Electronic reporting systems improve the quality and timeliness of the surveillance of communicable diseases. The aim of this paper is to present the process of the implementation and introduction of an electronic reporting system for the surveillance of communicable diseases in Lithuania. The project which started in 2002 was performed in collaboration between Lithuania and Sweden and was facilitated by the parallel process of adapting the surveillance system to European Union (EU) standards. The Lotus-based software, SmittAdm, was acquired from the Department of Communicable Diseases Control and Prevention of Stockholm County in Sweden and adopted for Lithuania, resulting in the Lithuanian software, ULISAS. A major advantage of this program for Lithuania was the possibility to work offline. The project was initiated in the two largest counties in Lithuania where ULISAS had been installed and put in use by January 2005. The introduction was gradual, the national level was connected to the system during late 2005, and all remaining counties were included during 2006 and 2007. The reporting system remains to be evaluated concerning timeliness and completeness of the surveillance. Further development is needed, for example the inclusion of all physicians and laboratories and an alert system for outbreaks. The introduction of this case-based, timely electronic reporting system in Lithuania allows better reporting of data to the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) compared to the former reporting system with paper-based, aggregated data.

We found a statistically significant lower HIV infection rate among participants aged 20-24 in 2011 compared to 2007 (5.0% vs 13.4%, p < 0.001) and among those who reported having ever tested for HIV (3.0% vs 10.5%, p = 0.02). Conclusion The number and magnitude of differences in the characteristics of the two samples suggests that the two rounds of RDS likely sampled different subsets of the Zanzibar MSM population, limiting their comparability and ability to assess trends over time. Similar findings have been reported with repeated RDS surveys in other settings. Our results highlight the continuing challenge in obtaining representative data among key populations affected by HIV to make evidence-based policy and programme planning decisions. While repeated bio-behavioural cross-sectional surveys using the same methodology in the same population are the backbone of surveillance in key populations, we advocate caution in implementation and interpretation of repeated RDS surveys and that other sampling approaches (e.g., Time Location Sampling) be tested.Estimating thE sizE of thE fEmalE sEx WorkEr PoPulation in asuncion, Paraguay by maPPing and multiPliEr EstimatEs

Lithuania, with a population of 3.5 million, has had a low reported incidence of measles for the past few years (figure 1). In 2002, however, a cluster of measles cases was detected in Kaunas, Lithuania’s second largest city with a population of nearly 400 000.