Dataset Information

Envisioning a learning surveillance system for tuberculosis.

ABSTRACT: Surveillance is critical for interrupting transmission of global epidemics. Research has highlighted gaps in the surveillance for tuberculosis that range from failure to collect real-time data to lack of standardization of data for informed decision-making at different levels of the health system. Our research aims to advance conceptual and methodological foundations for the development of a learning surveillance system for Tuberculosis, that involves systematic collection, analysis, interpretation, and feedback of outcome-specific data. It would concurrently involve the health care delivery system, public health laboratory, and epidemiologists. For our study, we systemically framed the cyber environment of TB surveillance as an ontology of the learning surveillance system. We validated the ontology by binary coding of dimensions and elements of the ontology with the metadata from an existing surveillance platform-GPMS TB Transportal. Results show GPMS TB Transportal collects a critical range of data for active case investigation and presumptive case screening for identifying and detecting confirmed TB cases. It is therefore targeted at assisting the Active Case Finding program. Building on the results, we demonstrate enhanced surveillance strategies for GPMS that are enumerated as pathways in the ontology. Our analysis reveals the scope for embedding learning surveillance pathways for digital applications in Direct Benefit Transfer, and Drug Resistance Treatment in National TB Elimination Programme in India. We discuss the possibilities of developing the transportal into a multi-level computer-aided decision support system for TB, using the innumerable pathways encapsulated in the ontology.

SUBMITTER: Gadicherla S

PROVIDER: S-EPMC7735594 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Envisioning a learning surveillance system for tuberculosis.

Gadicherla Suman S Krishnappa Lalitha L Madhuri Bindu B Mitra Susanna G SG Ramaprasad Arkalgud A Seevan Raja R Sreeganga S D SD Thodika Nibras K NK Mathew Salu S Suresh Vani V

PloS one 20201214 12

Surveillance is critical for interrupting transmission of global epidemics. Research has highlighted gaps in the surveillance for tuberculosis that range from failure to collect real-time data to lack of standardization of data for informed decision-making at different levels of the health system. Our research aims to advance conceptual and methodological foundations for the development of a learning surveillance system for Tuberculosis, that involves systematic collection, analysis, interpretat ...[more]

PMID: 33315902

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Project description:Bovine tuberculosis (bTB) is a common disease in cattle and wildlife, with health, zoonotic and economic implications. Infected wild animals, and particularly reservoirs, could hinder eradication of bTB from cattle populations, which could have an important impact on international cattle trade. Therefore, surveillance of bTB in wildlife is of particular importance to better understand the epidemiological role of wild species and to adapt the control measures. In France, a bTB surveillance system for free-ranging wildlife, the Sylvatub system, has been implemented since 2011. It relies on three surveillance components (SSCs) (passive surveillance on hunted animals (EC-SSC), passive surveillance on dead or dying animals (SAGIR-SSC) and active surveillance (PSURV-SSC)). The effectiveness of the Sylvatub system was previously assessed, through the estimation of its sensitivity (i.e. the probability of detecting at least one case of bTB infection by each SSC, specie and risk-level area). However, to globally assess the performance of a surveillance system, the measure of its sensitivity is not sufficient, as other factors such as economic or socio-economic factors could influence the effectiveness. We report here an estimation of the costs of the surveillance activities of the Sylvatub system, and of the cost-effectiveness of each surveillance component, by specie and risk-level, based on scenario tree modelling with the same tree structure as used for the sensitivity evaluation. The cost-effectiveness of the Sylvatub surveillance is better in higher-risk departments, due in particular to the higher probability of detecting the infection (sensitivity). Moreover, EC-SSC, which has the highest unit cost, is more efficient than the surveillance enhanced by the SAGIR-SSC, due to its better sensitivity. The calculation of the cost-effectiveness ratio shows that PSURV-SSC remains the most cost-effective surveillance component of the Sylvatub system, despite its high cost in terms of coordination, sample collection and laboratory analysis.

Project description:Bovine tuberculosis (bTB) is a common disease of cattle and wildlife, with economic repercussions and implications for animal and human health. The surveillance of bTB in wildlife is particularly important, to shed light on the epidemiological role of wild species and for the adaptation of control measures. In France, a bTB surveillance system for free-ranging wildlife, the Sylvatub system, was launched in 2011 on wild boars, red deer, roe deer and badgers. It relies on active and passive surveillance activities, constrained by practical difficulties, such as the accessibility of wild animals, and regulatory rules for the trapping of badgers, for example. We report here the first assessment of stakeholders' perceptions of the Sylvatub system and its acceptability, based on 20 individual semi-structured interviews with three types of stakeholder (collectors, coordinators, officers) in areas with different rates of bTB infection. With the caveat that these findings cannot be assumed to be representative of the national situation, we found that the Sylvatub system was considered useful by all the stakeholders interviewed. Those from the world of hunting participate in surveillance mostly to help livestock farmers, who are not systematically involved in bTB surveillance in wildlife. Many practical and regulatory constraints were raised, which could be offset by recognition of the work done by the "hunting community", to maintain the willingness of these individuals to participate. We also identified a need for improvements in communication and information. Qualitative information, such as that collected here, is essential to improve our understanding of the reasons favoring and disfavoring participation in surveillance, and should be taken into account in the evaluation process. These results are relevant to hunters and to veterinary authorities wishing to identify the determinants of participation in the Sylvatub system. They could provide support for decision-making processes to improve surveillance strategies.

Dataset Information

Envisioning a learning surveillance system for tuberculosis.

Publications

Envisioning a learning surveillance system for tuberculosis.

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