users who reported one or more ILIs did not seek medical attention. These results illustrate the potential of Grippenet in complementing Sentinella for ILI monitoring in Switzerland.
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Affiliation(s)
- Aude Richard
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland; (L.M.); (A.W.); (A.T.); (T.M.); (D.D.); (E.J.); (A.F.)
- Correspondence:
| | - Laura Müller
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland; (L.M.); (A.W.); (A.T.); (T.M.); (D.D.); (E.J.); (A.F.)
| | - Ania Wisniak
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland; (L.M.); (A.W.); (A.T.); (T.M.); (D.D.); (E.J.); (A.F.)
| | - Amaury Thiabaud
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland; (L.M.); (A.W.); (A.T.); (T.M.); (D.D.); (E.J.); (A.F.)
| | - Thibaut Merle
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland; (L.M.); (A.W.); (A.T.); (T.M.); (D.D.); (E.J.); (A.F.)
| | - Damien Dietrich
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland; (L.M.); (A.W.); (A.T.); (T.M.); (D.D.); (E.J.); (A.F.)
- Luxembourg Institute of Health, 1445 Strassen, Luxemburg
| | - Daniela Paolotti
- Institute for Scientific Interchange Foundation, 10126 Torino, Italy;
| | - Emilien Jeannot
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland; (L.M.); (A.W.); (A.T.); (T.M.); (D.D.); (E.J.); (A.F.)
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, 1004 Lausanne, Switzerland
| | - Antoine Flahault
- Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland; (L.M.); (A.W.); (A.T.); (T.M.); (D.D.); (E.J.); (A.F.)
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4
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Geneviève LD, Martani A, Wangmo T, Paolotti D, Koppeschaar C, Kjelsø C, Guerrisi C, Hirsch M, Woolley-Meza O, Lukowicz P, Flahault A, Elger BS. Participatory Disease Surveillance Systems: Ethical Framework. J Med Internet Res 2019; 21:e12273. [PMID: 31124466 PMCID: PMC6660191 DOI: 10.2196/12273] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 03/08/2019] [Accepted: 03/29/2019] [Indexed: 12/23/2022] Open
Abstract
Advances in information technology are changing public health at an unprecedented rate. Participatory surveillance systems are contributing to public health by actively engaging digital (eg, Web-based) communities of volunteer citizens to report symptoms and other pertinent information on public health threats and also by empowering individuals to promptly respond to them. However, this digital model raises ethical issues on top of those inherent in traditional forms of public health surveillance. Research ethics are undergoing significant changes in the digital era where not only participants' physical and psychological well-being but also the protection of their sensitive data have to be considered. In this paper, the digital platform of Influenzanet is used as a case study to illustrate those ethical challenges posed to participatory surveillance systems using digital platforms and mobile apps. These ethical challenges include the implementation of electronic consent, the protection of participants' privacy, the promotion of justice, and the need for interdisciplinary capacity building of research ethics committees. On the basis of our analysis, we propose a framework to regulate and strengthen ethical approaches in the field of digital public health surveillance.
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Affiliation(s)
| | - Andrea Martani
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | | | - Carl Koppeschaar
- De Grote Griepmeting, Science in Action BV, Amsterdam, Netherlands
| | | | - Caroline Guerrisi
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - Marco Hirsch
- German Research Center for Artificial Intelligence (DFKI), Kaiserslautern, Germany
| | - Olivia Woolley-Meza
- ETH Zurich, Swiss Federal Institute of Technology, Zurich, Switzerland
- Novartis Pharma AG, Basel, Switzerland
| | - Paul Lukowicz
- German Research Center for Artificial Intelligence (DFKI), Kaiserslautern, Germany
| | - Antoine Flahault
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Bernice Simone Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
- University Center of Legal Medicine, University of Geneva, Geneva, Switzerland
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5
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Geneviève LD, Wangmo T, Dietrich D, Woolley-Meza O, Flahault A, Elger BS. Research Ethics in the European Influenzanet Consortium: Scoping Review. JMIR Public Health Surveill 2018; 4:e67. [PMID: 30305258 PMCID: PMC6231872 DOI: 10.2196/publichealth.9616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 06/04/2018] [Accepted: 06/28/2018] [Indexed: 11/28/2022] Open
Abstract
