The University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Institute for Public Health, Chapel Hill, NC, USA.
Public Health Rep. 2012 May-Jun;127(3):310-7. doi: 10.1177/003335491212700311.
We sought to describe the integration of syndromic surveillance data into daily surveillance practice at local health departments (LHDs) and make recommendations for the effective integration of syndromic and reportable disease data for public health use.
Structured interviews were conducted with local health directors and communicable disease nursing staff from a stratified random sample of LHDs from May through September 2009. Interviews captured information on direct access to the North Carolina syndromic surveillance system and on the use of syndromic surveillance information for outbreak management, program management, and the creation of reports. We analyzed syndromic surveillance system data to assess the number of signals resulting in a public health response.
Syndromic surveillance data were used for outbreak investigation (19% of respondents) and program management and report writing (43% of respondents); a minority reported use of both syndromic and reportable disease data for these purposes (15% and 23%, respectively). Receiving data from frequent system users was associated with using data for these purposes (p=0.016 and p=0.033, respectively, for syndromic and reportable disease data). A small proportion of signals (<25%) resulted in a public health response.
Use of syndromic surveillance data by North Carolina local public health authorities resulted in meaningful public health action, including both case investigation and program management. While useful, the syndromic surveillance data system was oriented toward sensitivity rather than efficiency. Successful incorporation of new surveillance data is likely to require systems that are oriented toward efficiency.
我们旨在描述综合症状监测数据纳入地方卫生部门（LHD）日常监测实践的情况，并为有效整合症状和法定传染病数据以用于公共卫生目的提出建议。
2009 年 5 月至 9 月，我们采用分层随机抽样的方法，对来自 LHD 的地方卫生主管和传染病护理人员进行了结构化访谈。访谈内容包括直接访问北卡罗来纳州综合症状监测系统的情况，以及将症状监测信息用于疫情管理、项目管理和报告编制的情况。我们对症状监测系统数据进行了分析，以评估导致公共卫生应对的信号数量。
症状监测数据用于疫情调查（19%的受访者）和项目管理及报告编写（43%的受访者）；少数受访者报告同时使用症状和法定传染病数据来实现这些目的（分别为 15%和 23%）。接收来自频繁使用系统者的数据与将数据用于这些目的相关（p=0.016 和 p=0.033，分别用于症状和法定传染病数据）。仅有一小部分信号（<25%）导致了公共卫生应对。
北卡罗来纳州地方公共卫生部门使用症状监测数据进行了有意义的公共卫生行动，包括病例调查和项目管理。虽然有用，但症状监测数据系统侧重于敏感性而非效率。成功整合新的监测数据可能需要面向效率的系统。
