RESUMO
OBJECTIVE: To establish and evaluate an internet-based pilot programme for sentinel surveillance of emerging health problems among the private sector physicians in three Caribbean countries. DESIGN AND METHODS: Participating physicians were identified in cooperation with local chapters of the Caribbean College of Family Physicians in Jamaica, Trinidad andTobago and St Lucia. A menu-driven Epi Info programme was used for reporting as well as on-site analysis of individual site data. Hardware was installed,participants were trained and surveillance data entry began in September-October, 1999. Three disease entities were chosen by consensus as the initial targets for surveillance - diarrhoeal disease, fever/rash syndrome, and sexually transmitted diseases. Evaluation criteria for the programme included the achievement of timely data entry and reporting, the establishment of regular feedback, and the regular use of internet-based data transfer for reporting and communication. RESULTS: The practices of twenty-one physicians were chosen as initial pilot sites. All Ministries valued the enhancement of their existing surveillance through the project and cited improved public-private partnership as a positive impact. Reduced cost of communication through use of theinternet was partially offset by the high initial cost of computer hardware, and the relatively high cost of local internet connections. Other limitations included a constrained communication infrastructure, limited baseline computer skills administrative barriers, and cost. CONCLUSION: The strengths of the programme were simplicity; potential for improved data quality; and improved competency in computer skills and surveillance among participating physicians. Proposed changes in the next phase include improvement in the software programme and development of a more extended network and e-mail forum. (Au)
