Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Mar 3, 2022
Date Accepted: Sep 29, 2022
Date Submitted to PubMed: Oct 13, 2022
From paper to registries: establishing a digital SARI surveillance system in Malta
ABSTRACT
Background:
Background:
In late 2020, the European Centre for Disease Prevention and Control and Epiconcept started implementing a surveillance system for severe acute respiratory infections (SARI) across Europe. Our objective is to describe how SARI surveillance was digitised in Malta and describe the characteristics of people included in the surveillance system. We also compare different SARI case definitions including their advantages and disadvantages.
Objective:
Objective:
To describe the process of digitising and upgrading SARI surveillance in an island country with a centralized health system during a pandemic, discussing the process, output and future for SARI and other public health surveillance opportunities.
Methods:
Methods:
Malta has one main public hospital where, on admission, patient data are entered into electronic records as free text. Symptoms and comorbidities are manually extracted from these records, while other data are collected from registers. Collected data are formatted to produce weekly and monthly reports to inform public health actions.
Results:
Results:
From October 2020 to February 2021, we established an analogue incidence-based system for SARI surveillance. From February 2021 onwards we mapped key stakeholders and digitised most surveillance processes. By 30 November 2021, 903 SARI cases were reported, with 380 (42.2%) positive for SARS-CoV-2. Of all SARI hospitalisations, 69 (7.6%) were admitted to ICU, 769 (85.2%) have been discharged, 27 (2.9%) are still being treated, and 107 (11.8%) have died. Among those who died, 96 (89.7%) had more than one underlying condition, the most common of which were hypertension (57; 53.3%) and chronic heart disease (49; 45.8%).
Conclusions:
Conclusion: The implementation of an enhanced SARI surveillance in Malta was completed by the end of May 2021, allowing monitoring of SARI incidence and patient characteristics. A future shift to register-based surveillance should improve SARI detection through automated processes.
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.