Background Influenzanet was launched in several European countries to monitor influenza-like illness during flu seasons with the help of volunteering participants and Web-based technologies. As in the case of developing fields, ethical approaches are not well developed in the collection, processing, and analysis of participants’ information. Existing controversies and varying national ethical regulations can, thus, hamper efficient cross-border research collaboration to the detriment of quality disease surveillance. Objective This scoping review characterizes current practices on how ethical, legal, and social issues (ELSIs) pertinent to research ethics are handled by different Influenzanet country groups to analyze similarities and identify the need for further harmonization of ethical approaches. Methods A literature search was carried out on PubMed, Web of Science, Global Digital Library on Ethics, and Bioethics Literature Database to identify ELSIs for Influenzanet country platforms. Only English-language papers were included with publication dates from 2003 to 2017. Publications were screened for the application of bioethics principles in the implementation of country platforms. Additional publications gathered from the Influenzanet Consortium website, reference screening, and conference proceeding were screened for ELSIs. Results We gathered 96 papers from our search methodology. In total, 28 papers that mentioned ELSIs were identified and included in this study. The Research Ethics Committee (REC) approvals were sought for recruiting participants and collecting their data in 8 of 11 country platforms and informed e-consent was sought from participants in 9 of 11 country platforms. Furthermore, personal data protection was ensured throughout the Consortium using data anonymization before processing and analysis and using aggregated data. Conclusions Epidemics forecasting activities, such as Influenzanet, are beneficial; however, its benefits could be further increased through the harmonization of data gathering and ethical requirements. This objective is achievable by the Consortium. More transparency should be promoted concerning REC-approved research for Influenzanet-like systems. The validity of informed e-consent could also be increased through the provision of a user friendly and standard information sheet across the Consortium where participants agree to its terms, conditions, and privacy policies before being able to fill in the questionnaire. This will help to build trust in the general public while preventing any decline in participation.
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Affiliation(s)
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Damien Dietrich
- Department of Radiology and Medical Informatics, Geneva University Hospitals, Geneva, Switzerland.,Institute of Global Health, University of Geneva, Geneva, Switzerland
| | | | - Antoine Flahault
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Bernice Simone Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.,University Center of Legal Medicine, University of Geneva, Geneva, Switzerland
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6
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Smolinski MS, Crawley AW, Olsen JM, Jayaraman T, Libel M. Participatory Disease Surveillance: Engaging Communities Directly in Reporting, Monitoring, and Responding to Health Threats. JMIR Public Health Surveill 2017; 3:e62. [PMID: 29021131 PMCID: PMC5658636 DOI: 10.2196/publichealth.7540] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 06/04/2017] [Accepted: 06/06/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Since 2012, the International Workshop on Participatory Surveillance (IWOPS) has served as an informal network to share best practices, consult on analytic methods, and catalyze innovation to advance the burgeoning method of direct engagement of populations in voluntary monitoring of disease. OBJECTIVE This landscape provides an overview of participatory disease surveillance systems in the IWOPS network and orients readers to this growing field of practice. METHODS Authors reviewed participatory approaches that include human and animal health surveillance, both syndromic (self- reported symptoms) and event-based, and how these tools have been leveraged for disease modeling and forecasting. The authors also discuss benefits, challenges, and future directions for participatory disease surveillance. RESULTS There are at least 23 distinct participatory surveillance tools or programs represented in the IWOPS network across 18 countries. Organizations supporting these tools are diverse in nature. CONCLUSIONS Participatory disease surveillance is a promising method to complement both traditional, facility-based surveillance and newer digital epidemiology systems.
