A simplified method of performance indicators development for epidemiological surveillance networks--application to the RESAPATH surveillance network.

BACKGROUND: Develop and calculate performance indicators allows to continuously follow the operation of an epidemiological surveillance network. This is an internal evaluation method, implemented by the coordinators in collaboration with all the actors of the network. Its purpose is to detect weak points in order to optimize management. A method for the development of performance indicators of epidemiological surveillance networks was developed in 2004 and was applied to several networks. Its implementation requires a thorough description of the network environment and all its activities to define priority indicators. Since this method is considered to be complex, our objective consisted in developing a simplified approach and applying it to an epidemiological surveillance network. METHODS: We applied the initial method to a theoretical network model to obtain a list of generic indicators that can be adapted to any surveillance network. RESULTS: We obtained a list of 25 generic performance indicators, intended to be reformulated and described according to the specificities of each network. It was used to develop performance indicators for RESAPATH, an epidemiological surveillance network of antimicrobial resistance in pathogenic bacteria of animal origin in France. CONCLUSION: This application allowed us to validate the simplified method, its value in terms of practical implementation, and its level of user acceptance. Its ease of use and speed of application compared to the initial method argue in favor of its use on broader scale.

OASIS: an assessment tool of epidemiological surveillance systems in animal health and food safety.

The purpose of this study was to develop a standardized tool for the assessment of surveillance systems on zoonoses and animal diseases. We reviewed three existing methods and combined them to develop a semi-quantitative assessment tool associating their strengths and providing a standardized way to display multilevel results. We developed a set of 78 assessment criteria divided into ten sections, representing the functional parts of a surveillance system. Each criterion was given a score according to the prescription of a scoring guide. Three graphical assessment outputs were generated using a specific combination of the scores. Output 1 is a general overview through a series of pie charts synthesizing the scores of each section. Output 2 is a histogram representing the quality of eight critical control points. Output 3 is a radar chart representing the level reached by ten system attributes. This tool was applied on five surveillance networks.

Prevalence of Mycoplasma bovis udder infection in dairy cattle: preliminary field investigation in southeast France.

AIMS: To update epidemiological data on Mycoplasma bovis infection in dairy herds from six departments in the southeast of France, in order to obtain a first estimate of the prevalence of M. bovis infection through bacteriological investigations on bulk tank milk, and estimate the prevalence of M. bovis in clinical mastitis in this population of cattle. METHODS: To estimate a prevalence of M. bovis of 2%, with 95% confidence, a sample of >270 herds was required. Bulk tank milk samples were collected from herds between January and February 2005 and milk samples from cows with clinical mastitis were collected between January 2007 and March 2008. Bulk tank milk and composite mastitic samples were analysed for M. bovis using culture and/or PCR. RESULTS: Mycoplasma bovis was not detected by either technique in any of the 345 bulk tank milk samples. The prevalence of M. bovis infection in this population of dairy herds was <1%, with 95% confidence. Mycoplasma bovis was not isolated from any of the 166 composite samples obtained from 828 samples of mastitic milk. The prevalence of M. bovis in clinical mastitis was <0.44%, with 95% confidence. CONCLUSIONS: These preliminary results suggest that the prevalence of udder infections with M. bovis is very low in dairy herds in the southeast of France. These two studies provide preliminary data, that can be used to derive working hypotheses for future statistically representative investigations at the national level.

Development of performance indicators for the bovine clinical salmonellosis surveillance network in France.

Performance indicators are variables used to calculate on a continuous basis the operational level of a surveillance network's priority activities. A 10-step process was developed to enable network coordinators to identify specific performance indicators to help them monitor their networks. The methodology was based on a listing of surveillance activities, the definition and choice of network's global priority objectives, the construction of performance indicators and monitoring tables and the implementation of the system within the network. This process was implemented for the bovine clinical digestive salmonellosis surveillance network in France (RESSAB). The process produced a list of 26 activities synthesized into 15 global objectives, from which 12 were retained as priority objectives. This made it possible to develop 12 performance indicators. Indicators retrospectively calculated for the year 2003 indicated that RESSAB was operating according to the objectives set by the network's stakeholders and its financial supporter. The methodology was implemented successfully and was not very time consuming (12 person-days) or expensive. The decision makers and actors in the network quickly appropriated the system. The methodology can thus be considered validated through this example. Nevertheless, the risks inherent in the use of performance indicators must be addressed by ensuring the relevance of the selected indicators through external assessment and by prioritizing an internal and participatory approach to avoid a misuse of the performance indicators. In addition, considering that performance indicators address only the operation of the network, relevance of surveillance procedure should be addressed by external evaluation.