European Network of Sentinel Systems for VPD Surveillance (WP8) Survey |
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The full report of the survey is found here.
Synopsis
A survey was conducted to create an inventory of sentinel physician networks for vaccine preventable diseases (VPD) in Europe . In October 2006, an electronic questionnaire was sent to all EUVAC-NET national gatekeepers. The questionnaire included questions on general characteristics of sentinel systems, sources of data, choice of denominator, the case definitions used, the flow, collection, analysis and dissemination of data, and system monitoring. Only VPD included in the EUVAC.NET project were considered (i.e. measles, mumps, rubella, congenital rubella syndrome, pertussis, and varicella).
All 32 EUVAC.NET countries participated in the survey. Most countries (20) do not have a sentinel surveillance system in place for VPD, seven have one system in place (Cyprus, Greece, Ireland, Italy, Portugal, Switzerland, UK), four have two systems (Belgium, France, Germany, Netherlands), while one (Spain) has a regional system (Figure 1). In total, 15 national sentinel systems for VPD were included in the analysis.
Figure 1. Countries with sentinel surveillance systems for vaccine-preventable diseases in place
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The
oldest existing sentinel system was established 40 years ago in the UK. Five systems were established less than 5 years ago; of these, three systems were implemented for surveillance of varicella only, while one system included varicella among the diseases under surveillance.
Most
systems (11/15) collect data on more than one VPD. Varicella is the disease most frequently under surveillance and is included in 10 systems. Nine systems collect data on measles, eight on mumps, seven on pertussis, six on rubella, and two on congenital rubella syndrome. Varicella zoster is under surveillance by six sentinel systems. In three countries, the sentinel system is the only source of data for varicella, while in one country it is the only surveillance system for pertussis.
The
most frequently stated objective is to undertake epidemiological surveillance of VPD, including the measurement of disease burden and for monitoring trends. Other objectives included the collection of clinical information (including data on complications) and the evaluation of the impact of vaccination programmes. In the Netherlands , an objective of the sentinel system for varicella is to assess the health care costs for cases hospitalized with severe varicella zoster.
All systems identified are, at least to some degree, government funded, obtaining funds from the Ministry/Department of Health, National Health Institute, or research/surveillance centres. Two systems are partly privately funded.
Most (13/15) existing sentinel systems are based on primary care physicians; in two of these systems, hospitals are also involved. The remaining two systems are based on hospital sites only (sentinel surveillance of pertussis in France and of varicella in the Netherlands). The median number of physicians per system is 199 (range 42-1270). The systems monitor a proportion of the general or paediatric population which varies from 0.42-4.30%. In 3/13 countries with available information, fixed patient lists exist and therefore detailed denominator data are available. For the remaining systems, denominator is calculated by using census data, number of consultations or number of sentinel practices.
Regarding the variables collected, age and/or date of birth are collected by all systems, date of consultation/date of onset of symptoms and gender by fourteen systems, vaccination status by eleven, information on complications by eight and mortality data by seven systems.
The data is collected, analysed at variable frequencies and in fourteen systems is disseminated to participating sites, amongst others. Thirteen systems operate a website.
The survey concluded that sentinel systems for VPD in Europe are used particularly for frequent diseases (such as varicella) and can provide useful information on complications. However, there is a wide variability in the characteristics of existing sentinel systems and therefore a lack of comparable data. In addition, it is sometimes problematic to obtain accurate information on population under surveillance, especially in countries without patient registries.
Date of report: 9 October 2007
© Copyright 2008 EUVAC.NET
All rights reserved. No part of this report may be reproduced by any means, or transmitted, or translated into machine language without written permission of EUVAC.NET
This project receives funding from the European Commission (DG SANCO). Neither the European Commission,
nor any person acting on its behalf is liable for any use made of the information published here.
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