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Affiliation(s)
- Mark S Smolinski
- Skoll Global Threats Fund, Ending Pandemics, San Francisco, CA, United States
| | - Adam W Crawley
- Skoll Global Threats Fund, Ending Pandemics, San Francisco, CA, United States
| | - Jennifer M Olsen
- Skoll Global Threats Fund, Ending Pandemics, San Francisco, CA, United States
| | - Tanvi Jayaraman
- Skoll Global Threats Fund, Ending Pandemics, San Francisco, CA, United States
| | - Marlo Libel
- Skoll Global Threats Fund, Ending Pandemics, San Francisco, CA, United States
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7
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Koppeschaar CE, Colizza V, Guerrisi C, Turbelin C, Duggan J, Edmunds WJ, Kjelsø C, Mexia R, Moreno Y, Meloni S, Paolotti D, Perrotta D, van Straten E, Franco AO. Influenzanet: Citizens Among 10 Countries Collaborating to Monitor Influenza in Europe. JMIR Public Health Surveill 2017; 3:e66. [PMID: 28928112 PMCID: PMC5627046 DOI: 10.2196/publichealth.7429] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 06/23/2017] [Accepted: 06/26/2017] [Indexed: 11/13/2022] Open
Abstract
Background The wide availability of the Internet and the growth of digital communication technologies have become an important tool for epidemiological studies and health surveillance. Influenzanet is a participatory surveillance system monitoring the incidence of influenza-like illness (ILI) in Europe since 2003. It is based on data provided by volunteers who self-report their symptoms via the Internet throughout the influenza season and currently involves 10 countries. Objective In this paper, we describe the Influenzanet system and provide an overview of results from several analyses that have been performed with the collected data, which include participant representativeness analyses, data validation (comparing ILI incidence rates between Influenzanet and sentinel medical practice networks), identification of ILI risk factors, and influenza vaccine effectiveness (VE) studies previously published. Additionally, we present new VE analyses for the Netherlands, stratified by age and chronic illness and offer suggestions for further work and considerations on the continuity and sustainability of the participatory system. Methods Influenzanet comprises country-specific websites where residents can register to become volunteers to support influenza surveillance and have access to influenza-related information. Participants are recruited through different communication channels. Following registration, volunteers submit an intake questionnaire with their postal code and sociodemographic and medical characteristics, after which they are invited to report their symptoms via a weekly electronic newsletter reminder. Several thousands of participants have been engaged yearly in Influenzanet, with over 36,000 volunteers in the 2015-16 season alone. Results In summary, for some traits and in some countries (eg, influenza vaccination rates in the Netherlands), Influenzanet participants were representative of the general population. However, for other traits, they were not (eg, participants underrepresent the youngest and oldest age groups in 7 countries). The incidence of ILI in Influenzanet was found to be closely correlated although quantitatively higher than that obtained by the sentinel medical practice networks. Various risk factors for acquiring an ILI infection were identified. The VE studies performed with Influenzanet data suggest that this surveillance system could develop into a complementary tool to measure the effectiveness of the influenza vaccine, eventually in real time. Conclusions Results from these analyses illustrate that Influenzanet has developed into a fast and flexible monitoring system that can complement the traditional influenza surveillance performed by sentinel medical practices. The uniformity of Influenzanet allows for direct comparison of ILI rates between countries. It also has the important advantage of yielding individual data, which can be used to identify risk factors. The way in which the Influenzanet system is constructed allows the collection of data that could be extended beyond those of ILI cases to monitor pandemic influenza and other common or emerging diseases.
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Affiliation(s)
| | - Vittoria Colizza
- UPMC Univ Paris 06, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Sorbonne Universités, Paris, France
| | - Caroline Guerrisi
- UPMC Univ Paris 06, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Sorbonne Universités, Paris, France
| | - Clément Turbelin
- UPMC Univ Paris 06, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Sorbonne Universités, Paris, France
| | - Jim Duggan
- School of Engineering and Informatics, National University of Ireland, Galway, Ireland
| | - W John Edmunds
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Ricardo Mexia
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Yamir Moreno
- Institute for Biocomputation and Physics of Complex Systems, Department of Theoretical Physics, University of Zaragoza, Zaragoza, Spain
| | - Sandro Meloni
- Institute for Biocomputation and Physics of Complex Systems, Department of Theoretical Physics, University of Zaragoza, Zaragoza, Spain
| | | | | | | | - Ana O Franco
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Instituto Gulbenkian de Ciência, Oeiras, Portugal
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Participatory Online Surveillance as a Supplementary Tool to Sentinel Doctors for Influenza-Like Illness Surveillance in Italy. PLoS One 2017; 12:e0169801. [PMID: 28076411 PMCID: PMC5226807 DOI: 10.1371/journal.pone.0169801] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 12/21/2016] [Indexed: 11/20/2022] Open
Abstract
The monitoring of seasonal influenza yearly epidemics remains one of the main activity of national syndromic surveillance systems. The development of internet-based surveillance tools has brought an innovative approach to seasonal influenza surveillance by directly involving self-selected volunteers among the general population reporting their health status on a weekly basis throughout the flu season. In this paper, we explore how Influweb, an internet-based monitoring system for influenza surveillance, deployed in Italy since 2008 has performed during three years from 2012 to 2015 in comparison with data collected during the same period by the Italian sentinel doctors surveillance system.
