Muchaal P K, Parker S, Meganath K, Landry L, Aramini J
Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Guelph, ON.
Intelligent Health Solutions, Fergus, ON.
Can Commun Dis Rep. 2015 Sep 3;41(9):203-206. doi: 10.14745/ccdr.v41i09a01.
Traditional public health surveillance provides accurate information but is typically not timely. New early warning systems leveraging timely electronic data are emerging, but the public health value of such systems is still largely unknown.
To assess the timeliness and accuracy of pharmacy sales data for both respiratory and gastrointestinal infections and to determine its utility in supporting the surveillance of gastrointestinal illness.
To assess timeliness, a prospective and retrospective analysis of data feeds was used to compare the chronological characteristics of each data stream. To assess accuracy, Ontario antiviral prescriptions were compared to confirmed cases of influenza and cases of influenza-like-illness (ILI) from August 2009 to January 2015 and Nova Scotia sales of respiratory over-the-counter products (OTC) were compared to laboratory reports of respiratory pathogen detections from January 2014 to March 2015. Enteric outbreak data (2011-2014) from Nova Scotia were compared to sales of gastrointestinal products for the same time period. To assess utility, pharmacy sales of gastrointestinal products were monitored across Canada to detect unusual increases and reports were disseminated to the provinces and territories once a week between December 2014 and March 2015 and then a follow-up evaluation survey of stakeholders was conducted.
Ontario prescriptions of antivirals between 2009 and 2015 correlated closely with the onset dates and magnitude of confirmed influenza cases. Nova Scotia sales of respiratory OTC products correlated with increases in non-influenza respiratory pathogens in the community. There were no definitive correlations identified between the occurrence of enteric outbreaks and the sales of gastrointestinal OTCs in Nova Scotia. Evaluation of national monitoring showed no significant increases in sales of gastrointestinal products that could be linked to outbreaks that included more than one province or territory.
Monitoring of pharmacy-based drug prescriptions and OTC sales can provide a timely and accurate complement to traditional respiratory public health surveillance activities but initial evaluation did not show that tracking gastrointestinal-related OTCs were of value in identifying an enteric disease outbreak in more than one province or territory during the study period.
传统的公共卫生监测能提供准确信息，但通常不及时。利用及时电子数据的新型早期预警系统正在兴起，但其公共卫生价值仍大多未知。
评估呼吸系统和胃肠道感染的药房销售数据的及时性和准确性，并确定其在支持胃肠道疾病监测中的效用。
为评估及时性，采用前瞻性和回顾性数据分析来比较每个数据流的时间特征。为评估准确性，将安大略省2009年8月至2015年1月的抗病毒药物处方与确诊流感病例及流感样疾病（ILI）病例进行比较，将新斯科舍省2014年1月至2015年3月的呼吸道非处方药（OTC）销售与呼吸道病原体检测实验室报告进行比较。将新斯科舍省2011 - 2014年的肠道疫情数据与同期胃肠道产品销售情况进行比较。为评估效用，在加拿大全国监测胃肠道产品的药房销售情况以检测异常增长，并在2014年12月至2015年3月期间每周向各省和地区发布报告，随后对利益相关者进行后续评估调查。
2009年至2015年安大略省的抗病毒药物处方与确诊流感病例的发病日期和规模密切相关。新斯科舍省呼吸道OTC产品的销售与社区中非流感呼吸道病原体的增加相关。新斯科舍省肠道疫情的发生与胃肠道OTC销售之间未发现明确关联。全国监测评估显示，胃肠道产品销售未出现与涉及多个省或地区的疫情相关的显著增长。
监测基于药房的药物处方和OTC销售可为传统的呼吸道公共卫生监测活动提供及时且准确的补充，但初步评估表明，在研究期间，追踪与胃肠道相关的OTC在识别多个省或地区的肠道疾病疫情方面并无价值。
