COVID-19 surveillance: Large decrease in clinical notifications and epidemiological investigation questionnaires for laboratory-confirmed cases after the 2nd epidemic wave, Portugal March 2020–July 2021

Frontiers in Public Health

Public Health

Daniel Rhys Thomas¹  Alexis Sentis²  Carla Nunes³  Pedro Aguiar³  Alexandre Abrantes³  André Vieira³  Vasco Ricoca Peixoto³  Carlos Carvalho⁴ 

[1] Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, United Kingdom;Epidemiology Department, Epiconcept, Paris, France;NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal;Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal;

关键词: COVID-19;    completeness;    surveillance attribute;    epidemic surveillance;    surveillance system evaluation;    notifications;   

DOI  :  10.3389/fpubh.2023.963464

 received in 2022-06-07, accepted in 2023-01-30,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionIn Portugal, COVID-19 laboratory notifications, clinical notifications (CNs), and epidemiological investigation questionnaires (EI) were electronically submitted by laboratories, clinicians, and public health professionals, respectively, to the Portuguese National Epidemiological Surveillance System (SINAVE), as mandated by law. We described CN and EI completeness in SINAVE to inform pandemic surveillance efforts.MethodsWe calculated the proportion of COVID-19 laboratory-notified cases without CN nor EI, and without EI by region and age group, in each month, from March 2020 to July 2021. We tested the correlation between those proportions and monthly case counts in two epidemic periods and used Poisson regression to identify factors associated with the outcomes.ResultsThe analysis included 909,720 laboratory-notified cases. After October 2020, an increase in the number of COVID-19 cases was associated with a decrease in the submissions of CN and EI. By July 2021, 68.57% of cases had no associated CN nor EI, and 96.26% had no EI. Until January 2021, there was a positive correlation between monthly case counts and the monthly proportion of cases without CN nor EI and without EI, but not afterward. Cases aged 75 years or older had a lower proportion without CN nor EI (aRR: 0.842 CI95% 0.839–0.845). When compared to the Norte region, cases from Alentejo, Algarve, and Madeira had a lower probability of having no EI (aRR;0.659 CI 95%0.654–0.664; aRR 0.705 CI 95% 0.7–0.711; and aRR 0.363 CI 95% 0.354–0.373, respectively).DiscussionAfter January 2021, CN and EI were submitted in a small proportion of laboratory-confirmed cases, varying by age and region. Facing the large number of COVID-19 cases, public health services may have adopted other registry strategies including new surveillance and management tools to respond to operational needs. This may have contributed to the abandonment of official CN and EI submission. Useful knowledge on the context of infection, symptom profile, and other knowledge gaps was no longer adequately supported by SINAVE. Regular evaluation of pandemic surveillance systems' completeness is necessary to inform surveillance improvements and procedures considering dynamic objectives, usefulness, acceptability, and simplicity.

【 授权许可】

Unknown   
Copyright © 2023 Ricoca Peixoto, Vieira, Aguiar, Sentis, Carvalho, Rhys Thomas, Abrantes and Nunes.