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9
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Influenza during pregnancy: Incidence, vaccination coverage and attitudes toward vaccination in the French web-based cohort G-GrippeNet. Vaccine 2016; 34:2390-6. [DOI: 10.1016/j.vaccine.2016.03.034] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 03/07/2016] [Accepted: 03/14/2016] [Indexed: 11/23/2022]
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10
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Loubet P, Guerrisi C, Turbelin C, Blondel B, Launay O, Bardou M, Blanchon T, Bonmarin I, Goffinet F, Ancel PY, Colizza V, Hanslik T, Kernéis S. First nationwide web-based surveillance system for influenza-like illness in pregnant women: participation and representativeness of the French G-GrippeNet cohort. BMC Public Health 2016; 16:253. [PMID: 26969654 PMCID: PMC4788930 DOI: 10.1186/s12889-016-2899-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 02/19/2016] [Indexed: 11/25/2022] Open
Abstract
Background Pregnancy is a risk factor for severe influenza resulting in increased risks of hospitalisation and death in mothers and their new-borns. Our objective was to assess the representativeness and participation of French women to a new web-based collaborative tool for data collection and monitoring of Influenza Like Illness (ILI) during pregnancy. Methods During the 2014/2015 influenza season, pregnant women living in metropolitan France were enrolled through a web platform (https://www.grippenet.fr/). Then throughout the season, participants were asked to report, on a weekly basis, if they had experienced symptoms of ILI. Representativeness was assessed by comparing the characteristics of participants to those of the French National Perinatal Survey. For each participant, the participation rate was the number of weekly questionnaires completed, divided by the length of follow-up (in weeks). Predictors of active participation (participation rate >15 %) were assessed by multivariate logistic regression. Results A total of 153 women were enrolled. Participants were older (mean age 34 years vs. 29 years) and more highly educated (high school level 89 % versus 52 %) than the general population of pregnant women in France, but the sample did not differ on pregnancy-related characteristics (parity, history of hospitalisation during a previous pregnancy). The median rate of participation was high (78 %, interquartile range: 34–96). Higher educational level and participation to a previous GrippeNet.fr season were associated with active participation. Conclusion Despite small sample size and lack of representativeness, the retention rate was high, suggesting that pregnant women are prone to adhere to a longitudinal follow-up of their health status via the Internet.
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Affiliation(s)
- Paul Loubet
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France.,Department of Infectious diseases, CIC Cochin-Pasteur, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Caroline Guerrisi
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France
| | - Clément Turbelin
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France
| | - Béatrice Blondel
- INSERM U 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, France
| | - Odile Launay
- Department of Infectious diseases, CIC Cochin-Pasteur, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,INSERM U 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, France.,INSERM CIC 1417, Paris, France.,Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France
| | - Marc Bardou
- Clinical Investigation Center (CIC) INSERM 1432, Gynecology and Obstetrics CIC Network (GO-CIC) & Hepato-gastroenterology department, Dijon Hospital, Dijon, France
| | - Thierry Blanchon
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France
| | - Isabelle Bonmarin
- Department of Infectious Diseases, Institut de Veille Sanitaire (InVS), St Maurice, France
| | - François Goffinet
- INSERM U 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, France.,Department of Obstetrics and Gynecology, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Pierre-Yves Ancel
- INSERM U 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, France
| | - Vittoria Colizza
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France
| | - Thomas Hanslik
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012, Paris, France
| | - Solen Kernéis
- Department of Infectious diseases, CIC Cochin-Pasteur, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France. .,INSERM U 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, France. .,INSERM CIC 1417, Paris, France.
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Smolinski MS, Crawley AW, Baltrusaitis K, Chunara R, Olsen JM, Wójcik O, Santillana M, Nguyen A, Brownstein JS. Flu Near You: Crowdsourced Symptom Reporting Spanning 2 Influenza Seasons. Am J Public Health 2015; 105:2124-30. [PMID: 26270299 DOI: 10.2105/ajph.2015.302696] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES We summarized Flu Near You (FNY) data from the 2012-2013 and 2013-2014 influenza seasons in the United States. METHODS FNY collects limited demographic characteristic information upon registration, and prompts users each Monday to report symptoms of influenza-like illness (ILI) experienced during the previous week. We calculated the descriptive statistics and rates of ILI for the 2012-2013 and 2013-2014 seasons. We compared raw and noise-filtered ILI rates with ILI rates from the Centers for Disease Control and Prevention ILINet surveillance system. RESULTS More than 61 000 participants submitted at least 1 report during the 2012-2013 season, totaling 327 773 reports. Nearly 40 000 participants submitted at least 1 report during the 2013-2014 season, totaling 336 933 reports. Rates of ILI as reported by FNY tracked closely with ILINet in both timing and magnitude. CONCLUSIONS With increased participation, FNY has the potential to serve as a viable complement to existing outpatient, hospital-based, and laboratory surveillance systems. Although many established systems have the benefits of specificity and credibility, participatory systems offer advantages in the areas of speed, sensitivity, and scalability.
