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An assessment of public health surveillance of Zika virus infection and potentially associated outcomes in Latin America

Overview of attention for article published in BMC Public Health, May 2018
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Title
An assessment of public health surveillance of Zika virus infection and potentially associated outcomes in Latin America
Published in
BMC Public Health, May 2018
DOI 10.1186/s12889-018-5566-7
Pubmed ID
Authors

Leonelo E. Bautista, Víctor M. Herrera

Abstract

We evaluated whether outbreaks of Zika virus (ZIKV) infection, newborn microcephaly, and Guillain-Barré syndrome (GBS) in Latin America may be detected through current surveillance systems, and how cases detected through surveillance may increase health care burden. We estimated the sensitivity and specificity of surveillance case definitions using published data. We assumed a 10% ZIKV infection risk during a non-outbreak period and hypothetical increases in risk during an outbreak period. We used sensitivity and specificity estimates to correct for non-differential misclassification, and calculated a misclassification-corrected relative risk comparing both periods. To identify the smallest hypothetical increase in risk resulting in a detectable outbreak we compared the misclassification-corrected relative risk to the relative risk corresponding to the upper limit of the endemic channel (mean + 2 SD). We also estimated the proportion of false positive cases detected during the outbreak. We followed the same approach for microcephaly and GBS, but assumed the risk of ZIKV infection doubled during the outbreak, and ZIKV infection increased the risk of both diseases. ZIKV infection outbreaks were not detectable through non-serological surveillance. Outbreaks were detectable through serologic surveillance if infection risk increased by at least 10%, but more than 50% of all cases were false positive. Outbreaks of severe microcephaly were detected if ZIKV infection increased prevalence of this condition by at least 24.0 times. When ZIKV infection did not increase the prevalence of severe microcephaly, 34.7 to 82.5% of all cases were false positive, depending on diagnostic accuracy. GBS outbreaks were detected if ZIKV infection increased the GBS risk by at least seven times. For optimal GBS diagnosis accuracy, the proportion of false positive cases ranged from 29 to 54% and from 45 to 56% depending on the incidence of GBS mimics. Current surveillance systems have a low probability of detecting outbreaks of ZIKV infection, severe microcephaly, and GBS, and could result in significant increases in health care burden, due to the detection of large numbers of false positive cases. In view of these limitations, Latin American countries should consider alternative options for surveillance.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 64 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 64 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 12 19%
Student > Master 11 17%
Researcher 8 13%
Student > Doctoral Student 6 9%
Professor > Associate Professor 4 6%
Other 13 20%
Unknown 10 16%
Readers by discipline Count As %
Medicine and Dentistry 20 31%
Nursing and Health Professions 9 14%
Agricultural and Biological Sciences 4 6%
Social Sciences 3 5%
Pharmacology, Toxicology and Pharmaceutical Science 2 3%
Other 8 13%
Unknown 18 28%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 May 2018.
All research outputs
#9,954,179
of 13,010,971 outputs
Outputs from BMC Public Health
#7,364
of 8,895 outputs
Outputs of similar age
#187,799
of 271,344 outputs
Outputs of similar age from BMC Public Health
#1
of 1 outputs
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