The Research Of Army Infectious Disease Syndrome Surveillance System

Objective:To explore the model of establishing military infectious disease syndrome surveillance system(hereinafter referred to as "forces syndrome surveillance system") and obtain the epidemic situation and features of intensive syndromes in the army, to explore the method and mechanism of data collection and transmission, analysis and early warning, abnormal incident response, and to evaluate the public health value and the entire promotion feasibility of the forces syndrome surveillance system. To improve the low efficiency of the traditional infectious disease surveillance, identify and dispose the aggregation signs of the troops infectious diseases early. To avoid or reduce the losses caused by spread of the epidemic, better ensure soldiers’ health and maintain normal combat forces and life order.Content:The syndrome surveillance system of military infectious diseases was preliminary designed according to the theory and practice of syndrome surveillance at home and abroad in recent years, the epidemic characteristics of infectious diseases and the current situation of the health information in our army. The specific contents of the research are:(1) Investigate the current situation of the occurrence and surveillance of infectious disease in our army.(2) Discuss and try the 3 segments of forces syndrome surveillance system, data collection and transmission, data analysis and early warning, incident response, based on the core business function requirements.(3) Establish the process and model of infectious disease syndrome surveillance system.(4) Design the functional segment and develop the system according to the functional requirements of army syndrome surveillance system construction.(5) Evaluate the value and applicability of the system preliminarily via test run.Methods:(1)In this study, the present situation of infectious diseases syndrome surveillance at home and abroad and characteristic of infectious diseases outbreak in our army were investigated by literature review, field survey and telephone consultant.(2)Determine the target diseases of forces syndrome surveillance through the risk assessment(mainly including the probability of occurrence of disease in the army, the implementation of the spread, the severity of hazard to soldiers’ health and military combat, preventable and public awareness, etc.), and then select the symptoms and symptoms included into surveillance program according to the clinical features of target diseases.(3)The syndrome surveillance model, the surveillance process, the design of case report cards, the index for statistical analysis and the choice of early warning model were assessed and revised by expert consultation.(4)Develop the system software according to the function requirements of the surveillance system by utilizing the computer technology, and establish the forces syndrome surveillance system.(5) Evaluating and optimizing the system according to pilot applications. With the method of questionnaire and interview, listen to the feedback from the workers of forces syndrome surveillance system, and evaluate its public health value and the feasibility of the entire promotion preliminarily.(6)The date were statistically analyzed by excel and SPSS17.0.Result:1. Through the investigation of the literature related to the recent outbreak of infectious diseases in our army and the analysis of the relevant data of the military infectious diseases, it was known that the total number of troops infectious diseases reported cases didn’t drop obviously in recent years, and respiratory infectious disease replaced intestinal infectious diseases as the main infectious diseases gradually. It is imperative to strengthen the capacity of infectious disease surveillance. Through the investigation into the present situation of the PLA’s disease surveillance, it was known that the current epidemic reporting system was based on clinical diagnosis and laboratory test results, for some infectious diseases with atypical symptoms, it cannot report timely, which may cause the spread of diseases.2. Collected and standardized the basic information of the infectious disease syndrome surveillance and indexes of statistical analysis through expert consultation. The data included patients’ basic information, patients’ clinical information, patients’ syndrome information and the reporter’s information. Described the numbers of patient with each kind of syndrome according to the epidemiological distribution,which can be roughly divided into the time distribution, unit distribution, age distribution, gender distribution, identity constitute and syndrome construct.3. Made the construction plan for the forces syndrome surveillance system according to the functional requirements, considered each technical key point of the plan, and finally educed the methods of data acquisition and transmission, data analysis and early warning, abnormal incident response, and formulate the mode of the infectious disease syndrome surveillance and conventional workflow.4. Designed and developed the forces syndrome surveillance system software. The forces syndrome surveillance system relied on the military integrated information network, and based on the large relational database platform and the hybrid structure of C/S/S mode, using JAVA and XML technology. The syndrome surveillance system is made up of symptom information database and six function modules, with the functions of syndrome information collection, data import, data summary analysis, automatic abnormal incident early warning, early warning signal report and check, early warning information query, user management, rights management and so on. Established a center managing the syndrome surveillance data to realize long-term management, automatic integration, and separation and sharing, providing accurate, timely surveillance information of infectious disease symptoms for the entire epidemic surveillance management departments and health departments.5. Since commissioning of the infectious disease syndrome surveillance system, there was no obvious outbreak. Analyzed the collected 1660 report cards from a pilot camp and found that, most of them were the common cold syndrome, 1246 cases, accounting for 74.92% of the total number of reported cases, followed by pure fever associated syndrome, diarrhea associated syndrome, fever with respiratory associated syndrome, encephalitis and meningitis associated syndrome and fever with rash associated syndrome. It was generally consistent with the morbidity sequence of the target diseases in the army. Botulism syndrome and heat syndrome with bleeding has not yet been detected. Responded timely to the warning signals and excluded suspected events.6. The practicability and related attributes of the system were evaluated, and the force syndrome surveillance system was designed reasonably and meted the requirements of infectious diseases prevention, and could warn the outbreaks of infectious disease.But in the current condition, the forces syndrome surveillance work may increase the workload of surveillance workers, and more measures were required to boost the enthusiasm of the staff and data quality.Conclusion:1. An infectious disease syndrome surveillance system with comprehensive surveillance diseases was build and it ran smoothly and was suitable for the army. This study was based on the Army Epidemic Surveillance System, and was a positive beneficial exploration of syndrome surveillance on the infectious diseases in the army. The application and promotion of the system can not only realize the early detection, early warning and early management of infectious diseases in the grassroots units, and also can realize the standardization of early warming and surveillance of emergent public health events. At the same time, it also can promote the construction of information service, perfect the army disease surveillance information platform, provide real-time, convenient, interoperable and reliable early outbreak information for headquarters medical service offices, medical institutions and disease control departments.2. Developed symptoms surveillance information collection and statistical analysis software and completed real-time fill, automatic calibration, audit report, correction and concentration and the subsequent analysis, early warning, response, etc. through the network, with the mode of " scattered collection, two levels of storage, central processing and hierarchical analysis".3. Evaluated the applicability in the army and the value of public health of the forces syndrome surveillance system primarily. The system ran well and this study satisfied the requirements of the army for disease control and prevention work, it was very necessary.