An evaluation of the Zambia influenza sentinel surveillance system, 2011-2017.
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ABSTRACT:
SUBMITTER: Simusika P
PROVIDER: S-EPMC6958603 | biostudies-literature | 2020 Jan
REPOSITORIES: biostudies-literature
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An evaluation of the Zambia influenza sentinel surveillance system, 2011-2017.
Simusika Paul P Tempia Stefano S Chentulo Edward E Polansky Lauren L Mazaba Mazyanga Lucy ML Ndumba Idah I Mbewe Quinn K QK Monze Mwaka M
BMC health services research 20200113 1
<h4>Background</h4>Over the past decade, influenza surveillance has been established in several African countries including Zambia. However, information on the on data quality and reliability of established influenza surveillance systems in Africa are limited. Such information would enable countries to assess the performance of their surveillance systems, identify shortfalls for improvement and provide evidence of data reliability for policy making and public health interventions.<h4>Methods</h4 ...[more]
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Project description:PurposeTo develop the infrastructure to conduct timely active surveillance for safety of influenza vaccines and other medical countermeasures in the Sentinel System (formerly the Mini-Sentinel Pilot), a Food and Drug Administration-sponsored national surveillance system that typically relies on data that are mature, settled, and updated quarterly.MethodsThree Data Partners provided their earliest available ("fresh") cumulative claims data on influenza vaccination and health outcomes 3-4 times on a staggered basis during the 2013-2014 influenza season, collectively producing 10 data updates. We monitored anaphylaxis in the entire population using a cohort design and seizures in children ?4?years of age using both a self-controlled risk interval design (primary) and a cohort design (secondary). After each data update, we conducted sequential analysis for inactivated (IIV) and live (LAIV) influenza vaccines using the Maximized Sequential Probability Ratio Test, adjusting for data-lag.ResultsMost of the 10 sequential analyses were conducted within 6?weeks of the last care-date in the cumulative dataset. A total of 6?682?336 doses of IIV and 782?125 doses of LAIV were captured. The primary analyses did not identify any statistical signals following IIV or LAIV. In secondary analysis, the risk of seizures was higher following concomitant IIV and PCV13 than historically after IIV in 6- to 23-month-olds (relative risk?=?2.7), which requires further investigation.ConclusionsThe Sentinel System can implement a sequential analysis system that uses fresh data for medical product safety surveillance. Active surveillance using sequential analysis of fresh data holds promise for detecting clinically significant health risks early. Limitations of employing fresh data for surveillance include cost and the need for careful scrutiny of signals. © 2015 The Authors. Pharmacoepidemiology and Drug Safety Published by John Wiley & Sons Ltd.
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