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Evaluation of the national surveillance system for invasive meningococcal disease, Italy, 2015–2018

Enhanced laboratory-based surveillance of invasive meningococcal disease (IMD) in Italy was only assessed indirectly by numerically comparing surveillance data cases with hospital discharge records (HDR). In this study, we evaluated the completeness, timeliness and sensitivity of the IMD surveillanc...

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Autores principales: Andrianou, Xanthi D., Riccardo, Flavia, Caporali, Maria Grazia, Fazio, Cecilia, Neri, Arianna, Vacca, Paola, Ambrosio, Luigina, Pezzotti, Patrizio, Stefanelli, Paola
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793274/
https://www.ncbi.nlm.nih.gov/pubmed/33417620
http://dx.doi.org/10.1371/journal.pone.0244889
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author Andrianou, Xanthi D.
Riccardo, Flavia
Caporali, Maria Grazia
Fazio, Cecilia
Neri, Arianna
Vacca, Paola
Ambrosio, Luigina
Pezzotti, Patrizio
Stefanelli, Paola
author_facet Andrianou, Xanthi D.
Riccardo, Flavia
Caporali, Maria Grazia
Fazio, Cecilia
Neri, Arianna
Vacca, Paola
Ambrosio, Luigina
Pezzotti, Patrizio
Stefanelli, Paola
author_sort Andrianou, Xanthi D.
collection PubMed
description Enhanced laboratory-based surveillance of invasive meningococcal disease (IMD) in Italy was only assessed indirectly by numerically comparing surveillance data cases with hospital discharge records (HDR). In this study, we evaluated the completeness, timeliness and sensitivity of the IMD surveillance in Italy from 2015 to 2018. Completeness and timeliness were described at the national and subnational level. A capture-recapture analysis was conducted to evaluate the sensitivity and positive predictive value (PPV) using HDR as the external source with a combination of deterministic and probabilistic approaches. The characteristics of the unmatched vs. matched cases were compared using multivariable Poisson modeling. Overall, the completeness of data improved, except for specific variables. Timeliness of notifications also improved to a median of 4 days from onset to reporting. For the years 2015–2017, the sensitivity of the surveillance was estimated at 71.4% and the PPV at 77.5%, changing to 80.6% and 66.9% respectively after removing cases with a secondary meningitis diagnosis. We noted substantial sub-national differences. In 2018 sensitivity was 66.5% (135/203) and the PPV was 79.4% (135/170). The adjusted relative risk of being unmatched in 2015–2017 was higher in cases that were ≥60 years, had missing information or symptom onset in December. The IMD surveillance system overall performs well with completeness and timeliness improving in time. Specific challenges identified for individual variables should guide further improvement. Notwithstanding limitations posed by the comparison database, sensitivity and PPV are promising. The study highlights that promoting etiological ascertainment in people ≥60 years and addressing sub-national challenges are the main current challenges to address.
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spelling pubmed-77932742021-01-27 Evaluation of the national surveillance system for invasive meningococcal disease, Italy, 2015–2018 Andrianou, Xanthi D. Riccardo, Flavia Caporali, Maria Grazia Fazio, Cecilia Neri, Arianna Vacca, Paola Ambrosio, Luigina Pezzotti, Patrizio Stefanelli, Paola PLoS One Research Article Enhanced laboratory-based surveillance of invasive meningococcal disease (IMD) in Italy was only assessed indirectly by numerically comparing surveillance data cases with hospital discharge records (HDR). In this study, we evaluated the completeness, timeliness and sensitivity of the IMD surveillance in Italy from 2015 to 2018. Completeness and timeliness were described at the national and subnational level. A capture-recapture analysis was conducted to evaluate the sensitivity and positive predictive value (PPV) using HDR as the external source with a combination of deterministic and probabilistic approaches. The characteristics of the unmatched vs. matched cases were compared using multivariable Poisson modeling. Overall, the completeness of data improved, except for specific variables. Timeliness of notifications also improved to a median of 4 days from onset to reporting. For the years 2015–2017, the sensitivity of the surveillance was estimated at 71.4% and the PPV at 77.5%, changing to 80.6% and 66.9% respectively after removing cases with a secondary meningitis diagnosis. We noted substantial sub-national differences. In 2018 sensitivity was 66.5% (135/203) and the PPV was 79.4% (135/170). The adjusted relative risk of being unmatched in 2015–2017 was higher in cases that were ≥60 years, had missing information or symptom onset in December. The IMD surveillance system overall performs well with completeness and timeliness improving in time. Specific challenges identified for individual variables should guide further improvement. Notwithstanding limitations posed by the comparison database, sensitivity and PPV are promising. The study highlights that promoting etiological ascertainment in people ≥60 years and addressing sub-national challenges are the main current challenges to address. Public Library of Science 2021-01-08 /pmc/articles/PMC7793274/ /pubmed/33417620 http://dx.doi.org/10.1371/journal.pone.0244889 Text en © 2021 Andrianou et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Andrianou, Xanthi D.
Riccardo, Flavia
Caporali, Maria Grazia
Fazio, Cecilia
Neri, Arianna
Vacca, Paola
Ambrosio, Luigina
Pezzotti, Patrizio
Stefanelli, Paola
Evaluation of the national surveillance system for invasive meningococcal disease, Italy, 2015–2018
title Evaluation of the national surveillance system for invasive meningococcal disease, Italy, 2015–2018
title_full Evaluation of the national surveillance system for invasive meningococcal disease, Italy, 2015–2018
title_fullStr Evaluation of the national surveillance system for invasive meningococcal disease, Italy, 2015–2018
title_full_unstemmed Evaluation of the national surveillance system for invasive meningococcal disease, Italy, 2015–2018
title_short Evaluation of the national surveillance system for invasive meningococcal disease, Italy, 2015–2018
title_sort evaluation of the national surveillance system for invasive meningococcal disease, italy, 2015–2018
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793274/
https://www.ncbi.nlm.nih.gov/pubmed/33417620
http://dx.doi.org/10.1371/journal.pone.0244889
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