Factors Influencing Consistency of Laboratory Reporting in Surveillance of Respiratory Syncytial Virus Open Access

Abstract

Factors Influencing Consistency of Laboratory Reporting in Surveillance of Respiratory Syncytial Virus

By Sara Demas

Background: Respiratory Syncytial Virus (RSV) is the leading cause of viral lower respiratory tract infections in young children in both developed and developing countries, with almost 34 million new cases occurring worldwide each year. Comprehensive and well-timed information on RSV characteristics is essential for determining seasonality, burden of disease, and effective prevention and control measures. The objective of this thesis is to examine the factors that affect consistency of RSV reporting to NREVSS.

Methods: Using data from the National Respiratory and Enteric Virus Surveillance System between 2003 and 2013 and a standardized laboratory assessment, analysis of variance and a logistical regression model were performed to study the association between the outcome, consistent reporting, and exposure variable, mode of reporting, adjusting for laboratory locale, testing protocols and diagnostic test used.

Results: Data collected from 884 participating laboratories reported a total of 4,989,768 RSV tests for the sum period of 188,994 lab weeks. Mode of reporting (direct vs. indirect), regional location, and diagnostics methods (antigen, PCR, and culture) were all factors significantly associated with consistent reporting. Among the subset of assessed laboratories, year round testing and selection of testing methods were also found to be significant modifiers in consistent reporting.

Conclusion: Laboratories that were direct reporters, located in the Southern region, and used antigen detection had greater odds of reporting consistently to NREVSS. Of the subset of assessed laboratories, reporting year round and using a standard protocol for selection of testing methods also increases odds of consistent reporting. This study suggests direct reporting and testing methods are good measures of reporting consistency and allow for more representative data on RSV circulation.

Table of Contents

TABLE OF CONTENTS
BACKGROUND/INTRODUCTION .................................................................................................................... 1
Respiratory Syncytial Virus ....................................................................................................................... 1
NREVSS ...................................................................................................................................................... 2
Surveillance ............................................................................................................................................... 4
Data Quality .............................................................................................................................................. 4
METHODS ...................................................................................................................................................... 8
Description of NREVSS .............................................................................................................................. 8
Analysis of all labs ..................................................................................................................................... 9
Analysis of surveyed labs ........................................................................................................................ 10
RESULTS ...................................................................................................................................................... 12
Descriptive Characteristics ...................................................................................................................... 12
Subset of Laboratories ............................................................................................................................ 13
Assessment of Lab Practices and Testing ............................................................................................... 14
Analysis ................................................................................................................................................... 15
All labs ................................................................................................................................................. 15
Subset Labs ......................................................................................................................................... 16
DISCUSSION ................................................................................................................................................. 17
Strengths and Limitations ....................................................................................................................... 19
REFERENCES ..............................................................................................................................

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	surveillance respiratory syncytial virus
Committee Chair / Thesis Advisor	Spaulding, Anne C, Emory University
Partnering Agencies	CDC

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