Meynard Jean-Baptiste, Chaudet Herve, Green Andrew D, Jefferson Henry L, Texier Gaetan, Webber Daniel, Dupuy Bruce, Boutin Jean-Paul
Institut Pasteur de Guyane, Avenue Pasteur, Cayenne, French Guiana.
BMC Public Health. 2008 Apr 30;8:146. doi: 10.1186/1471-2458-8-146.
In recent years a wide variety of epidemiological surveillance systems have been developed to provide early identification of outbreaks of infectious disease. Each system has had its own strengths and weaknesses. In 2002 a Working Group of the Centers for Disease Control and Prevention (CDC) produced a framework for evaluation, which proved suitable for many public health surveillance systems. However this did not easily adapt to the military setting, where by necessity a variety of different parameters are assessed, different constraints placed on the systems, and different objectives required. This paper describes a proposed framework for evaluation of military syndromic surveillance systems designed to detect outbreaks of disease on operational deployments.
The new framework described in this paper was developed from the cumulative experience of British and French military syndromic surveillance systems. The methods included a general assessment framework (CDC), followed by more specific methods of conducting evaluation. These included Knowledge/Attitude/Practice surveys (KAP surveys), technical audits, ergonomic studies, simulations and multi-national exercises. A variety of military constraints required integration into the evaluation. Examples of these include the variability of geographical conditions in the field, deployment to areas without prior knowledge of naturally-occurring disease patterns, the differences in field sanitation between locations and over the length of deployment, the mobility of military forces, turnover of personnel, continuity of surveillance across different locations, integration with surveillance systems from other nations working alongside each other, compatibility with non-medical information systems, and security.
A framework for evaluation has been developed that can be used for military surveillance systems in a staged manner consisting of initial, intermediate and final evaluations. For each stage of the process parameters for assessment have been defined and methods identified.
The combined experiences of French and British syndromic surveillance systems developed for use in deployed military forces has allowed the development of a specific evaluation framework. The tool is suitable for use by all nations who wish to evaluate syndromic surveillance in their own military forces. It could also be useful for civilian mobile systems or for national security surveillance systems.
近年来，已开发出各种各样的流行病学监测系统，用于早期识别传染病疫情。每个系统都有其自身的优缺点。2002年，疾病控制与预防中心（CDC）的一个工作组制定了一个评估框架，该框架被证明适用于许多公共卫生监测系统。然而，这并不容易适用于军事环境，因为在军事环境中，需要评估各种不同的参数，对系统有不同的限制，并且有不同的目标要求。本文描述了一个用于评估军事症候群监测系统的框架，该系统旨在检测作战部署中的疾病爆发。
本文所述的新框架是根据英法两国军事症候群监测系统的累积经验制定的。方法包括一个通用评估框架（CDC），随后是更具体的评估方法。这些方法包括知识/态度/实践调查（KAP调查）、技术审核、人体工程学研究、模拟和多国演习。各种军事限制因素需要纳入评估。这些因素的例子包括实地地理条件的变化、部署到对自然疾病模式没有先验了解的地区、不同地点以及整个部署期间实地卫生条件的差异、军事力量的机动性、人员更替、不同地点监测的连续性、与其他协同工作的国家的监测系统的整合、与非医疗信息系统的兼容性以及安全性。
已开发出一个评估框架，可分阶段用于军事监测系统，包括初始、中期和最终评估。对于该过程的每个阶段，都已定义了评估参数并确定了方法。
为部署的军事部队开发的英法两国症候群监测系统的综合经验促成了一个特定评估框架的开发。该工具适用于所有希望评估其本国军队症候群监测情况的国家。它也可能对民用移动系统或国家安全监测系统有用。
