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. 2018 Dec 7;18(1):633.
doi: 10.1186/s12879-018-3552-4.

Hepatitis A surveillance: sensitivity of two information sources

Gloria Carmona  1 , Marta Vilaró  2   3 , Pilar Ciruela  4   3 , Mireia Jané  4   3 , Lluis Giralt  3 , Laura Ruiz  4 , Sergi Hernández  4   2 , Àngela Domínguez  2   3 ; Working Group of the Epidemiological Surveillance Network of Catalonia; Working Group of the Microbiological Reporting System of Catalonia
Collaborators, Affiliations

Hepatitis A surveillance: sensitivity of two information sources

Gloria Carmona et al. BMC Infect Dis. .

Abstract

Background: The frequency of mild forms of hepatitis A, especially in children, could lead to underreporting. The objective of the study was to investigate the sensitivity of two surveillance systems, mandatory Statutory Disease Reports and the Microbiological Reporting System of Catalonia, using capture-recapture techniques.

Methods: The study was conducted in Catalonia between 2011 and 2015. Hepatitis A cases reported to two independent surveillance systems were included: Statutory Disease Reports (SDR) and Microbiological Reporting System of Catalonia (MRS). The variables collected were: age, sex, year of declaration, size of municipality (< 10,000 and ≥ 10,000), country of birth (Spain or abroad), reporting centre (primary care/hospital) and notification method (electronic or paper). The capture-recapture analysis and the estimate of 95% confidence intervals were made using the Chapman formula for comparison of two sources, both for the estimate of the total number of cases and the stratification according to variables. Multinomial logistic regression was performed to obtain an adjusted estimate.

Results: The SDR had a greater overall sensitivity than the MRS (48.8%; 43.5-55.6 vs. 19.3%; 17.2-21.9). In cases aged < 15 years the sensitivity of both systems was higher (76.6%; 72.7-81 vs. 25.2%; 20.9-29.5) than in cases aged > 15 years (25.5%; 22.8-28.3 vs. 12.1%; 10-14.2). For those born in Spain, the sensitivity was 57.2% (49.6-67.4) in the SDR and 27.1% (23.5-31.9) in the MRS, lower than that for foreign-born patients (58%; 51.2-66.8 vs. 49.1%; 43.4-56.6). In electronically-reported cases, the sensitivity was much higher in the SDR than in the MRS (47.2%; 42.3-52.1 vs. 9.4%; 6.5-12.3). No differences were observed according to sex, size of municipality, and year of declaration or reporting centre. The estimated total number of cases using the Chapman formula was very similar to the adjusted estimate (1121; 985-1258 vs. 1120; 876-1525), indicating the robustness of the results.

Conclusions: The sensitivity of the SDR was greater than that of MRS, especially in patients aged < 15 years, although for patients born abroad the difference in sensitivity was lower. Reinforced surveillance combining the SDR and MRS improves the efficiency in the detection of cases.

Keywords: Capture-recapture; Estimated incidence; Hepatitis A.

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Conflict of interest statement

Ethics approval and consent to participate

The study was not submitted for research ethics approval as the activities described were conducted as part of the legislated mandate of the Health Department of Catalonia, the competent authority for the surveillance of communicable diseases, which is officially authorized to receive, treat and temporarily store personal data on cases of infectious disease according to Decree 203/2015 of the 15 September which created the epidemiological surveillance network. Therefore, all study activities formed part of public health surveillance and were thus exempt from institutional board review and did not require informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Cases by age groups reported to MRS and SDR systems and estimation cases by capture-recapture method
See this image and copyright information in PMC

References

    1. Generalitat de Catalunya. Manual de notificació per als declarants al sistema de notificació de les Malalties de Declaració Obligatòria (MDO), 2016. http://canalsalut.gencat.cat/ca/professionals/vigilanciaepidemiologica/m....
    1. Generalitat de Catalunya. Decret 203/2015, de 15 de setembre, pel qual es crea la Xarxa de Vigilància Epidemiològica i es regulen els sistemes de notificació de malalties de declaració obligatòria i els brots epidèmics. DOGC 2015; núm 6958:1-19
    1. Generalitat de Catalunya. Manual de procediment de notificació microbiològica obligatòria (SNMC), 2016. http://canalsalut.gencat.cat/ca/professionals/vigilanciaepidemiologica/s....
    1. Keramarou M, Evans MR. Completeness of infectious disease notification in the United Kingdom: a systematic review. J Inf Secur. 2012;64:555–564. - PubMed
    1. Murphy TD, Denniston MM, Hill HA, Mc Donald M, Klevens MR, Elam-Evans LD, Nelson NP, Iskander J, Ward JD. Progress toward eliminating hepatitis a disease in the United States. MMWR. 2016;65:29–41. doi: 10.15585/mmwr.su6501a6. - DOI - PubMed

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