Dataset Information

Enhanced sentinel surveillance for hepatitis B infection in 200 counties in China, 2013-2016.

ABSTRACT: Hepatitis B infection is a major public health challenge in China. Clinicians report hepatitis B cases to the National Notifiable Disease Reporting System. A 2007 study found that only 35% of hepatitis B cases that had been reported as acute infections met a rigorous case definition of acute hepatitis B, implying overreporting of new-onset infections. To increase the accuracy of reported acute hepatitis B infections, in 2013, we initiated enhanced hepatitis B surveillance in 200 sentinel counties. We compared incidences and proportions of different stages of hepatitis B infection before and after implementation of enhanced surveillance. We checked the accuracy of reported data and re-diagnosed hepatitis B cases reported as acute infection according to the enhanced diagnostic criteria and calculated positive predictive value(PPV) of acute hepatitis B reports. Compared to previous surveillance, with enhanced surveillance, the incidence of reported acute hepatitis B infection decreased by 53.7% and the proportion of unclassified hepatitis B infection was reduced by 79.4%. From 2013 to 2016, the PPV of acute hepatitis B increased (55.8% to 71.0%); PPV rates in western and rural areas were lower than in other areas. We recommend enhancing hepatitis B surveillance nationwide using these new standards, and raising western and rural areas clinicians' diagnostic and reporting capacity, and ensuring sufficient resources for IgM anti-HBc testing.

SUBMITTER: Miao N

PROVIDER: S-EPMC6478295 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Enhanced sentinel surveillance for hepatitis B infection in 200 counties in China, 2013-2016.

Miao Ning N Zheng Hui H Sun Xiaojin X Shen Liping L Wang Feng F Cui Fuqiang F Yin Zundong Z Zhang Guomin G Wang Fuzhen F

PloS one 20190423 4

Hepatitis B infection is a major public health challenge in China. Clinicians report hepatitis B cases to the National Notifiable Disease Reporting System. A 2007 study found that only 35% of hepatitis B cases that had been reported as acute infections met a rigorous case definition of acute hepatitis B, implying overreporting of new-onset infections. To increase the accuracy of reported acute hepatitis B infections, in 2013, we initiated enhanced hepatitis B surveillance in 200 sentinel countie ...[more]

PMID: 31013293

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Project description:BACKGROUND:Malaria surveillance system strengthening is essential in the progress towards malaria elimination. In Nigeria, more attention is being given to this recently as the country is striving towards achieving elimination. However, the surveillance system performance is fraught with challenges including poor data quality with varying magnitude by state. This study evaluated the operation of the Kano State malaria surveillance system and assessed its key attributes. METHODS:An observational study design comprising a survey, record review and secondary data analysis, and mixed methods data collection approach were used. Four key stakeholders' and 35 Roll Back Malaria Focal Persons (RBMs) semi-structured interviews on operation of the system and attributes of the surveillance system, were conducted. We analyzed the abstracted 2013-2016 National Health Management Information System web-based malaria datasets. The surveillance system was evaluated using the "2001 United States Centers for Disease Control's updated guidelines for Evaluating Public Health Surveillance Systems". Data were described using means, standard deviation, frequencies and proportions. Chi-squared for linear trends was used. RESULTS:Overall, 24 RBMs (68.6%) had ≤ 15-year experience on malaria surveillance, 29 (82.9%) had formal training on malaria surveillance; 32 RBMs (91.4%) reported case definitions were easy-to-use, reporting forms were easy-to-fill and data flow channels were clearly defined. Twenty-seven respondents (69.2%) reported data tools could accommodate changes and all RBMs understood malaria case definitions. All respondents (4 stakeholders and 34 RBMs [97.1%]) expressed willingness to continue using the system and 33 (84.6%) reported analyzed data were used for decision-making. Public health facilities constituted the main data source. Overall, 65.0% of funding were from partner agencies. Trend of malaria cases showed significant decline (χ2trend = 7.49; P = 0.0006). Timeliness of reporting was below the target (≥ 80%), except being 82% in 2012. CONCLUSIONS:Malaria surveillance system in Kano State was simple, flexible, acceptable, useful and donor-driven but the data were not representative of all health facilities. Timeliness of reporting was suboptimal. We recommended reporting from private health facilities, strengthening human resource capacity for supportive supervision and ensuring adequate government funding to enhance the system's representativeness and improve data quality.

Project description:Importance:Infection with hepatitis C virus (HCV) is a major cause of morbidity and mortality in the United States, and incidence has increased rapidly in recent years, likely owing to increased injection drug use. Current estimates of prevalence at the state level are needed to guide prevention and care efforts but are not available through existing disease surveillance systems. Objective:To estimate the prevalence of current HCV infection among adults in each US state and the District of Columbia during the years 2013 to 2016. Design, Setting, and Participants:This survey study used a statistical model to allocate nationally representative HCV prevalence from the National Health and Nutrition Examination Survey (NHANES) according to the spatial demographics and distributions of HCV mortality and narcotic overdose mortality in all National Vital Statistics System death records from 1999 to 2016. Additional literature review and analyses estimated state-level HCV infections among populations not included in the National Health and Nutrition Examination Survey sampling frame. Exposures:State, accounting for birth cohort, biological sex, race/ethnicity, federal poverty level, and year. Main Outcomes and Measures:State-level prevalence estimates of current HCV RNA. Results:In this study, the estimated national prevalence of HCV from 2013 to 2016 was 0.84% (95% CI, 0.75%-0.96%) among adults in the noninstitutionalized US population represented in the NHANES sampling frame, corresponding to 2?035?100 (95% CI, 1?803?600-2?318?000) persons with current infection; accounting for populations not included in NHANES, there were 231?600 additional persons with HCV, adjusting prevalence to 0.93%. Nine states contained 51.9% of all persons living with HCV infection (California [318?900], Texas [202?500], Florida [151?000], New York [116?000], Pennsylvania [93?900], Ohio [89?600], Michigan [69?100], Tennessee [69?100], and North Carolina [66?400]); 5 of these states were in Appalachia. Jurisdiction-level median (range) HCV RNA prevalence was 0.88% (0.45%-2.34%). Of 13 states in the western United States, 10 were above this median. Three of 10 states with the highest HCV prevalence were in Appalachia. Conclusions and Relevance:Using extensive national survey and vital statistics data from an 18-year period, this study found higher prevalence of HCV in the West and Appalachian states for 2013 to 2016 compared with other areas. These estimates can guide state prevention and treatment efforts.

Dataset Information

Enhanced sentinel surveillance for hepatitis B infection in 200 counties in China, 2013-2016.

Publications

Enhanced sentinel surveillance for hepatitis B infection in 200 counties in China, 2013-2016.

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