Abstract
Infectious diseases still represent a major challenge for humanity. In this context, their surveillance is critical. From 2010 to 2016, two Point-Of-Care (POC) laboratories have been successfully implemented in the rural Saloum region of Senegal. In parallel, a homemade syndromic surveillance system called EPIMIC was implemented to monitor infectious diseases using data produced by the POC laboratory of the Timone hospital in Marseille, France. The aim of this study is to describe the steps necessary for implementing EPIMIC using data routinely produced by two POC laboratories (POC-L) established in rural Senegal villages. After improving EPIMIC, we started to monitor the 15 pathogens routinely diagnosed in the two POC-L using the same methodology we used in France. In 5 years, 2,577 deduplicated patients-samples couples from 775 different patients have been tested in the Dielmo and Ndiop POC-L. 739 deduplicated patients-samples couples were found to be positive to at least one of the tested pathogens. The retrospective analysis of the Dielmo and Ndiop POC data with EPIMIC allowed to generate 443 alarms. Since January 2016, 316 deduplicated patients-samples couples collected from 298 different patients were processed in the Niakhar POC laboratory. 56 deduplicated patients-samples couples were found to be positive to at least one of the tested pathogens. The retrospective analysis of the data of the Niakhar POC laboratory with EPIMIC allowed to generate 14 alarms. Although some improvements are still needed, EPIMIC has been successfully spread using data routinely produced by two rural POC-L in Senegal, West Africa.
Highlights
In their 2015 report, the Global Burden of Disease study group estimated that in 2013 54.9 million people died worldwide, with 11.8 million deaths due to communicable, maternal, neonatal, and nutritional disorders [1]
This study describes how automated surveillance systems have been implemented in two rural areas in Senegal for the weekly surveillance of 15 pathogens responsible for fever in Africa and on the basis of laboratory data from
The two surveillance systems prospectively and retrospectively detected several abnormal events, and allowed us to observe that the distribution of the pathogens was not the same depending on the region under surveillance
Summary
In their 2015 report, the Global Burden of Disease study group estimated that in 2013 54.9 million people died worldwide, with 11.8 million deaths due to communicable, maternal, neonatal, and nutritional disorders [1]. Infectious diseases were directly involved in a significant part of them, with 2.7 million deaths due to lower respiratory infections, 1.3 million deaths due to HIV/AIDS, 1.3 million deaths due to tuberculosis, 1.3 million deaths due to diarrhoeal diseases, and 854,600 deaths due to malaria [1] This situation clearly underlines that infectious diseases are still a big challenge for humanity in the 21st century, especially because i) we still discover more and more possible pathogens with new technologies, ii) pathogens are naturally evolving, leading to the emergence or re-emergence of pathogens, iii) people and resources are moving and exchanging faster and faster around the world, which directly affects the ecosystems, and iv) their appearance and disappearance in the different human populations cannot be reliably modeled [2,3,4,5]. Thirteen main sources of data are currently available for the infectious disease surveillance, including, among others, the Internet, drug sales reports, sentinel surveillance notifications, notifiable diseases reports, and microbiology orders reports
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