1. Evaluation of Outbreak Detection Performance Using Multi-Stream Syndromic Surveillance for Influenza-Like Illness in Rural Hubei Province, China: A Temporal Simulation Model Based on Healthcare-Seeking Behaviors.
- Author
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Fan, Yunzhou, Wang, Ying, Jiang, Hongbo, Yang, Wenwen, Yu, Miao, Yan, Weirong, Diwan, Vinod K., Xu, Biao, Dong, Hengjin, Palm, Lars, and Nie, Shaofa
- Subjects
INFLUENZA ,DISEASE outbreaks ,MEDICAL care ,DISEASE susceptibility ,RURAL geography ,SIMULATION methods & models - Abstract
Background: Syndromic surveillance promotes the early detection of diseases outbreaks. Although syndromic surveillance has increased in developing countries, performance on outbreak detection, particularly in cases of multi-stream surveillance, has scarcely been evaluated in rural areas. Objective: This study introduces a temporal simulation model based on healthcare-seeking behaviors to evaluate the performance of multi-stream syndromic surveillance for influenza-like illness. Methods: Data were obtained in six towns of rural Hubei Province, China, from April 2012 to June 2013. A Susceptible-Exposed-Infectious-Recovered model generated 27 scenarios of simulated influenza A (H1N1) outbreaks, which were converted into corresponding simulated syndromic datasets through the healthcare-behaviors model. We then superimposed converted syndromic datasets onto the baselines obtained to create the testing datasets. Outbreak performance of single-stream surveillance of clinic visit, frequency of over the counter drug purchases, school absenteeism, and multi-stream surveillance of their combinations were evaluated using receiver operating characteristic curves and activity monitoring operation curves. Results: In the six towns examined, clinic visit surveillance and school absenteeism surveillance exhibited superior performances of outbreak detection than over the counter drug purchase frequency surveillance; the performance of multi-stream surveillance was preferable to signal-stream surveillance, particularly at low specificity (Sp <90%). Conclusions: The temporal simulation model based on healthcare-seeking behaviors offers an accessible method for evaluating the performance of multi-stream surveillance. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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