Are we missing anything? Completeness of laboratory surveillance in the East of England
PHE ePoster Library. West D. Apr 9, 2019; 257510; 15416
Daniel West
Daniel West
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Abstract Introduction
Laboratory reporting of notifiable infections has greatly improved since the introduction of the Second Generation Surveillance System (SGSS) in 2015, particularly with regards to timelier reporting and improved data quality. This has enabled more sophisticated and robust processes to be developed to identify exceedances however these processes do not adequately detect under-reportingMethodsUsing a combination of SQL and R, SGSS data concerning notifiable infections in the East of England, was interrogated on a monthly basis for the preceding six month period. This process has been in place since August 2018. Data was flagged for investigation if the number of cases reported was >1 standard deviation below the mean; or the mean was zero. Where true under reports were identified, solutions were discussed and implemented with the laboratory concernedKey.
All thirteen East of England laboratories had at least one under reporting flag for investigation. Some were discounted due to genuine lower reporting; however, seven laboratories were shown to have potentially significant under reporting issues for infections such as Hepatitis and Influenza. Subsequent investigation found that one laboratory had reported zero to very low levels of all non-isolate results for at least nine monthsDiscussionUnder-reporting by laboratories is a common issue and is likely to be under-detected. Field Service teams should be vigilant and proactively implement interventions to ensure completeness of laboratory surveillance. This will help to reduce the risk of missed public health action being taken by Health Protection Teams, and improve laboratory surveillance across England.
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