Steele Lindsay, Orefuwa Emma, Bino Silvia, Singer Shepherd Roee, Lutwama Julius, Dickmann Petra
New York City Department of Health and Mental Hygiene, New York, NY, United States.
Connecting Organizations for Regional Disease Surveillance (CORDS), Lyon, France.
Front Public Health. 2020 Sep 11;8:452. doi: 10.3389/fpubh.2020.00452. eCollection 2020.
Infectious disease outbreaks can have significant impact on individual health, national economies, and social well-being. Through early detection of an infectious disease, the outbreak can be contained at the local level, thereby reducing adverse effects on populations. Significant time and funding have been invested to improve disease detection timeliness. However, current evaluation methods do not provide evidence-based suggestions or measurements on how to detect outbreaks earlier. Key conditions for earlier detection and their influencing factors remain unclear and unmeasured. Without clarity about conditions and influencing factors, attempts to improve disease detection remain and unsystematic. We developed a generic five-step disease detection model and a novel methodology to use for data collection, analysis, and interpretation. Data was collected in two workshops in Southeast Europe ( = 33 participants) and Southern and East Africa ( = 19 participants), representing mid- and low-income countries. Through systematic, qualitative, and quantitative data analyses, we identified key conditions for earlier detection and prioritized factors that influence them. As participants joined a workshop format and not an experimental setting, no ethics approval was required. Our analyses suggest that governance is the most important condition for earlier detection in both regions. Facilitating factors for earlier detection are risk communication activities such as information sharing, communication, and collaboration activities. Impeding factors are lack of communication, coordination, and leadership. Governance and risk communication are key influencers for earlier detection in both regions. However, inadequate technical capacity, commonly assumed to be a leading factor impeding early outbreak detection, was not found a leading factor. This insight may be used to pinpoint further improvement strategies.
传染病爆发会对个人健康、国家经济和社会福祉产生重大影响。通过早期发现传染病，可以在地方层面控制疫情爆发，从而减少对人群的不利影响。为提高疾病检测的及时性，已投入大量时间和资金。然而，目前的评估方法并未就如何更早地检测疫情爆发提供基于证据的建议或衡量标准。早期检测的关键条件及其影响因素仍不明确且未得到衡量。如果不清楚这些条件和影响因素，改善疾病检测的努力就会仍然是零散和无系统的。我们开发了一个通用的五步疾病检测模型以及一种用于数据收集、分析和解读的新方法。数据是在东南欧（33名参与者）以及南部和东部非洲（19名参与者）的两个研讨会上收集的，这些地区代表了中低收入国家。通过系统的定性和定量数据分析，我们确定了早期检测的关键条件，并对影响这些条件的因素进行了优先排序。由于参与者是参加研讨会形式而非实验环境设定，因此无需伦理批准。我们的分析表明，治理是两个地区早期检测的最重要条件。早期检测的促进因素是风险沟通活动，如信息共享、交流和协作活动。阻碍因素是缺乏沟通、协调和领导力。治理和风险沟通是两个地区早期检测的关键影响因素。然而，通常被认为是阻碍早期疫情检测的主要因素的技术能力不足，并未被发现是一个主要因素。这一见解可用于确定进一步的改进策略。
