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Evaluation of outbreak detection performance using multi-stream syndromic surveillance for influenza-like illness in rural hubei province, china: a temporal simulation model based on healthcare-seeking behaviors

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  • Evaluation of outbreak detection performance using multi-stream syndromic surveillance for influenza-like illness in rural hubei province, china: a temporal simulation model based on healthcare-seeking behaviors

    PLoS One. 2014 Nov 19;9(11):e112255. doi: 10.1371/journal.pone.0112255. eCollection 2014.
    Evaluation of outbreak detection performance using multi-stream syndromic surveillance for influenza-like illness in rural hubei province, china: a temporal simulation model based on healthcare-seeking behaviors.
    Fan Y1, Wang Y1, Jiang H1, Yang W1, Yu M1, Yan W2, Diwan VK3, Xu B4, Dong H5, Palm L6, Nie S1.
    Author information
    Abstract
    BACKGROUND:

    Syndromic surveillance promotes the early detection of diseases outbreaks. Although syndromic surveillance has increased in developing countries, performance on outbreak detection, particularly in cases of multi-stream surveillance, has scarcely been evaluated in rural areas.
    OBJECTIVE:

    This study introduces a temporal simulation model based on healthcare-seeking behaviors to evaluate the performance of multi-stream syndromic surveillance for influenza-like illness.
    METHODS:

    Data were obtained in six towns of rural Hubei Province, China, from April 2012 to June 2013. A Susceptible-Exposed-Infectious-Recovered model generated 27 scenarios of simulated influenza A (H1N1) outbreaks, which were converted into corresponding simulated syndromic datasets through the healthcare-behaviors model. We then superimposed converted syndromic datasets onto the baselines obtained to create the testing datasets. Outbreak performance of single-stream surveillance of clinic visit, frequency of over the counter drug purchases, school absenteeism, and multi-stream surveillance of their combinations were evaluated using receiver operating characteristic curves and activity monitoring operation curves.
    RESULTS:

    In the six towns examined, clinic visit surveillance and school absenteeism surveillance exhibited superior performances of outbreak detection than over the counter drug purchase frequency surveillance; the performance of multi-stream surveillance was preferable to signal-stream surveillance, particularly at low specificity (Sp <90%).
    CONCLUSIONS:

    The temporal simulation model based on healthcare-seeking behaviors offers an accessible method for evaluating the performance of multi-stream surveillance.

    PMID:
    25409025
    [PubMed - in process]

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