Tracking Patterns of Enteric Illnesses in Populations and Communities

Abstract

BackgroundEnteric illness arising from contaminated water and food is a major health concern worldwide, and tracking the incidences and severity of outbreaks is still a challenging task. Most developed and developing countries have administrative databases for medical visits and services maintained by the government and/or health insurance authorities. Although these databases could be extremely valuable resources to track patterns of environmental and other health issues, test hypotheses, and develop epidemiologic models and predictions, very little research has been done to develop methods to ensure the robustness of such databases and to demonstrate their utility as a research tool.ObjectivesWe used the Medical Services Plan (MSP) database of British Columbia, Canada, to develop innovative ways to use medical billing and fee-for-services data to track long-term patterns of enteric illness at the level of populations and communities.ResultsTo illustrate the power and robustness of the method, we provided several examples covering 8 years of data from each of four communities covering a large range of population size. Not only could this method generalize to other diseases for which specific fee item markers can be found, but also it gives results consistent with a known outbreak and yields data patterns, which could not be revealed by the currently used methods. Because diagnostic code and fee item data for medical services are collected by most medical insurance agencies, our method can have global applications for tracking enteric and other illnesses at the level of populations and communities.

Microbiological quality of drinking water from dispensers in Italy

“…It is well known that the quality and safety of the drinking water continues to be an important public health issue [ 1 , 2 ], because its contamination has been frequently described as responsible for the transmission of infectious diseases that have caused serious illnesses and associated mortality worldwide [ 3 - 6 ]. Clearly, point-of-use water quality is a critical public health indicator [ 2 ].…”

Infection control strategy by killing drug-resistant bacteria

“…For instance, diarrhoea is regarded as the leading cause of morbidity and mortality in children in Africa and South Asia. 9,10 In the city of Karachi alone, more than 20 000 children die annually, the majority of these deaths are thought to be associated with waterborne pathogens. Among others, major waterborne diseases include cholera, enterohaemorrhagic Escherichia coli, viral hepatitis, bacillary dysentery, typhoid, campylobacteriosis, cryptosporidiosis, giardiasis, and legionellosis.…”

“…Routine monitoring of microbial changes including presence of amoebae, during and after application of various disinfection treatments, is essential to safeguard domestic water systems against infectious diseases that account for more than 50% of global child mortality. 9,10 Future research is needed to determine the efficacy of the proposition to add an anti-amoebic line of defence to combat bacterial infections in hospitals, nursing homes, schools, and water systems.…”