Operations on the ECDC/WHO joint TB information system
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1 Operations on the ECDC/WHO joint TB information system Annual Meeting on TB Surveillance in Europe Dubrovnik, Croatia; May 2009 Andrei Dadu Communicable Diseases Unit, WHO Regional Office for Europe
2 Conceptual aspects Keep the geographic coverage of the System avoiding efforts duplication Simplify the data base content and keep it historically consistent (core components: TB cases and programme data) Member States are the data owners Collaboration between ECDC and WHO to ensure the Executive of the joint surveillance System Standardize the data management by ensuring of unique case definition (at least not mutual exclusive) 2
3 European Joint TB information system The joint TB IS database is jointly hosted by ECDC and WHO/EURO: EU countries are able to upload their: case management data via TESSy programme management data via CISID Non-EU countries are reporting all data via CISID 3
4 Country participation on data reporting, EUR, out of
5 Framework of collaboration with MS The Network (members states) EU/EEA and EFTA: country TB contact point Epi Lab Non-EU: TB surveillance national correspondents The Network executive and coordination: ECDC and WHO Executive advisory: discuss and advise ECDC and WHO on any technical, epidemiological and other scientific aspects of TB surveillance that will enable the network to develop further and improve its effectiveness and added value 5
6 Data processing tools Joint website TESSy - The European surveillance system (TUB specific component) CISID - the Centralized Information System for Infectious Diseases (TUB specific component) TB data questionnaire (optional) 6
7 TB Data 53+1 MS of the Region WHO/EURO validation of non-eu/eea/efta countries data ECDC-WHO/EURO joint web website Common rules for validation ECDC validation of EU/EEA/EFTA countries data CISID Data bases synchronization TESSy ECDC TB experts Validated TB data in joint ECDC/WHO database WHO/Europe TB experts Common Rules for Access & Data Use 53 TB national contact points Annual Report Website reports and information 7
8 Data processing For EU/EEA & EFTA, submission of TB notification 2 Log in TESSy Public users Country 1 correspondent TESSy data push out Aggregated data extraction from individualized data set CISID data push out 4 For all 53 (except step 2), submission of all data Log in Public users 8
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11 Username/password (i.e. RUS-TUB / rustbrustbrustb) defined by CISID manager based on the country name (ISO3) and module name 11
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13 Content of the Joint TB IS, since 2009 Countries data reporting workload according High incident (-60%) Low incidence (-80%) From EU via TESSy: with case based data, then & XDR-TB 13
14 MDR-TB prevalence, EUR, 2007 high sensitivity vs. low specificity Estimated, among new 10.35%(43 600) Estimated, among re treatment 43,41% Notified, among new 9,59%(7 351) Notified, among re treatment 38,55 % Detection rate, new 17% 14
15 Can we trust DRS data? CHALLENGES EQA, international: EUR: 36 out of 53 EU: 21 out of 24 Balkans: 2 out of 6 18 EEUR: 11 out of 18 Coverage, country-wide EUR: 34 out of EEUR: 7 out of 18 Duplication of MDR-TB data collection at supra-national level XDR-TB surveillance SOLUTION Acting via EUR and EU lab strengthening task-forces Expending DST network with keeping QA at high level and then integrate DRS into routine TB surveillance Providing DRS surveys or establishing ongoing DRS sentinel surveillance Merging the existing tools Expanding the existing tools and make them more specific COMMENT/IMPLICATION Cooperate with: EUR lab task-force, countries NRL technical agencies TESSy/DRS.QES to => CISID TESSy <=> CISID 15
16 DRS integration into the System From all MS via CISID Include DRS questionnaire questions (sections A&B) that are missing in CISID From EU via TESSy: with case based data, then aggregated into CISID From non-eu via CISID & XDR-TB Expend CISID with content from DRS questionnaire, section TT status and ad 2 nd line drugs 16
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19 HIV prevalence among new TB cases, EUR, 2007 low sensitivity & low specificity Estimated, among new 9.8%(42.322) Notified, among new 4.0%(6.710) Detection rate 16 % Compared to previous year: less tests more cases 19
20 Challenges of HIV-TB data collection? CHALLENGES Low country response rate to TB/HIV co-infection surveillance: country legislation infrastructure challenges (unlinked HIV databases) no or poor collaborative data management Duplication of HIV-TB data collection at supra-national level SOLUTION Exclude/keep the section of TB care among PLWHA from CISID Emphasize data collection on TB case finding among PLWHA Extract data from HIV data bases COMMENT/IMPLICATION HIV finding among TB CPT ARV TB finding among PLWHA IPT ARV TESSy/HIV => CISID/TB 20
21 Expectation from 2008 data collection & analysis Data with standardized case definition used throughout the Region or SOPs for data reading; Integrated approach on TB data collection at the Regional level (formats, channels/tools, responsibilities); An increased response rate and better data quality. for emphasising the use of cohort analysis for treatment outcome monitoring; developing a better insight into the TB/HIV co-epidemic; conducting careful assessments of prevalence and trends of MDR-TB at country and regional level. 21
22 Helpdesks at your service ECDC/SUN/TUB ECDC/SUN/TESSy WHO/SAM/TUB WHO/SAM/CISID Tel. No: +46 (85) Skype: TESSyHelpdesk Tel. No: +45 (39)
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