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. 2018 Apr;146(5):594-599.
doi: 10.1017/S0950268818000407. Epub 2018 Mar 13.

Evaluation of measles and rubella integrated surveillance system in Apulia region, Italy, 3 years after its introduction

I A Turiac  1   2 , F Fortunato  2 , M G Cappelli  2 , A Morea  3 , M Chironna  3 , Rosa Prato  2 , D Martinelli  2
Affiliations

Evaluation of measles and rubella integrated surveillance system in Apulia region, Italy, 3 years after its introduction

I A Turiac et al. Epidemiol Infect. 2018 Apr.

Abstract

This study aimed at evaluating the integrated measles and rubella surveillance system (IMRSS) in Apulia region, Italy, from its introduction in 2013 to 30 June 2016. Measles and rubella case reports were extracted from IMRSS. We estimated system sensitivity at the level of case reporting, using the capture-recapture method for three data sources. Data quality was described as the completeness of variables and timeliness of notification as the median-time interval from symptoms onset to initial alert. The proportion of suspected cases with laboratory investigation, the rate of discarded cases and the origin of infection were also computed. A total of 127 measles and four rubella suspected cases were reported to IMRSS and 82 were laboratory confirmed. Focusing our analysis on measles, IMRSS sensitivity was 82% (95% CI: 75-87). Completeness was >98% for mandatory variables and 57% for 'genotyping'. The median-time interval from symptoms onset to initial alert was 4.5 days, with a timeliness of notification of 33% (41 cases reported ⩽48 h). The proportion of laboratory investigation was 87%. The rate of discarded cases was 0.1 per 100 000 inhabitants per year. The origin of infection was identified for 85% of cases. It is concluded that IMRSS provides good quality data and has good sensitivity; still efforts should be made to improve the completeness of laboratory-related variables, timeliness and to increase the rate of discarded cases.

Keywords: Apulia; Italy; evaluation; measles; rubella; surveillance system.

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Conflict of interest statement

None.

Figures

Fig. 1.
Fig. 1.
Evaluation features of the IMRSS in the Apulia region, Italy, 1 January 2013–30 June 2016. (a) Number of confirmed measles cases reported to the IMRSS by month of the report; (b) Age-specific distribution of measles confirmed cases per year; (c) Vaccination status of confirmed and suspected measles cases and (d) Venn diagram on the distribution of measles cases in three date sources without correction for false-positives.
Fig. 2.
Fig. 2.
Measles cases confirmed by epidemiological linkage (n = 16), by sex, age and date of symptoms onset, Apulia region, Italy, 1 January 2013–30 June 2016.
See this image and copyright information in PMC

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