Preliminary Study On Population-based Severe Acute Respiratory Infection And Invasive Pneumococcal Disease" Surveillance Evaluation

Objective:With the aim to evaluate the characteristics of "Population-based Severe Acute Respiratory Infection and Invasive Pneumococcal Disease "surveillance system (Accuracy, completeness and consistency), identify the weakness of the actual situation and discrepancy between the surveillance objective and program results to make judgments, improve effectiveness, or lessons learned.Method:Referring to evaluation method developed by World Health Organization and US Centers for Disease Control and Prevention for the surveillance system, Based on the program objectives and actual situation, adopted the on-site monitoring and evaluation to evaluate the characteristics of surveillance system(completeness, timeliness and accuracy). Compare the value of program performance via systematic evaluation between ideal value to identify the discrepancy. Utilized the input indicator, process indicator and output indicator for supplemental evaluation. Collect the surveillance data generated from four surveillance hospitals from July2010to June2012for analysis via EPI DATA3.0and SPSS19.0.Results:Input indicator consists of total expenditure of system establishment and maintenance, it is up to9million RMB in total, including staffing recruitment, lab equipment and reagent, training, meeting and travel, etc.). There are459people from twelve organizations and departments directly involved in the surveillance work. Process indicator includes12times of on-site visit, monitoring and investigation at national and provincial level and35coordination meetings and trainings in total.690person-times are trained from the surveillance work. Output indicator:Developed two copies of SARI&IPD protocol (plus revision version); one copy of management manual; one copy of data entry and management manual;1copy of standard operation standard of respiratory specimen;1copy of standard operation procedure influenza virus;1copy of SOP for specimen collection, transportation, processing and package, storage of flu virus and rapid detection method.24monthly SARI&IPD surveillance report;20regular project progress reports from provincial CDCs.1copy of Laboratory Supply management manual;1copy of monitoring and evaluation plan;25,438case registered in SARI&IPD surveillance system, of which25,319is SARI cases and119meningitis cases.24,340Nasopharyngeal (NP) and Oropharyngeal (OP) swabs were collected,4,259blood samples were bacterial cultured,26(0.6%).2,049urine specimen for Streptococcus pneumonia (SP) antigen testing, of which88(4.3%) is SP positive. During the period of monitoring and evaluation, it finds that all the key selected indicators meet the pre-defined criteria except collection rate of child (11.97%) and collection rate of urine specimen (64.62%). Nevertheless, the indicator varies among four surveillance hospitals.â‘ Accuracy of case enrollment:Maternal and Child hospital ranks the first, which is99%, No.2hospital is the lowest(86%).â‘¡Under-reporting rate:Central hospital is the highest (19.86%), maternal and child hospital is the lowest(11.03%);â‘¢Urine specimen Collection rate in No.1Hospital is the highest(87.86%); the lowest is No.2Hospital (72.94%). With four times of evaluation, it demonstrated that the accuracy of case enrollment is increased from79.86%of the1st time to100%of the4th time; Under-reporting rate decreased from23.33%of the1st time to16.84%of the4th time; collection rate of NP/OP swab raised from95.99%to98.79%; collection rate of blood specimen in Adults added to94.57%from77.47%; Urine specimen increased from64.62%to83.17%.Conclusion:â‘ the study finds that not only the progress and changes of surveillance activities can be closely monitored, but also the characteristics of surveillance systems (completeness, consistency and accuracy) can be demonstrated by the selected key evaluation indicators.â‘¡the overall surveillance quality is greatly improved during the different evaluation period. In particular, accuracy of case enrollment, collection rate of Nasopharyngeal (NP)/Oropharyngeal (OP) swabs, adult blood and urine is substantively increased. Due to the complexity of population-based system,the indicator such as underreporting rate is not stable.â‘¢Evaluation assists to address the gap area and potential barrier for the surveillance activities and help to adjust the evaluation criteria accordingly.