Surveillance of infectious diseases by the sentinel laboratory network in Belgium: 30 years of continuous improvement

In 1983 the sentinel laboratory network was established because of the need to describe the epidemiological evolution of infectious diseases. During the study period of 30 years (1983-2013), microbiology laboratories reported on weekly basis the laboratory diagnosed cases for a selection of infectious diseases. This resulted in a large longitudinal laboratory based database allowing to provide trends over time and distribution by person and place. During this period, adaptations to data collection were made due to changes in diagnostic methods and public health priorities, introduction and application of digital revolution, and multiple reorganizations of the laboratories. Since the surveillance network is dynamic, it necessitates a continuous evaluation to ensure that, over time, it continues to be representative of the general epidemiological trends in the country. Secondly the aim is to examine the robustness and stability of this surveillance system. Here we demonstrated that the flexibility of the data collection methodology by the sentinel laboratory network is unique and that adaptations do not affect the capacity of the system to follow trends. Therefore, the surveillance by this network is representative of the current epidemiological situation in Belgium. To our knowledge, no such surveillance network with such a long-term follow-up and demonstrated stability for multiple infectious diseases in the general population was earlier described. Furthermore, expected trends due to the implementation of vaccination or other events were accurately detected. The collected data obtained from this network allows interesting comparisons with other national and international information sources.0SCOPUS: ar.jinfo:eu-repo/semantics/publishe

HIV-1 resistance and trend analysis in newly diagnosed patients in Belgium

A total of 1055 nucleotide sequences obtained from HIV patients diagnosed in 2008 and 2009 in Belgium were included in this prevalence study. The study population is a group of patients whose visit was considered by the clinician as the first contact with a Belgian AIDS reference centre or with another clinical centre experienced in HIV care. Prevalences of surveillance drug resistance mutations (SDRM) of 11·7% (47/394) and 11·0% (73/661) were observed in 2008 and 2009, respectively. The highest level of SDRM was observed towards nucleoside reverse transcriptase inhibitors (NRTIs) (7·8%), followed by the non-nucleoside reverse transcriptase inhibitors (NNRTIs) (4·2%) and Protease inhibitors (PIs) (2·3%). A potential clinical impact of the SDRM was demonstrated when using the current first-line therapy. A particularly high prevalence of SDRM was observed among intravenous drug users (IDUs) (29·4%). Reanalysis and comparing the data from previous Belgian studies using similar interpretation algorithms could not reveal a significant trend in SDRM prevalence over the last 5 years

Prevalence of Fragilysin Gene in Bacteroides fragilis Isolates from Blood and Other Extraintestinal Samples

Of 166 Bacteroides fragilis isolates, 26.2% of 103 isolates from blood and 20.6% of 63 extraintestinal isolates harbored the fragilysin gene (difference not statistically significant). Clinical characteristics and evolution were comparable in patients with B. fragilis bacteremia with or without this enterotoxin. Fragilysin seems not to be an important virulence factor in B. fragilis disease

Surveillance of Infectious Diseases by the Sentinel Laboratory Network in Belgium: 30 Years of Continuous Improvement.

In 1983 the sentinel laboratory network was established because of the need to describe the epidemiological evolution of infectious diseases. During the study period of 30 years (1983-2013), microbiology laboratories reported on weekly basis the laboratory diagnosed cases for a selection of infectious diseases. This resulted in a large longitudinal laboratory based database allowing to provide trends over time and distribution by person and place. During this period, adaptations to data collection were made due to changes in diagnostic methods and public health priorities, introduction and application of digital revolution, and multiple reorganizations of the laboratories. Since the surveillance network is dynamic, it necessitates a continuous evaluation to ensure that, over time, it continues to be representative of the general epidemiological trends in the country. Secondly the aim is to examine the robustness and stability of this surveillance system. Here we demonstrated that the flexibility of the data collection methodology by the sentinel laboratory network is unique and that adaptations do not affect the capacity of the system to follow trends. Therefore, the surveillance by this network is representative of the current epidemiological situation in Belgium. To our knowledge, no such surveillance network with such a long-term follow-up and demonstrated stability for multiple infectious diseases in the general population was earlier described. Furthermore, expected trends due to the implementation of vaccination or other events were accurately detected. The collected data obtained from this network allows interesting comparisons with other national and international information sources

Number of sentinel laboratories participating to the sentinel laboratory network (A) and percentage of microbiology laboratories participating to the network as compared to the total number of registered microbiology laboratories (B).

<p>Number of sentinel laboratories participating to the sentinel laboratory network (A) and percentage of microbiology laboratories participating to the network as compared to the total number of registered microbiology laboratories (B).</p

Number of reported cases before removal of the duplicates from 2007 when the digital data transfer became available until 2013.

<p>The total number of reported cases (Total) is transferred by sending the information on paper format by regular mail (Paper), by importing the cases via a web application developed by the WIV-ISP (WebForm), or by sending an extraction of the cases from the laboratory information management system (Export).</p

Overview of the number of sentinel laboratories reporting a particular infectious disease.

<p>The indicated number of reporting laboratories is calculated from the median number of sentinel laboratories reporting cases during the last 5 years of the study period.</p

Trend analyses for some representative infectious diseases as measured by the sentinel laboratory network from 1993 (if available) until 2013.

<p>The dashed line represents the monthly number of cases while the orange line represents a smoothed curve obtained by the Loess statistical method (SAS Institute Inc. ^®, Cary, NC, USA), a weighted scatterplot through these data points. <i>Campylobacter</i>, <i>Y</i>. <i>enterocolitica</i>, <i>Chlamydia trachomatis</i>, <i>Neisseria gonorrhoeae</i>, <i>Haemophilus influenzae</i>, <i>Neisseria meningitidis</i>, <i>Borrelia burgdorferi</i>, Rotavirus, and RSV.</p

Surveillance of Infectious Diseases by the Sentinel Laboratory Network in Belgium: 30 Years of Continuous Improvement.

In 1983 the sentinel laboratory network was established because of the need to describe the epidemiological evolution of infectious diseases. During the study period of 30 years (1983-2013), microbiology laboratories reported on weekly basis the laboratory diagnosed cases for a selection of infectious diseases. This resulted in a large longitudinal laboratory based database allowing to provide trends over time and distribution by person and place. During this period, adaptations to data collection were made due to changes in diagnostic methods and public health priorities, introduction and application of digital revolution, and multiple reorganizations of the laboratories. Since the surveillance network is dynamic, it necessitates a continuous evaluation to ensure that, over time, it continues to be representative of the general epidemiological trends in the country. Secondly the aim is to examine the robustness and stability of this surveillance system. Here we demonstrated that the flexibility of the data collection methodology by the sentinel laboratory network is unique and that adaptations do not affect the capacity of the system to follow trends. Therefore, the surveillance by this network is representative of the current epidemiological situation in Belgium. To our knowledge, no such surveillance network with such a long-term follow-up and demonstrated stability for multiple infectious diseases in the general population was earlier described. Furthermore, expected trends due to the implementation of vaccination or other events were accurately detected. The collected data obtained from this network allows interesting comparisons with other national and international information sources