Viral hepatitis in Germany: poor vaccination coverage and little knowledge about transmission in target groups

<p>Abstract</p> <p>Background</p> <p>In Germany, vaccination against hepatitis B is recommended for infants, children and adolescents since 1995 and for specific target groups since 1982. Little is known about knowledge about viral hepatitis and attitudes toward hepatitis B vaccination-factors likely to influence vaccine uptake.</p> <p>Methods</p> <p>In order to estimate vaccination coverage in adult target groups and in the overall adult population and to assess knowledge and attitudes, we conducted a nationwide cross-sectional telephone survey among 412 persons in November 2004. We defined participants as being vaccinated if they reported at least one previous vaccination against hepatitis B.</p> <p>Results</p> <p>Vaccination coverage (vc) standardised for age, sex and residence was 29.6% in the general population and 58.2% in target groups for hepatitis B vaccination. Particular gaps in vaccine coverage were detected among health care workers (vc: 69.5%) and chronically ill persons (vc: 22.0%). Knowledge on risk factors and transmission was far below expectations, whereas the acceptance of vaccination in the majority of the population (79.0%) was good.</p> <p>Conclusion</p> <p>We conclude that educational measures could lead to a higher vaccination uptake in adult target groups.</p

Event-based surveillance at health facility and community level in low-income and middle-income countries: a systematic review.

BACKGROUND: The International Health Regulations require member states to establish "capacity to detect, assess, notify and report events". Event-based surveillance (EBS) can contribute to rapid detection of acute public health events. This is particularly relevant in low-income and middle-income countries (LMICs) which may have poor public health infrastructure. To identify best practices, we reviewed the literature on the implementation of EBS in LMICs to describe EBS structures and to evaluate EBS systems. METHODS: We conducted a systematic literature search of six databases to identify articles that evaluated EBS in LMICs and additionally searched for grey literature. We used a framework approach to facilitate qualitative data synthesis and exploration of patterns across and within articles. RESULTS: We identified 778 records, of which we included 15 studies concerning 13 different EBS systems. The 13 EBS systems were set up as community-based surveillance, health facility-based surveillance or open surveillance (ie, notification by non-defined individuals and institutions). Four systems were set up in outbreak settings and nine outside outbreaks. All EBS systems were integrated into existing routine surveillance systems and pre-existing response structures to some extent. EBS was described as useful in detecting a large scope of events, reaching remote areas and guiding outbreak response. CONCLUSION: Health facility and community-based EBS provide valuable information that can strengthen the early warning function of national surveillance systems. Integration into existing early warning and response systems was described as key to generate data for action and to facilitate rapid verification and response. Priority in its implementation should be given to settings that would particularly benefit from EBS strengths. This includes areas most prone to outbreaks and where traditional 'routine' surveillance is suboptimal

Electronic data collection, management and analysis tools used for outbreak response in low- and middle-income countries: a systematic review and stakeholder survey

BACKGROUND: Use of electronic data collection, management and analysis tools to support outbreak response is limited, especially in low income countries. This can hamper timely decision-making during outbreak response. Identifying available tools and assessing their functions in the context of outbreak response would support appropriate selection and use, and likely more timely data-driven decision-making during outbreaks. METHODS: We conducted a systematic review and a stakeholder survey of the Global Outbreak Alert and Response Network and other partners to identify and describe the use of, and technical characteristics of, electronic data tools used for outbreak response in low- and middle-income countries. Databases included were MEDLINE, EMBASE, Global Health, Web of Science and CINAHL with publications related to tools for outbreak response included from January 2010-May 2020. Software tool websites of identified tools were also reviewed. Inclusion and exclusion criteria were applied and counts, and proportions of data obtained from the review or stakeholder survey were calculated. RESULTS: We identified 75 electronic tools including for data collection (33/75), management (13/75) and analysis (49/75) based on data from the review and survey. Twenty-eight tools integrated all three functionalities upon collection of additional information from the tool developer websites. The majority were open source, capable of offline data collection and data visualisation. EpiInfo, KoBoCollect and Open Data Kit had the broadest use, including for health promotion, infection prevention and control, and surveillance data capture. Survey participants highlighted harmonisation of data tools as a key challenge in outbreaks and the need for preparedness through training front-line responders on data tools. In partnership with the Global Health Network, we created an online interactive decision-making tool using data derived from the survey and review. CONCLUSIONS: Many electronic tools are available for data -collection, -management and -analysis in outbreak response, but appropriate tool selection depends on knowledge of tools' functionalities and capabilities. The online decision-making tool created to assist selection of the most appropriate tool(s) for outbreak response helps by matching requirements with functionality. Applying the tool together with harmonisation of data formats, and training of front-line responders outside of epidemic periods can support more timely data-driven decision making in outbreaks

