Risebro Helen L, Hunter Paul R
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, NR4 7TJ, UK.
J Water Health. 2007;5 Suppl 1:19-38. doi: 10.2166/wh.2007.135.
We sought to explore perceived strengths and weaknesses of surveillance systems for the detection of drinking-water-related illness in Europe based on the experience of individuals utilising such systems. We designed and conducted a qualitative semi-structured interview study with thematic analysis. Interviews took place in six European countries with seven experts in epidemiology, water and public health. Interviewees remarked upon variation between and within countries in laboratory and sampling protocols and reporting practice; these were felt to influence timeliness and sensitivity of laboratory- and clinician-report-based surveillance. Electronic reporting, reminders to report and direct report relay to national level were considered strengths of report-based surveillance. A need was expressed for more detailed case demographic information to facilitate outbreak detection. Existing infrastructure permitting, prescriptions data, anti-diarrhoeal pharmaceutical sales, absenteeism and consultations were cited as useful outbreak indicators. Information regarding consumer water quality complaints was highlighted as a potentially useful data source. Collaboration with water companies (concerning water distribution and incidents), and constructing and maintaining relationships with local and external data providers were cited as requisites of effective surveillance. Inter- and intra-organisational collaboration and information integration are likely to improve surveillance, leading to more astute estimates of the waterborne disease burden.
我们试图基于使用此类系统的个人经验，探索欧洲用于检测与饮用水相关疾病的监测系统的感知优势和劣势。我们设计并开展了一项采用主题分析的定性半结构化访谈研究。访谈在六个欧洲国家与七位流行病学、水和公共卫生领域的专家进行。受访者谈到了各国之间以及国内在实验室和采样方案及报告实践方面的差异；这些被认为会影响基于实验室报告和临床医生报告的监测的及时性和敏感性。电子报告、报告提醒以及直接向国家层面报告被视为基于报告的监测的优势。有人表示需要更详细的病例人口统计信息以促进疫情检测。在现有基础设施允许的情况下，处方数据、止泻药物销售、缺勤率和会诊被认为是有用的疫情指标。有关消费者水质投诉的信息被强调为一个潜在的有用数据源。与自来水公司合作（涉及水的分配和事件）以及与当地和外部数据提供者建立和维护关系被认为是有效监测的必要条件。组织间和组织内的合作以及信息整合可能会改善监测，从而对水传播疾病负担做出更敏锐的估计。
