目的:研究的目的是使用国家传染病通报系统(ISIN)的新电子版评估麻疹监测的完整性和敏感性,以评估其性能。
方法:ISIN中关于人口统计学特征的麻疹报告的完整性(报告的周和地区,年龄和性别),发病日期,并发症,住院治疗,疫苗接种状况,对2018年1月至2019年6月使用的实验室方法和进口国进行了评估。使用捕获-再捕获方法(CRM)比较了国家参考实验室(NRL)和ISIN的寄存器。使用唯一的个人标识符匹配案例。使用Chapmans公式评估了人群中的麻疹病例总数。报告的敏感性是通过将报告的病例数除以CRM估计的真实病例数来计算的。
结果:在ISIN中,在规定的时间段内登记了765例麻疹病例。对于许多变量,发现100%的完整性。数据缺失主要是疫苗接种状况(20%),血清学结果(55%)和使用实验室方法(8%)。NRL确认了653个患者样本在相应的时期。在两个登记册(ISIN和NRL)中,共有612例病例匹配。使用CRM的麻疹病例的估计真实数量为816(95%CI:809-823),而报告的病例为806例。估计监测系统灵敏度为98.8%。在NRL中测试阳性的病例中有5%(n=41)未向ISIN报告。
结论:我们发现大多数变量的ISIN报告麻疹数据的完整性水平很高。估计的实际和报告的病例数具有良好的相关性,并且ISIN的计算灵敏度非常高。不过,研究中使用的数据源不是相互独立的,因此,结果可能不完全准确。建议在ISIN中进行技术更改(更多的强制性字段和更多的逻辑语法来检查数据),以提高数据完整性。数据提供者应以最大的精度向ISIN报告所有麻疹病例,以输入单个变量,调查实验室应在所需病例中向NRL发送样品进行确认。
OBJECTIVE: The aim of study was to evaluate completeness and estimate sensitivity of the measles surveillance using the new electronic version of the national notification system of infectious diseases (ISIN) in order to assess its performance.
METHODS: The completeness of measles reporting in the ISIN for demographic characteristics (week and region of reporting, age and gender), date of onset, complications, hospitalisations, vaccination status, used laboratory methods and country of import from January 2018 to June 2019 was assessed. The register from National Reference Laboratory (NRL) and the ISIN were compared using the capture-recapture method (CRM). Cases were matched using unique personal identifier. The total number of measles cases in the population was assessed using the Chapmans formula. Sensitivity of reporting was calculated by dividing the number of reported cases by the CRM estimated true number of cases.
RESULTS: In the ISIN, 765 measles cases were registered within specified time period. For many variables 100% completeness was found. The data were missing mainly for vaccination status (20%), serology results (55%) and used laboratory methods (8%). The NRL confirmed 653 patient samples in respected period. Within both registries (ISIN and NRL) the total 612 cases were matched. Estimated real number of measles cases using the CRM was 816 (95% CI: 809-823) compared to 806 reported cases. The estimated surveillance system sensitivity was 98.8%. Five percent (n = 41) of cases tested positively in the NRL were not reported to the ISIN.
CONCLUSIONS: We found high level of reported measles data completeness in the ISIN for most variables. Estimated real and reported number of cases was in a good correlation and calculated sensitivity of the ISIN was on very high level. Though, the data sources used in the study were not independent on each other, therefore results may not be fully accurate. The technical changes (more mandatory fields and more logical syntax to check data) in the ISIN to improve data completeness are being recommended. Data providers should report all measles cases to the ISIN with maximum precision in entering individual variables and investigating laboratories should send samples for confirmation to the NRL in required cases.