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Sentinel surveillance system for early outbreak detection in Madagascar.

Randrianasolo L, Raoelina Y, Ratsitorahina M, Ravolomanana L, Andriamandimby S, Heraud JM, Rakotomanana F, Ramanjato R, Randrianarivo-Solofoniaina AE, Richard V - BMC Public Health (2010)

Bottom Line: Of these 26,669 fever cases, 12.3% were related to Dengue-like fever, 11.1% to Influenza-like illness and 9.7% to malaria cases confirmed by a specific rapid diagnostic test.The sentinel surveillance system represents the first nationwide real-time-like surveillance system ever established in Madagascar.Our findings should encourage other African countries to develop their own syndromic surveillance systems.Prompt detection of an outbreak of infectious disease may lead to control measures that limit its impact and help prevent future outbreaks.

View Article: PubMed Central - HTML - PubMed

Affiliation: Unité d'Epidémiologie, Institut Pasteur de Madagascar, Antananarivo, République de Madagascar.

ABSTRACT

Background: Following the outbreak of chikungunya in the Indian Ocean, the Ministry of Health directed the necessary development of an early outbreak detection system. A disease surveillance team including the Institut Pasteur in Madagascar (IPM) was organized to establish a sentinel syndromic-based surveillance system. The system, which was set up in March 2007, transmits patient data on a daily basis from the various voluntary general practitioners throughout the six provinces of the country to the IPM. We describe the challenges and steps involved in developing a sentinel surveillance system and the well-timed information it provides for improving public health decision-making.

Methods: Surveillance was based on data collected from sentinel general practitioners (SGP). The SGPs report the sex, age, visit date and time, and symptoms of each new patient weekly, using forms addressed to the management team. However, the system is original in that SGPs also report data at least once a day, from Monday to Friday (number of fever cases, rapid test confirmed malaria, influenza, arboviral syndromes or diarrhoeal disease), by cellular telephone (encrypted message SMS). Information can also be validated by the management team, by mobile phone. This data transmission costs 120 ariary per day, less than US$1 per month.

Results: In 2008, the sentinel surveillance system included 13 health centers, and identified 5 outbreaks. Of the 218,849 visits to SGPs, 12.2% were related to fever syndromes. Of these 26,669 fever cases, 12.3% were related to Dengue-like fever, 11.1% to Influenza-like illness and 9.7% to malaria cases confirmed by a specific rapid diagnostic test.

Conclusion: The sentinel surveillance system represents the first nationwide real-time-like surveillance system ever established in Madagascar. Our findings should encourage other African countries to develop their own syndromic surveillance systems.Prompt detection of an outbreak of infectious disease may lead to control measures that limit its impact and help prevent future outbreaks.

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Related in: MedlinePlus

Daily Sentinel surveillance time series plots (%) of total visits of fever and of total fever of the 3 syndrome groups and the moving average Apr. 10, 2007 - Dec. 31, 2008.
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Figure 3: Daily Sentinel surveillance time series plots (%) of total visits of fever and of total fever of the 3 syndrome groups and the moving average Apr. 10, 2007 - Dec. 31, 2008.

Mentions: To understand the epidemiological characteristics of groups with fever-related syndromes or those with rapid diagnostic test (RDT)-confirmed cases of malaria under the sentinel surveillance system, data of their daily counts were plotted on a graph (Figure 2 and 3, respectively). Daily and weekly counts as a function of the regional pattern were also plotted and analyzed for each sentinel center. Analysis of the weekly trends showed that the number of people visiting was greater on Monday (p < 0.001) than on any other day, probably related to the weekend closure effect. Figure 2 showed 2 peaks for daily visits count on January and November 2008 in relation with an increasing of fever syndrome on January (Figure 3).


Sentinel surveillance system for early outbreak detection in Madagascar.

Randrianasolo L, Raoelina Y, Ratsitorahina M, Ravolomanana L, Andriamandimby S, Heraud JM, Rakotomanana F, Ramanjato R, Randrianarivo-Solofoniaina AE, Richard V - BMC Public Health (2010)

Daily Sentinel surveillance time series plots (%) of total visits of fever and of total fever of the 3 syndrome groups and the moving average Apr. 10, 2007 - Dec. 31, 2008.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2823701&req=5

Figure 3: Daily Sentinel surveillance time series plots (%) of total visits of fever and of total fever of the 3 syndrome groups and the moving average Apr. 10, 2007 - Dec. 31, 2008.
Mentions: To understand the epidemiological characteristics of groups with fever-related syndromes or those with rapid diagnostic test (RDT)-confirmed cases of malaria under the sentinel surveillance system, data of their daily counts were plotted on a graph (Figure 2 and 3, respectively). Daily and weekly counts as a function of the regional pattern were also plotted and analyzed for each sentinel center. Analysis of the weekly trends showed that the number of people visiting was greater on Monday (p < 0.001) than on any other day, probably related to the weekend closure effect. Figure 2 showed 2 peaks for daily visits count on January and November 2008 in relation with an increasing of fever syndrome on January (Figure 3).

Bottom Line: Of these 26,669 fever cases, 12.3% were related to Dengue-like fever, 11.1% to Influenza-like illness and 9.7% to malaria cases confirmed by a specific rapid diagnostic test.The sentinel surveillance system represents the first nationwide real-time-like surveillance system ever established in Madagascar.Our findings should encourage other African countries to develop their own syndromic surveillance systems.Prompt detection of an outbreak of infectious disease may lead to control measures that limit its impact and help prevent future outbreaks.

View Article: PubMed Central - HTML - PubMed

Affiliation: Unité d'Epidémiologie, Institut Pasteur de Madagascar, Antananarivo, République de Madagascar.

ABSTRACT

Background: Following the outbreak of chikungunya in the Indian Ocean, the Ministry of Health directed the necessary development of an early outbreak detection system. A disease surveillance team including the Institut Pasteur in Madagascar (IPM) was organized to establish a sentinel syndromic-based surveillance system. The system, which was set up in March 2007, transmits patient data on a daily basis from the various voluntary general practitioners throughout the six provinces of the country to the IPM. We describe the challenges and steps involved in developing a sentinel surveillance system and the well-timed information it provides for improving public health decision-making.

Methods: Surveillance was based on data collected from sentinel general practitioners (SGP). The SGPs report the sex, age, visit date and time, and symptoms of each new patient weekly, using forms addressed to the management team. However, the system is original in that SGPs also report data at least once a day, from Monday to Friday (number of fever cases, rapid test confirmed malaria, influenza, arboviral syndromes or diarrhoeal disease), by cellular telephone (encrypted message SMS). Information can also be validated by the management team, by mobile phone. This data transmission costs 120 ariary per day, less than US$1 per month.

Results: In 2008, the sentinel surveillance system included 13 health centers, and identified 5 outbreaks. Of the 218,849 visits to SGPs, 12.2% were related to fever syndromes. Of these 26,669 fever cases, 12.3% were related to Dengue-like fever, 11.1% to Influenza-like illness and 9.7% to malaria cases confirmed by a specific rapid diagnostic test.

Conclusion: The sentinel surveillance system represents the first nationwide real-time-like surveillance system ever established in Madagascar. Our findings should encourage other African countries to develop their own syndromic surveillance systems.Prompt detection of an outbreak of infectious disease may lead to control measures that limit its impact and help prevent future outbreaks.

Show MeSH
Related in: MedlinePlus