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Epidemiology and Infection December 2011 139 : pp 1827-1834
Copyright ? Cambridge University Press 2011
DOI: 10.1017/S095026881100015X (About DOI)
Methods and modelling
Performance of public health surveillance systems during the influenza A(H1N1) pandemic in the Americas: testing a new method based on Benford's Law
A. J. IDROVOa1 c1, J. A. FERN?NDEZ-NI?Oa2, I. BOJ?RQUEZ-CHAPELAa3 and J. MORENO-MONTOYAa4
a1 Centre for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
a2 Institute for Research, Sanitas Universitary Foundation, Bogot? DC, Colombia
a3 Population Studies Department, El Colegio de la Frontera Norte, Tijuana, Baja California, Mexico
a4 School of Public Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
SUMMARY
The A(H1N1) influenza pandemic has been a challenge for public health surveillance systems in all countries. An objective evaluation has not been conducted, as yet, of the performance of those systems during the pandemic. This paper presents an algorithm based on Benford's Law and the mortality ratio in order to evaluate the quality of the data and the sensitivity of surveillance systems. It analyses records of confirmed cases reported to the Pan American Health Organization by its 35 member countries between epidemiological weeks 13 and 47 in 2009. Seventeen countries did not fulfil Benford's Law, and mortality exceeded the regional average in 40% of the countries. The results suggest uneven performance by surveillance systems in the different countries, with the most frequent problem being low diagnostic coverage. Benford's Law proved to be a useful tool for the evaluation of a public health surveillance system's performance.
Copyright ? Cambridge University Press 2011
DOI: 10.1017/S095026881100015X (About DOI)
Methods and modelling
Performance of public health surveillance systems during the influenza A(H1N1) pandemic in the Americas: testing a new method based on Benford's Law
A. J. IDROVOa1 c1, J. A. FERN?NDEZ-NI?Oa2, I. BOJ?RQUEZ-CHAPELAa3 and J. MORENO-MONTOYAa4
a1 Centre for Health Systems Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
a2 Institute for Research, Sanitas Universitary Foundation, Bogot? DC, Colombia
a3 Population Studies Department, El Colegio de la Frontera Norte, Tijuana, Baja California, Mexico
a4 School of Public Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
SUMMARY
The A(H1N1) influenza pandemic has been a challenge for public health surveillance systems in all countries. An objective evaluation has not been conducted, as yet, of the performance of those systems during the pandemic. This paper presents an algorithm based on Benford's Law and the mortality ratio in order to evaluate the quality of the data and the sensitivity of surveillance systems. It analyses records of confirmed cases reported to the Pan American Health Organization by its 35 member countries between epidemiological weeks 13 and 47 in 2009. Seventeen countries did not fulfil Benford's Law, and mortality exceeded the regional average in 40% of the countries. The results suggest uneven performance by surveillance systems in the different countries, with the most frequent problem being low diagnostic coverage. Benford's Law proved to be a useful tool for the evaluation of a public health surveillance system's performance.