FIFA World Cup 2006 in Germany: enhanced surveillance improved timeliness and detection

Enhanced surveillance for infectious disease events, with accelerated routine reporting and daily supplementary reports, was undertaken during the 2006 FIFA World Cup in Germany. We evaluated the surveillance outputs, reporting intervals and detection of World Cup-relevant events for the enhanced system. Outbreak numbers for measles, Norovirus and Campylobacter were significantly higher than in previous years, but all increases were explained by prior trends. The median interval (disease onset to receipt at national centre) fell from 17 days in 2005 to 12 days in 2006. Detection of World Cup-relevant events was 44% (8/18) in the routine system and 77% (14/18) in supplementary reports. We did not identify any significant effect on infectious disease epidemiology relating to the FIFA 2006 World Cup. Daily reporting improved timeliness, and supplementary reporting improved relevant event detection. Enhancing existing systems, without the addition of syndromic surveillance, can be an effective approach to mass-event surveillance

Enhanced Surveillance of Infectious Diseases : the 2006 FIFA World Cup experience, Germany

The 2006 FIFA World Cup was held in 12 German cities between 9 June and 9 July 2006. We identified a need to accelerate and sensitise the pre-existing surveillance system for infectious diseases in order to timely detect adverse health events during the World Cup. Enhanced surveillance, based on Germany's pre-existing system of mandatory notifications was conducted between 7 June and 11 July 2006 in the 12 World Cup cities by: accelerating frequency of electronic data transmission of case-definition based notifiable diseases from weekly to daily transmission, additional reporting of non-case definition-based infectious disease events, lay and expert press screening and intensifying communication between all stakeholders of the surveillance system. Median delay of notification data transmission from the community to the federal level was reduced from three days to one day. The enhanced reporting system detected a norovirus outbreak in the International Broadcast Centre in Munich with 61 epidemiologically linked cases within the first week after onset, as well as four single cases related to the World Cup, two of them with relevance for the International Health Regulations. After the World Cup, all surveillance stakeholders agreed that communication between local, state and federal levels had improved considerably. Unlike the majority of health planners of previous mass gatherings in the last decade we did not introduce syndromic surveillance. Nevertheless, enhancement of infectious disease surveillance successfully detected adverse health events in a timely manner during the FIFA World Cup. Additionally, it provided a valuable communication and networking exercise for potentially critical health-related events. We recommend continuing daily notification data transmission for routine infectious disease surveillance in Germany

Support files for: "Electronic data collection, management and analysis tools used for outbreak response in low- and middle-income countries: a systematic review and stakeholder survey"

A collection of files that underpin the analysis outlined in "Electronic data collection, management and analysis tools used for outbreak response in low- and middle-income countries: a systematic review and stakeholder survey". It consists of (1)a document that outlines the search strategies applied; (2) a list of definitions used for data extraction; (3) a data dictionary of the online Enketo Stakeholder survey on electronic data collection, management and analysis tools; (4) a dataset outlining studies excluded from the systematic review and the reasons for exclusion; (5) a documentation outlining number and percentage of respondents to the stakeholder survey per responding organisation; (6) a dataset that lists electronic tools reported by organisations with at least two respondents to the survey; (7) a dataset that lists electronic tools identified and their reported uses from the systematic review (2010–2020 and/or stakeholder survey; (8) a dataset that lists technical characteristics of identified tools; and (9) the PRISMA checklist

Viral hepatitis in Germany: poor vaccination coverage and little knowledge about transmission in target groups-1

<p><b>Copyright information:</b></p><p>Taken from "Viral hepatitis in Germany: poor vaccination coverage and little knowledge about transmission in target groups"</p><p>http://www.biomedcentral.com/1471-2458/8/132</p><p>BMC Public Health 2008;8():132-132.</p><p>Published online 23 Apr 2008</p><p>PMCID:PMC2387145.</p><p></p