La performance dei sistemi di sorveglianza per le malattie infettive in Italia: un’analisi comparativa su due casi studio

[Autom. eng. transl.] INTRODUCTION: Infectious disease surveillance (MI) is a primary activity for Public Health in each country. In Italy, alongside the Infectious Diseases Information System, which collects mandatory notifications, special surveillance systems have been activated with the aim of improving information on the data. This work aims to compare the performance of the mandatory notification system and special surveillance systems in Italy, through two case studies conducted on hepatitis B and measles. METHODS: Measles and hepatitis B are MI subject to mandatory notification in Italy; however, two special surveillance systems were established in 2000 and 1985 respectively for their control: surveillance of sentinel pediatricians (SPES) and the Integrated Epidemiological System of Acute Viral Hepatitis (SEIEVA). The first is based on an annual average of 300 freely chosen paediatricians who voluntarily join the system, while the second collects data from the Local Health Authorities that voluntarily adhere to the initiative, with a coverage of around 60% of the national territory. The work was conducted by comparing incidence data per 100,000 inhabitants, from 2005 to 2008, coming from the SPES and SEIEVA systems with those calculated by dividing the number of mandatory notifications received by the Infectious Diseases Information System for the resident population found by ISTAT. Data were stratified by age groups: 0, 1-4; 5-9 and 10-14 for measles and 0-14, 15-24 and "25 for hepatitis B. Results: Considering the entire study period, the incidence data reported by the SPES were 15% to over 100% higher than those from the mandatory notification system. The data coming from the two systems were, however, more overlapping in 2008, the year in which an outbreak was recorded; some slight differences were observed between age groups. On the contrary, the data from the SEIEVA were 26% to 12% lower than those of the mandatory system, except for what was observed in 2008. Even by comparing the data from the SEIEVA and the mandatory notification system, differences emerged associated with age, with a gap between the two sources less marked in the group and "25. CONCLUSIONS: This preliminary assessment suggests that the presence of special surveillance systems can improve the control of infectious diseases, although the integration of data from different sources and the awareness of individual professionals involved in surveillance remain important