Rob van Hest Capture-recapture Methods in Surveillance - RePub ...

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Underreporting of Legionnaires’ disease in the Netherlands Mexico, Peru, USA, Venezuela; Asia: China, Indonesia, Japan, Kazakhstan, Malaysia. Africa: Morocco and Tunis; ‡ confirmed laboratory diagnosis: positive culture, positive urine antigen test or a fourfold rise in antibody titre against Legionella species in paired acute and convalescent serum samples, ≥128 IU; probable laboratory diagnosis: positive PCR, a high titre in one serum sample against Legionella species, ≥256 IU, or direct fluorescent antibody staining of the organism. A sensitivity analysis, assuming double or half the number of false-positive cases due to E. coli pneumonia only known to Hospital, estimated the number of Legionnaires’ disease patients to range between 727 (95%CI 689-813) and 966 (95%CI 896-1126). Discussion After record-linkage and log-linear covariate capture-recapture analysis of three registers of Legionnaires’ disease in 2000 and 2001 in the Netherlands we found a notified, ascertained and estimated annual incidence rate of 1.15, 2.42 and 2.77 cases per 100 000 inhabitants respectively. Ascertained and estimated under-notification was 52.2% and 57.9% respectively. This indicates the need for more consistent notification, e.g. through treatment of Legionnaires’ disease by a limited group of clinicians, familiar with notification. The southern part of the Netherlands had a higher notified, ascertained and estimated incidence rate of Legionnaires’ disease. Legionella pneumonia might be responsible for 0%-14% of all nosocomial pneumonia’s and for 2%-16% of all community-acquired pneumonias. 27 In the Netherlands legionella pneumonia is reportedly responsible for 7% of all nosocomial pneumonias and 2%-8% of all community-acquired pneumonias in hospitalised patients. 28-30 Under-notification of Legionnaires’ disease is estimated at 67% in France, 90% in England and 95% in the United States. 3,31-33 At 57.9% we estimated lower undernotification in the Netherlands, possibly influenced by increased awareness after a major outbreak or increased use of the urine antigen test (although this use is proportionally still low compared to the average EWGLI data for Europe). 4,31 Among patients in the laboratory survey with positive legionella results under-notification was 28.7%, much lower than reported in France. 2 Parallel to mandatory notification by clinicians, many Dutch laboratories report positive results voluntarily to the Public Health Services, which reduces under-notification of Legionnaires’ disease and other infectious diseases. The ascertained and estimated register-specific coverage rates for the laboratories would be higher with a better response. Record-linkage improved completeness of information in the linked dataset but, unlike laboratories, clinicians are not a useful source of additional information. Several assumptions must be met for valid results of three-source log-linear capture-recapture models and limitations of capture-recapture analysis are described. 13,16,34-39 Violation of the closed population assumption is assumed limited for Legionnaires’ disease as opportunities for notification, laboratory-verification or hospitalisation are largely determined within a short period of time, but could result in overestimation of the number of patients. Due to lack of a unique patient identification number used in all registrations and incomplete information on personal identifiers in 73
Table 5.2 Number and proportion of the laboratory test results for Legionella species in the Netherlands in 2000 and 2001, in total and stratified per region Confirmed laboratory test Probable laboratory test Unknown* Positive PCR (%) High single titre (%) DFA Fourfold rise in antibody titre (%) Urine antigen test (%) Culture (%) All legionella pneumonia 71 (100%) 216 (100%) 92 (100%) 33 (100%) 119 (100%) 0 56/441 (13%) (100% of population) Region North (11%) 0 (0%) 15 (7%) 14 (15%) 2 (6%) 8 (7%) 0 3/34 (9%) Region East (18%) 16 (22%) 61 (28%) 23 (25%) 5 (15%) 33 (28%) 0 14/123 (11%) Region West (41%) 31 (44%) 78 (36%) 17 (19%) 3 (9%) 30 (25%) 0 31/149 (21%) Region South (30%) 24 (34%) 62 (29%) 38 (41%) 23 (70%) 48 (40%) 0 8/135 (6%) * for 441 patients information of Region was known Table 5.3 Ascertained total number of Legionnaires’ disease patients and number stratified by region of the Netherlands in three linked Legionnaires’ disease registrations in 2000 and 2001, after proportional adjustment for false-positive Escherichia coli pneumonia patients only known to the Hospital register. LAB and HOSP NOT and LAB and HOSP Nascertained Only NOT * Only LAB † Only HOSP ‡ NOT and LAB NOT and HOSP All Legionnaires’ disease 780 56 30 332 31 131 45 155 patients Region North § 69 3 2 35 2 6 8 13 Region East § 185 13 13 62 3 42 7 45 Region West § 286 23 5 136 7 55 14 46 Region South § 234 13 9 99 19 28 15 51 * NOT: Notification register (373 patients); † LAB: Laboratory register (261 patients); ‡ HOSP: Hospital admission register. The proportional correction for the Escherichia coli pneumonia patients in the regions North, East, West and South is 13, 22, 49 and 36 patients respectively (663 patients); § for 6 Legionnaires’ disease patients the place of residence unknown