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Affiliation(s)
- Mark S Smolinski
- Mark S. Smolinski, Adam W. Crawley, and Jennifer M. Olsen are with the Skoll Global Threats Fund, San Francisco, CA. At the time of study, Rumi Chunara was with and Kristin Baltrusaitis, Oktawia Wójcik, Mauricio Santillana and John S. Brownstein are currently with the Boston Children's Hospital Informatics Program, Boston, MA. Andre Nguyen is with the Harvard School of Engineering and Applied Sciences, Harvard University, Cambridge, MA
| | - Adam W Crawley
- Mark S. Smolinski, Adam W. Crawley, and Jennifer M. Olsen are with the Skoll Global Threats Fund, San Francisco, CA. At the time of study, Rumi Chunara was with and Kristin Baltrusaitis, Oktawia Wójcik, Mauricio Santillana and John S. Brownstein are currently with the Boston Children's Hospital Informatics Program, Boston, MA. Andre Nguyen is with the Harvard School of Engineering and Applied Sciences, Harvard University, Cambridge, MA
| | - Kristin Baltrusaitis
- Mark S. Smolinski, Adam W. Crawley, and Jennifer M. Olsen are with the Skoll Global Threats Fund, San Francisco, CA. At the time of study, Rumi Chunara was with and Kristin Baltrusaitis, Oktawia Wójcik, Mauricio Santillana and John S. Brownstein are currently with the Boston Children's Hospital Informatics Program, Boston, MA. Andre Nguyen is with the Harvard School of Engineering and Applied Sciences, Harvard University, Cambridge, MA
| | - Rumi Chunara
- Mark S. Smolinski, Adam W. Crawley, and Jennifer M. Olsen are with the Skoll Global Threats Fund, San Francisco, CA. At the time of study, Rumi Chunara was with and Kristin Baltrusaitis, Oktawia Wójcik, Mauricio Santillana and John S. Brownstein are currently with the Boston Children's Hospital Informatics Program, Boston, MA. Andre Nguyen is with the Harvard School of Engineering and Applied Sciences, Harvard University, Cambridge, MA
| | - Jennifer M Olsen
- Mark S. Smolinski, Adam W. Crawley, and Jennifer M. Olsen are with the Skoll Global Threats Fund, San Francisco, CA. At the time of study, Rumi Chunara was with and Kristin Baltrusaitis, Oktawia Wójcik, Mauricio Santillana and John S. Brownstein are currently with the Boston Children's Hospital Informatics Program, Boston, MA. Andre Nguyen is with the Harvard School of Engineering and Applied Sciences, Harvard University, Cambridge, MA
| | - Oktawia Wójcik
- Mark S. Smolinski, Adam W. Crawley, and Jennifer M. Olsen are with the Skoll Global Threats Fund, San Francisco, CA. At the time of study, Rumi Chunara was with and Kristin Baltrusaitis, Oktawia Wójcik, Mauricio Santillana and John S. Brownstein are currently with the Boston Children's Hospital Informatics Program, Boston, MA. Andre Nguyen is with the Harvard School of Engineering and Applied Sciences, Harvard University, Cambridge, MA
| | - Mauricio Santillana
- Mark S. Smolinski, Adam W. Crawley, and Jennifer M. Olsen are with the Skoll Global Threats Fund, San Francisco, CA. At the time of study, Rumi Chunara was with and Kristin Baltrusaitis, Oktawia Wójcik, Mauricio Santillana and John S. Brownstein are currently with the Boston Children's Hospital Informatics Program, Boston, MA. Andre Nguyen is with the Harvard School of Engineering and Applied Sciences, Harvard University, Cambridge, MA
| | - Andre Nguyen
- Mark S. Smolinski, Adam W. Crawley, and Jennifer M. Olsen are with the Skoll Global Threats Fund, San Francisco, CA. At the time of study, Rumi Chunara was with and Kristin Baltrusaitis, Oktawia Wójcik, Mauricio Santillana and John S. Brownstein are currently with the Boston Children's Hospital Informatics Program, Boston, MA. Andre Nguyen is with the Harvard School of Engineering and Applied Sciences, Harvard University, Cambridge, MA
| | - John S Brownstein
- Mark S. Smolinski, Adam W. Crawley, and Jennifer M. Olsen are with the Skoll Global Threats Fund, San Francisco, CA. At the time of study, Rumi Chunara was with and Kristin Baltrusaitis, Oktawia Wójcik, Mauricio Santillana and John S. Brownstein are currently with the Boston Children's Hospital Informatics Program, Boston, MA. Andre Nguyen is with the Harvard School of Engineering and Applied Sciences, Harvard University, Cambridge, MA
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12
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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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