Syndromic surveillance of acute gastroenteritis based on drug consumption

Abstract

Since 1998, the French Health Insurance (NHI) system had established a national database in order to reimburse drug prescriptions. These electronical data are a considerable potential source for syndromic surveillance because of their exhaustive and regular updates. The aim of this study was to develop a method to identify acute gastroenteritis (AG) cases from drug reimbursements of the NHI database. The algorithm aimed at discriminating AG from other pathologies was determined from a sample of 206 AG prescriptions and 351 non-AG prescriptions collected in five pharmacies. The AG case identification was mainly based on the lag time between the prescription and delivery day, the occurrence of non-AG case-specific drugs, AG case-specific drug associations and treatment duration. The discriminant algorithm led to a sensitive and specific indicator of medically treated cases of AG with a time-spatial resolution power which met the need for waterborne AG surveillance.

A method for neighborhood‐level surveillance of food purchasing

“…In this work, we have demonstrated how these sales indictors can be used to develop a public health surveillance indicator, which provides interpretable information over time and at a high geographical resolution. We do not know of any previous efforts to develop a similar sort of indicator using food sales data, but in public health settings, surveillance systems increasingly rely on automated feeds of data captured for other purposes, such as electronic medical records, telehealth calls, and pharmaceutical sales . With respect to our substantive finding, the small amount of evidence regarding the negative association between CSD sales and median personal income is based on survey data and is difficult to compare to our results, as the measures of added sugar intake and income were different in those studies .…”

Description of two waterborne disease outbreaks in France: a comparative study with data from cohort studies and from health administrative databases

“…AGI medications are included in this database if they are reimbursable, prescribed by a GP and dispensed in a pharmacy. The identification of AGI cases in the two WBDO above required two consecutive steps: (i) data extraction from the SNIIRAM database and (ii) using the AGI algorithm developed by Bounoure et al [3] for selecting AGI cases. The criterion for the data extraction step was the reimbursement for at least one prescribed target drug used to treat AGI † bought by people living in the impacted municipality.…”

“…In France, an algorithm was specifically developed to identify AGI cases in 2011. It uses data on reimbursement for payment of prescribed drugs from the French National Health Insurance Information System (SNIIRAM; Système national d'information inter régimes de l'Assurance maladie) database [3]. The SNIIRAM database covers 98% of the French population and collects both administrative and individual medical information [4].…”

Time series study of weather, water quality, and acute gastroenteritis at Water Safety Plan implementation sites in France and Spain

“…Water quality indicators (e.g., turbidity, free chlorine) used in this study likewise do not measure pathogen presence directly, but serve as more readily measurable surrogates for exposure. The outcome measure is probably affected by missing data (Bounoure et al, 2011), especially for mild acute gastroenteritis cases treated at home. Additional indicators (e.g., high-resolution water quality data from distribution systems, self-reported consumption) were not typically available to confirm all steps in the theoretical causal chain from water contamination to consumption to symptom development and reporting.…”

“…Acute gastroenteritis surveillance is based on hospital reporting (ICD-9-CM codes for intestinal infectious diseases 001–009) in Spain, courtesy of Servei Català de la Salut (Cat-Salut), and an algorithm for processing prescription reimbursement records (e.g., for anti-emetics, antispasmodics, and oral rehydration salts) in France (Bounoure et al, 2011), courtesy of Santé Publique France and the French national health insurance program. Since most cases are treated at home, this public health surveillance data is expected to capture about 33% of total cases in France and about 1–2% in Spain (Bounoure et al, 2011). Use of data from human subjects was approved by the Institutional Review Board (IRB) at the University of North Carolina at Chapel Hill (study #15-2118).…”