Analysis of timeliness of infectious disease reporting in the Netherlands

<p>Abstract</p> <p>Background</p> <p>Timely reporting of infectious disease cases to public health authorities is essential to effective public health response. To evaluate the timeliness of reporting to the Dutch Municipal Health Services (MHS), we used as quantitative measures the intervals between onset of symptoms and MHS notification, and between laboratory diagnosis and notification with regard to six notifiable diseases.</p> <p>Methods</p> <p>We retrieved reporting data from June 2003 to December 2008 from the Dutch national notification system for shigellosis, EHEC/STEC infection, typhoid fever, measles, meningococcal disease, and hepatitis A virus (HAV) infection. For each disease, median intervals between date of onset and MHS notification were calculated and compared with the median incubation period. The median interval between date of laboratory diagnosis and MHS notification was similarly analysed. For the year 2008, we also investigated whether timeliness is improved by MHS agreements with physicians and laboratories that allow direct laboratory reporting. Finally, we investigated whether reports made by post, fax, or e-mail were more timely.</p> <p>Results</p> <p>The percentage of infectious diseases reported within one incubation period varied widely, between 0.4% for shigellosis and 90.3% for HAV infection. Not reported within two incubation periods were 97.1% of shigellosis cases, 76.2% of cases of EHEC/STEC infection, 13.3% of meningococcosis cases, 15.7% of measles cases, and 29.7% of typhoid fever cases. A substantial percentage of infectious disease cases was reported more than three days after laboratory diagnosis, varying between 12% for meningococcosis and 42% for shigellosis. MHS which had agreements with physicians and laboratories showed a significantly shorter notification time compared to MHS without such agreements.</p> <p>Conclusions</p> <p>Over the study period, many cases of the six notifiable diseases were not reported within two incubation periods, and many were reported more than three days after laboratory diagnosis. An increase in direct laboratory reporting of diagnoses to MHS would improve timeliness, as would the use of fax rather than post or e-mail. Automated reporting systems have to be explored in the Netherlands. Development of standardised and improved measures for timeliness is needed.</p

Real-time intelligent production monitoring of a North Sea asset

The increasing complexity of natural gas extraction because of reducing reserves, complex behavior and more intricate contractual rules (due to liberalization of the West European energy markets) creates a need for more effective production efficiency. In order to deal with these challenges Wintershall is realizing a real-time monitoring system to optimize production for its (Southern) North Sea fields. As part of this initiative Wintershall and TNO Science and Industry are developing a model-based advisory tool that uses realtime production monitoring data to optimize production. This paper describes deployment of that tool to optimize production from reservoir to export of one of Wintershall's North Sea assets. The tool is being used for early event detection, intelligent condition monitoring and support of operators and engineers to make informed decisions that have direct added value to operations. The cases in the paper show the system's applicability for early detection of deviation of the measured productivity indices from the mass balance controlled dynamic model predictions and optimizing downtime of wells by mitigating effects of salt precipitation and optimal water washing procedures. Next to the case data, data preprocessing and validation, two key aspects of the development of the tool will be discussed. Firstly, we will discuss how (dynamic) models are used in model-based monitoring methods that provide the operator with crucial information about production. Secondly, the paper will present a framework that was used to create distinct levels of production monitoring functionality. Next to this, the paper will present application results and validation of the results obtained. E&P is nowadays getting more familiar with the potential benefits of integrated asset modeling, intelligent monitoring, production optimization and integrated operations - while at the same time it is experiencing many challenges associated with its successful implementation. We feel the work presented in this paper underlines these benefits and offers valuable lessons learned about a successful implementation case

A randomized trial on dose-response in radiation therapy of low-grade cerebral glioma: European Organization for Research and Treatment of Cancer (EORTC) Study 22844.

Contains fulltext : 23917___.PDF (publisher's version ) (Open Access

Modelling Reporting Delays in a Multilevel Structured Surveillance System - Application to Portuguese HIV-AIDS Data

In a deeply interconnected world of people and goods, infectious diseases constitute a serious threat. An active vigilance is required. The collection of adequate data is vital and coordinated by surveillance systems. It is widely-acknowledged that every case-reporting system has some degree of under-reporting and reporting delay in particular in HIV-AIDS Portuguese Surveillance System. To better understand the processes generating the reporting delays, which is an administrative process, it was used a flexible continuous time fully parametric survival analysis approach. It was taken into consideration the hierarchical administrative and organizational structure of the system as well as the relevant changes in the procedures throughout the time. The best multilevel structure to represent reporting delays in continuous time is the model where the individuals are nested into Reporting Entities (20.24% of the variance) which are nested into Type of services (8% of the variance) with the log-normal distribution.info:eu-repo/semantics/publishedVersio