Dawson Greer, Gilmour Robin, Tobin Sean, Travaglia Joanne
NSW Public Health Training Program, NSW Ministry of Health, Sydney, Australia; School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia,
Communicable Diseases Branch, Health Protection NSW, NSW Health, Sydney, Australia.
Public Health Res Pract. 2016 Apr 15;26(2):2621621. doi: 10.17061/phrp2621621.
In New South Wales (NSW), influenza surveillance is informed by a number of discrete data sources, including laboratories, emergency departments, death registrations and community surveillance programs. The purpose of this study was to evaluate the NSW influenza surveillance system using the US Centers for Disease Control and Prevention guidelines for evaluating public health surveillance systems. Importance of study: Having a strong influenza surveillance system is important for both seasonal and pandemic influenza preparedness. The findings will inform recommendations for strengthening surveillance in NSW.
The scope was limited to all sources included in the NSW Health Influenza Report in 2012-13. To assess the performance of the system, in-depth interviews (N = 21) were conducted with key stakeholders and thematically analysed. Respiratory testing data gathered through the sentinel laboratories in 2012 were used to estimate sensitivity, and laboratory notifications were analysed to assess timeliness and representativeness. Key documents - including reports, guidelines, correspondence and meeting minutes - were also reviewed, providing a method of triangulation.
The NSW influenza surveillance system integrates multiple sources of surveillance of influenza and influenza-like illness to provide a comprehensive picture of influenza in the community. Despite its structural complexity, the system delivers quality, timely and relevant data to inform a range of public health activities, and the NSW Health Influenza Report is well regarded by stakeholders. Challenges include managing system complexity, key person risk and cross-jurisdictional issues. Stakeholders commented that system flexibility would depend on additional resourcing. Although the sensitivity of sentinel laboratory surveillance was estimated as 1-25%, depending on the time of year, understanding sensitivity remains a challenge in influenza surveillance where the true incidence of infection is unknown.
Influenza surveillance is critical for monitoring virological changes, understanding disease epidemiology and informing public health responses. The system was found to deliver timely and good-quality surveillance information. Additional value could be achieved by increasing flexibility and stability, automating systems (where possible) and formalising processes of data acquisition. The system continues to negotiate a number of constraints, including complexity and cross-jurisdictional issues, which are ongoing obstacles to realising some potential system improvements.
在新南威尔士州（NSW），流感监测由多个独立数据源提供信息，包括实验室、急诊科、死亡登记和社区监测项目。本研究的目的是根据美国疾病控制与预防中心评估公共卫生监测系统的指南，对新南威尔士州的流感监测系统进行评估。研究的重要性：拥有一个强大的流感监测系统对于季节性流感和大流行性流感的防范都很重要。研究结果将为加强新南威尔士州监测的建议提供依据。
范围限于2012 - 13年新南威尔士州卫生流感报告中包含的所有来源。为评估该系统的性能，对关键利益相关者进行了深入访谈（N = 21）并进行了主题分析。2012年通过哨点实验室收集的呼吸道检测数据用于估计敏感性，并对实验室报告进行分析以评估及时性和代表性。还审查了关键文件，包括报告、指南、信函和会议记录，提供了一种三角验证方法。
新南威尔士州流感监测系统整合了流感及流感样疾病的多种监测来源，以全面呈现社区中的流感情况。尽管其结构复杂，但该系统能提供高质量、及时且相关的数据，为一系列公共卫生活动提供信息，新南威尔士州卫生流感报告受到利益相关者的高度评价。挑战包括管理系统复杂性、关键人员风险和跨辖区问题。利益相关者表示，系统的灵活性将取决于额外的资源投入。尽管哨点实验室监测的敏感性估计为1% - 25%，具体取决于一年中的时间，但在流感监测中，由于感染的真实发病率未知，理解敏感性仍然是一个挑战。
流感监测对于监测病毒学变化、了解疾病流行病学和为公共卫生应对提供信息至关重要。该系统被发现能够提供及时且高质量的监测信息。通过提高灵活性和稳定性、尽可能自动化系统以及规范数据采集流程，可以实现额外的价值。该系统仍在应对一些限制因素，包括复杂性和跨辖区问题，这些是实现一些潜在系统改进的持续障碍。
