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

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...

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Hauptverfasser: Fan, Yunzhou (VerfasserIn) , Dong, Hengjin (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: November 19, 2014
In: PLOS ONE
Year: 2014, Jahrgang: 9, Heft: 11
ISSN:1932-6203
DOI:10.1371/journal.pone.0112255
Online-Zugang:Verlag, Volltext: https://doi.org/10.1371/journal.pone.0112255
Verlag: https://dx.plos.org/10.1371/journal.pone.0112255
Volltext
Verfasserangaben:Yunzhou Fan, Ying Wang, Hongbo Jiang, Wenwen Yang, Miao Yu, Weirong Yan, Vinod K. Diwan, Biao Xu, Hengjin Dong, Lars Palm, Shaofa Nie

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520 |a 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 SusceptibleExposed-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 multistream 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. 
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