School Absenteeism As an Adjunct Surveillance Indicator Experience during the Second Wave of the 2009 H1N1 Pandemic in Quebec, Canada 英文参考文献.docVIP

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School Absenteeism As an Adjunct Surveillance Indicator Experience during the Second Wave of the 2009 H1N1 Pandemic in Quebec, Canada 英文参考文献.doc

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SchoolAbsenteeismAsanAdjunctSurveillance Indicator:ExperienceduringtheSecondWaveofthe 2009H1N1PandemicinQuebec,Canada ChristelleA?¨chaKomMogto1,GastonDeSerres1,2*,MoniqueDouvilleFradet2,GermainLebel2, SteveToutant2,RodicaGilca2,ManaleOuakki2,NaveedZafarJanjua3,4,DanutaM.Skowronski3,4 1DepartmentofSocialandPreventiveMedicine,Universite′ Laval,QuebecCity,Quebec,Canada,2Institutnationaldesante′ publiqueduQue′bec, QuebecCity,Quebec, Canada,3BritishColumbiaCentreforDiseaseControl,Vancouver, BritishColumbia,Canada, 4SchoolofPopulationandPublicHealth,UniversityofBritishColumbia, Vancouver,BritishColumbia,Canada Abstract Background:AschoolabsenteeismsurveillancesystemwasimplementedintheprovinceofQuebec,Canadaduringthe secondwaveofthe2009H1N1pandemic.Thispapercomparesthissurveillanceapproachwithotheravailableindicators. Method:All(3432)elementaryandhighschoolsfromQuebecwereincluded.Eachschoolwasrequiredtoreportthrougha web-basedsystemanydaywheretheproportionofstudentsabsentforinfluenza-likeillness(ILI)exceeded10%ofcurrent schoolenrolment. Results: Between October 18 and December 12 2009, 35.6% of all schools met the 10% absenteeism threshold. This proportionwasgreaterinelementarycomparedtohighschools(40%vs19%)andinsmallercomparedtolargerschools (44%vs22%).Themaximumabsenteeismratewasreachedthefirstdayofreportingorwithinthenexttwodaysin55%and 31%ofschoolsrespectively.Thefirstreportsandsubsequentpeakinschoolabsenteeismprovinciallyprecededthepeakin paediatric hospitalization by two and one weeks, respectively. Trends in school surveillance otherwise mirrored other indicators. Conclusion: During a pandemic, school outbreak surveillance based on a 10% threshold appears insufficient to trigger timely intervention within a given affected school. However, school surveillance appears well-correlated and slightly anticipatory compared to other population indicators. As such, school absenteeism warrants further evaluation as an adjunctsurveillanceindicatorwhoseoverallutil