比较国家传染病监测系统：中国与荷兰。
Comparing national infectious disease surveillance systems: China and the Netherlands.
作者信息
Vlieg Willemijn L, Fanoy Ewout B, van Asten Liselotte, Liu Xiaobo, Yang Jun, Pilot Eva, Bijkerk Paul, van der Hoek Wim, Krafft Thomas, van der Sande Marianne A, Liu Qi-Yong
机构信息
Department of Health, Ethics & Society, CAPHRI School of Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Centre for Infectious Diseases, Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
出版信息
BMC Public Health. 2017 May 8;17(1):415. doi: 10.1186/s12889-017-4319-3.
BACKGROUND
Risk assessment and early warning (RAEW) are essential components of any infectious disease surveillance system. In light of the International Health Regulations (IHR)(2005), this study compares the organisation of RAEW in China and the Netherlands. The respective approaches towards surveillance of arboviral disease and unexplained pneumonia were analysed to gain a better understanding of the RAEW mode of operation. This study may be used to explore options for further strengthening of global collaboration and timely detection and surveillance of infectious disease outbreaks.
METHODS
A qualitative study design was used, combining data retrieved from the literature and from semi-structured interviews with Chinese (5 national-level and 6 provincial-level) and Dutch (5 national-level) experts.
RESULTS
The results show that some differences exist such as in the use of automated electronic components of the early warning system in China ('CIDARS'), compared to a more limited automated component in the Netherlands ('barometer'). Moreover, RAEW units in the Netherlands focus exclusively on infectious diseases, while China has a broader 'all hazard' approach (including for example chemical incidents). In the Netherlands, veterinary specialists take part at the RAEW meetings, to enable a structured exchange/assessment of zoonotic signals.
CONCLUSION
Despite these differences, the main conclusion is that for the two infections studied, the early warning system in China and the Netherlands are remarkably similar considering their large differences in infectious disease history, population size and geographical setting. Our main recommendations are continued emphasis on international corporation that requires insight into national infectious disease surveillance systems, the usage of a One Health approach in infectious disease surveillance, and further exploration/strengthening of a combined syndromic and laboratory surveillance system.
背景
风险评估与早期预警（RAEW）是任何传染病监测系统的重要组成部分。根据《国际卫生条例（2005）》，本研究比较了中国和荷兰的RAEW组织情况。分析了两国在虫媒病毒病和不明原因肺炎监测方面的各自方法，以更好地了解RAEW的运作模式。本研究可用于探索进一步加强全球合作以及及时发现和监测传染病暴发的选项。
方法
采用定性研究设计，结合从文献中检索到的数据以及对中国（5名国家级和6名省级）和荷兰（5名国家级）专家进行的半结构化访谈。
结果
结果表明存在一些差异，例如中国早期预警系统使用自动化电子组件（“CIDARS”），而荷兰的自动化组件则较为有限（“晴雨表”）。此外，荷兰的RAEW单位仅专注于传染病，而中国采用更广泛的“全危害”方法（包括例如化学事件）。在荷兰，兽医专家参加RAEW会议，以便对人畜共患病信号进行结构化交流/评估。
结论
尽管存在这些差异，但主要结论是，对于所研究的两种感染，考虑到中国和荷兰在传染病历史、人口规模和地理环境方面存在巨大差异，两国的早期预警系统非常相似。我们的主要建议是继续强调国际合作，这需要深入了解国家传染病监测系统，在传染病监测中采用“同一健康”方法，并进一步探索/加强综合症状监测和实验室监测系统。
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