Sentinel physician's network in Reunion Island: a tool for infectious diseases surveillance.

UNLABELLED: The surveillance of infectious diseases in Reunion Island is based on a sentinel network of family physicians (FPs) coordinated by the Indian Ocean regional institute for public health surveillance (French acronym OI Cire). The objectives are to identify and monitor outbreaks of influenza, gastroenteritis, and chicken pox, and to characterize circulating influenza viruses. The network can monitor other potentially epidemic diseases. METHOD: The Réunion sentinel network ensures a continuous and permanent surveillance. Physicians send their weekly activity data to the Cire that collects, processes, and interprets it; they also collect samples for biological surveillance of influenza. Statistical thresholds, based on historical data and the estimated numbers of incident cases, are calculated to follow the trend, detect outbreaks, and quantify their impact. RESULTS: The network currently includes 56 FPs and pediatricians, accounting for 6.5% of FPs on the island. The network has clarified the seasonality of influenza during the austral winter and identified the seasonality of acute diarrhea with an epidemic peak when school starts in August. The sentinel FPs's reports allowed monitoring the epidemic trend and estimating the number of cases during the 2005 and 2006 chikungunya outbreaks and 2009 influenza A (H1N1) outbreaks. CONCLUSION: The network has proven its contribution, responsiveness, and reliability for epidemiological surveillance during outbreak. It is an essential tool for infectious diseases surveillance in Reunion Island.

[Using French national health insurance data for non-specific monitoring on Reunion Island]. / Utilisation des données de la Caisse générale de Sécurité sociale de la Réunion dans le cadre de la surveillance non spécifique.

BACKGROUND: In Reunion Island, non-specific surveillance developed mainly in 2009 and was based on the activity of hospital emergency department, emergency calls and mortality. From March 2010, a new surveillance was implemented in collaboration between the Indian Ocean regional epidemiology unit and the regional office of the National Health Insurance. The system is based on the weekly number of general practitioner consultations and home visits by municipality. This article presents methods of using these data for non-specific monitoring in Reunion Island. MATERIALS AND METHODS: Data analyzed cover consultations and visits to general practitioners and pediatricians for each of the 24 municipalities. Data were received in week S+1 and were updated week by week following the flow of repayments. To perform weekly monitoring, determine monitoring impact and detect any unusual health event, a correction factor was thus calculated and applied for the overall data set and for each municipality. Received data covered 72% of the population of the island. RESULTS: Over the study period from 2005 to 2009, the monthly average of consultations was 80,000 (min: 58,000 - max 12,0000). Two main peaks of activity were noticed throughout the island during the study period, the first one from weeks 4 to 9 of 2006 with a peak of 105,000 consultations in week 8 and the second one from weeks 34 to 41 of 2009 with a peak of 120,000 consultations in week 35. CONCLUSION: The two peaks described in 2006 and 2009 respectively correspond to outbreaks of chikungunya and influenza A(H1N1) 2009. This monitoring study has two main advantages: an almost exhaustive data set corresponding to three-quarters of the Reunion Island population and the geographic analysis by municipality. Positioned alongside other monitoring networks, this system expands the indicators monitored reflecting varying uses of care.