Correlation of Syndromic Surveillance of Gastrointestinal Illnesses with Laboratory-confirmed Notifiable Enteric Disease, by Time and Place, State of Georgia, 2015-2016 Open Access

Patel, Kelsey (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/ff3655923?locale=en
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Abstract

Correlation of Syndromic Surveillance of Gastrointestinal Illnesses with Laboratory-confirmed Notifiable Enteric Disease, by Time and Place, State of Georgia, 2015 - 2016

Background: The Georgia Department of Public Health (DPH) has used syndromic surveillance (SS) since 2004 as part of the public health protection activities for the G8 Summit in Sea Island, GA to identify events that may threaten the health of residents. A common problem in creating interoperable, analogous SS is the lack of standardization of syndrome definitions. This is as an area for further research to strengthen syndromic data collection and studies.

Objective: Describe the temporal relationship between GI-related syndromic and notifiable disease counts.

Methods: This analysis examined data from GI-related (shigellosis, salmonellosis, campylobacteriosis, and E. coli) SS and notifiable diseases from 2015 - 2016 in six counties in Georgia. The notifiable disease data were classified as enteric. Data analyses consisted of two methods: Spearman correlations to assess the relationship between syndromic and enteric (notifiable) disease counts by season and creation of figures showing syndromic and enteric counts varied by event, county, and time.

Results: For the GI event, there is a statistically significant association between GI syndrome counts and enteric notifiable counts in the spring months only (spearman coefficient = 0.23, p=0.0045). Additionally, there is a statistically significant association between vomit syndrome counts and enteric notifiable counts in the spring months (spearman coefficient = 0.24, p=0.0036). For the diarrhea event, there are statistically significant associations with enteric notifiable counts during the spring months (spearman coefficient = 0.16, p=0.046) and winter months (spearman coefficient = -0.16, p=0.05). For both the bloody diarrhea (spearman coefficient = -0.27, p=0.0007) and bloody vomit (spearman coefficient = -0.17, p=0.033) syndromes, there are only statistically significant associations with enteric notifiable counts during the winter months.

Conclusions/Implications: To better understand the baseline counts of syndromic data by event, future studies should increase number of years used in the study. Summing counts over 3-4 years instead of two years could help establish a more accurate baseline from which to observe aberrations of counts from the baseline. Moving forward, DPH could conduct analyses like those done in this paper for all syndromes to assess the competency of Georgia's SS program.


Table of Contents

Chapter I: Literature Review 1

Classifying GI Syndromes and Establishing Case Definitions 1

SS Programs in the United States 3

SS Research in the United States 5

Global SS Research 6

Summary of Current Problem and Study Relevance 9

Chapter II: Manuscript 10

Title, Author(s), Abstract 10

Introduction 11

Methods 13

Results 19

Discussion 22

References 25

Tables 27

Figures 30

Chapter III: Summary, Public Health Implications, Possible Future Directions 37

Appendices 39

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