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Capture-recapture Methods in Survei
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Colofon Capture-recapture methods i
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Promotiecommissie Promotor: Prof.dr
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Contents Page 1 Introduction 9 2 Me
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Chapter 1 1.1 Assessing completenes
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Chapter 1 94% among AIDS patients w
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Table 1.1 Objectives, methods, data
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Researchers Objective Method Data-s
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Chapter 1 source capture-recapture
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Chapter 1 32. Bradley BL, Kerr KM,
Page 24 and 25: 2 Methodology of capture-recapture
Page 26 and 27: Methodology of capture-recapture an
Page 36: Methodology of capture-recapture an
Page 39 and 40: Chapter 3 3.1 Application of captur
Page 41 and 42: Table 3.1 Published capture-recaptu
Page 43 and 44: Disease Authors Objective Method Da
Page 49 and 50: Chapter 3 3.3 References 1. Hook EB
Page 51 and 52: Chapter 3 52. Reintjes R, Termorshu
Page 53 and 54: Chapter 4 Abstract The aim of this
Page 55 and 56: Chapter 4 Methods Nearly all Dutch
Page 57 and 58: Chapter 4 Table 4.2 The number of m
Page 59 and 60: Chapter 4 diagnosis. Other patients
Page 61 and 62: Chapter 4 stratify the population i
Page 63 and 64: Chapter 4 25. Lambeth, Southwark an
Page 65 and 66: Chapter 5 Abstract To estimate inci
Page 67 and 68: Chapter 5 patients. Capture-recaptu
Page 69 and 70: Chapter 5 Figure 5.1 Four regions o
Page 71 and 72: Chapter 5 Hospital records From 385
Page 73: Chapter 5 Table 5.1 Epidemiological
Page 77 and 78: Chapter 5 cautious about the associ
Page 79 and 80: Chapter 5 Incidence of community-ac
Page 81 and 82: Chapter 6 Abstract The aim of this
Page 83 and 84: Chapter 6 3. Hospitalised patients
Page 85 and 86: Chapter 6 Record-linkage of all 537
Page 87 and 88: Chapter 6 Figure 6.1 Schematic view
Page 89 and 90: Chapter 6 Table 6.2 Total and strat
Page 91 and 92: Chapter 6 administrative discrepanc
Page 93 and 94: Chapter 6 the patients, and complet
Page 96 and 97: 7 Undetected burden of tuberculosis
Page 98 and 99: Introduction Underreporting of tube
Page 100 and 101: Underreporting of tuberculosis in t
Page 102 and 103: Table 7.1 Total and subset numbers
Page 104 and 105: Table 7.2 Capture-recapture estimat
Page 106 and 107: Underreporting of tuberculosis in t
Page 108: Underreporting of tuberculosis in t
Page 111 and 112: Chapter 8 Abstract In 1999 the Enha
Page 113 and 114: Chapter 8 bacteriological confirmat
Page 115 and 116: Chapter 8 Results Table 8.1 shows t
Page 117 and 118: Table 8.3 Annual and overall observ
Page 119 and 120: Table 8.4 Annual and overall estima
Page 121 and 122: Chapter 8 interaction however, i.e.
Page 123 and 124: Chapter 8 shows that observed under
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9 Estimating the coverage of tuberc
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Introduction Estimating targeted mo
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Estimating targeted mobile tubercul
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References Estimating targeted mobi
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10 Estimating infectious diseases i
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Introduction Estimating infectious
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Estimating infectious disease incid
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Study Disease and number of patient
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4. Gallay A, Vaillant V, Bouvet P,
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Table 10.3 Comparison of the variou
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Discussion Estimating infectious di
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Chapter 11 The aim of this thesis i
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Chapter 11 overestimation of the nu
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Chapter 11 clinicians to the Public
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Chapter 11 operation with the chest
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Chapter 11 of the proportion of fal
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Chapter 11 Question 3: What is the
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Chapter 11 11.2 Some findings of th
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Chapter 11 • To improve timelines
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Summary Summary Surveillance is an
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Summary linkage of notification and
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Samenvatting Samenvatting Surveilla
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Samenvatting subgroepen binnen de b
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Acknowledgements Acknowledgements W
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Curriculum vitae Rob van Hest was b
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Publications This thesis Van Hest N
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