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Sentinel laboratory network: 30 years of continuous improvement
27/11/2014
Rue Juliette Wytsmanstraat 14 | 1050 Brussels | Belgium T +32 2 642 51 11 | F +32 2 642 54 10 | email: [email protected] | http://www.wiv-isp.be
Why sentinel lab network (1983)?
Need of epidemiological information on infectious diseases
Provide trends over time and distribution by person and place
Data reporting
Principles of data transfer system
Participation is voluntary and unpaid Data transfer is anonymous and on a weekly basis Selection of limited number of micro-organisms Feedback (3-monthly and annual) foreseen Forwarding of strains to reference
laboratories/centers is encouraged (antimicrobial resistance, geno-and pheno-typing,… )
Laboratories+ WIV-ISP
Data cleaning
Organisation of the network of sentinel labs
WIV-ISP
TESSy
WIV-ISP
Clinical labs
Participating sentinel labs Reference laboratories/ NRC
Datareporting EPISTAT
Laboratories
30 years of surveillance
Campylobacter Chlamydia trachomatis Entamoeba histolitica Haemophilus influenza Legionella pneumophila Neisseria gonorrhoeae N. meningitidis Plasmodium Streptococcus pneumoniae Yersinia enterocolitica
Campylobacter
Yersinia enterocolitica
Chlamydia trachomatis
Neisseria gonorrhoeae
Haemophilus influenzae
Neisseria meningitidis
>20 years of surveillance
Borrelia burgdorferi Bordetella Chlamydia psitacci Cryptosporidium Giardia Hantavius Hepatitis A virus Influenza Mycoplasma pneumoniae Streptococcus pyogenes VTEC
Rotavirus
RSV
30 years – evolution of detection techniques
1983 : culture positive cases for 26 pathogens 2013 : molecular techniques included for 31/35
pathogens
30 years – evolution # pathogens
Laboratory participation
# %
- records
Changes in datatransfer method
http://www.wiv-isp.be/epidemio/epistat
Analysis module
Ref: Mathias Leroy
Ref: Mathias Leroy
Coverge = #Tests among sentinel labs #Tests among all labs
All clinical labs
Sentinel labs
Ref: Nicolas Berger
Stable and high coverage by region
Ref: Nicolas Berger
Uneven coverage by province
Ref: Nicolas Berger
All clinical labs
Participation/ pathogen
Sentinel labs
Equally participation for all pathogens?
Top 10 of pathogen reporting labs
Pathogen Reporting labs (median last 5 y)
Campylobacter 92 Rotavirus 82 RSV 75 Giardia 74 S. pneumoniae 72 Y. enterocolitica 67 N. gonorrhoeae 67 S. pyogenes 54 M. pneumoniae 54 C. trachomatis 53
Not requested but reported infectious diseases
Pathogen Removed from list
H. pylori 1993 M. tuberculosis 1997 Cryptococcus 1999 C. burnetii 1999 Pasteurella 1999 Leishmania 1999 C. neoformans 1999 Brucella 1999 C. pneumoniae 2001 Toxoplasma 2003 Parvovirus B19 2008 Salmonella 2009 Papillomavirus 2013
Pathogen never in list Human metapneumovirus S. agalactiae C. difficile S. aureus Rhinovirus Herpes simplex virus Candida
Variability in reporting respiratory infectious diseases
Pathogen Reporting labs (median last 5 y)
RSV 75 M. pneumoniae 54 Adenovirus 41 Parainfluenza 17
M. pneumoniae (54)
Adenovirus (41) Parainfluenza virus (17)
RSV (75)
Trends (median participants last 5 years)
Strengths of sentinel network
Stability and flexibility of the network (number of
participants) High level of coverage Important surveillance tool at national and
international level Allows comparison with other data sources Capacity to detect recent changes (alert when
outbreak)
Limitations
Calculate incidence rates Differences in participation rates Lack of standardization of case reporting (case
definition) Lack of clinical information Low coverage in some provinces (Namur, Liège,
Limburg, BW) Cross pathogen comparison for a symptomatic
disease ie. Respiratory pathogens
Acknowledgement
Initiator: André Stroobant Financial support: Federal Public Health, French and
Flemish communities Sentinel laboratories and reference laboratories Previous coordinators: Denise Walckiers, Frank Van
Loock, Geneviève Ducoffre,… Datamanagers: Roger Cornelis, Yves Dupont, Guy
Jeanfils, Mathias Leroy, … Data handling: Dominique Meunier, Marleen Maganck,
Ellen De Blanc, Nathalie Verhocht, Luce De Gendt… Previous data analysis: Hans Vandenberghe, Nicolas
Berger,…
