Assessing the sensitivity and representativeness of the Belgian Sentinel Network of Laboratories using test reimbursement data.

BACKGROUND: The Belgian Sentinel Network of Laboratories (SNL) was created in 1983 in order to monitor trends in infectious diseases. Given the evolution of the surveillance system, such as the waivers, fusions and adhesions of laboratories over time, it is important to evaluate whether the SNL is still fit for purpose. This study aims to evaluate aspects of the sensitivity and representativeness of the SNL by means of a test coverage analysis. METHODS: We estimated test coverage of the SNL using the ratio of reimbursed tests performed by participating laboratories to the total number of tests performed between 2007 and 2012, for 12 (groups of) pathogens. We further evaluated the geographical difference coverage of the SNL at regional and provincial levels. RESULTS: We found that test coverage of the SNL was stable over time and close to, or greater than, 50 % for the 12 (groups of) pathogens studied. These results hold for the three regions of Belgium but not for all provinces. We showed that some provinces had a low test coverage for some pathogens and that test coverage was more variable over time at provincial level. CONCLUSIONS: This sensitivity and representativeness study based on test coverage suggests that the SNL is capable to describe trend and to monitor changes in the 12 (groups of) pathogens studied both at national and regional levels. Therefore, the SNL is useful to contribute to estimate the burden of disease and to inform preventive measures. It should however be reinforced to allow to be used as an alert system at provincial level

Pathological breathing patterns after pneumococcal rhombencephalitis

status: publishe

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