Opportunities for Improved Disease Surveillance and Control by Use of Integrated Data on Animal and Human Health

Abstract

The global challenges and threats from infectious diseases including antimicrobial drug resistance and emerging infections due to the rapidly changing climate require that we continuously revisit the fitness of our infrastructure. The databases used for surveillance represent an important infrastructure. Historically, many databases have evolved from different needs and from different organizations. Despite growing data storage and computing capacities, data are, however, rarely used to their full potential. The objective of this review was to outline different data sources available in Denmark. We applied a one-health perspective and included data sources on animal demographics and movements, medicine prescription, diagnostic test results as well as relevant data on human health. Another objective was to suggest approaches for fit-for-purpose integration of data as a resource for risk assessment and generation of evidence for policies to protect animal and human health. Danish databases were reviewed according to a systematic procedure including ownership, intended purposes of the database, target and study populations, metrics and information used, measuring methods (observers, diagnostic tests), recording procedures, data flow, database structure, and control procedures to ensure data quality. Thereby, structural metadata were gathered across available Danish databases including animal health, zoonotic infections, antimicrobial use, and relevant administrative data that can support the overall aim of supporting risk assessment and development of evidence. Then illustrative cases were used to assess how combinations and integration of databases could improve existing evidence to support decisions in animal health policies (e.g., combination of information on diseases in different herds or regions with information on isolation of pathogens from humans). Due to the complexity of databases, full integration at the individual level is often not possible. Still, integration of data at a higher level (e.g., municipality or region) can provide important information on risks and hence risk management. We conclude by discussing how databases by linkage can be improved in the future, and emphasize that legal issues are important to address in order to optimize the use of the available data.

A Survey on One Health Perception and Experiences in Europe and Neighboring Areas

“…This reflects the endemic situation and the challenge posed to public health by these diseases in the Balkan countries ( 33 – 36 ). It is noteworthy that Salmonella falls in the top three issues in the Scandinavian and Baltic Europe: this foodborne pathogen, which has been the object of a strong and successful surveillance and control programme in these countries ( 37 ), is nonetheless considered as a top priority when public health is involved.…”

Assessment of Evaluation Tools for Integrated Surveillance of Antimicrobial Use and Resistance Based on Selected Case Studies

“…With each score, a comment was requested explaining the score. The 11 aspects were as follows: (1) user friendliness, (2) compliance with evaluation objectives, (3) efficiency (number of people and time taken vs. what the evaluation should be used for), (4) use of a step-wise approach to the evaluation, (5) overall appearance, (6) generation of actionable evaluation outputs, (7) evaluation of OH aspects, (8) workability in terms of required data, (9) workability in terms of required people to include, (10) workability in terms of analysis to be done, and (11) time taken for application of the tool.…”

“…An integrated approach provides a better understanding of the epidemiology of AMR and an easier identification of the best intervention points and enhances the timeliness of surveillance by providing early warning of emergence of new resistant strains from one sector to another. Furthermore, a cross-sectoral collaboration may lead to knowledge/resource sharing, expertise exchange, and capacity building ( 8 ), which may result in cost savings and create more efficient and effective systems ( 9 ). Full integration might not be necessary to achieve the wanted outputs, and integration and collaboration in itself can be costly without always improving outputs ( 7 , 10 ).…”

Data_Sheet_1.DOCX

“…Having these data publicly available increases transparency and presents an important source of information for stakeholders, including policymakers, the livestock industry, and other interested actors. There is work ongoing to explore options for improved sharing of AMR surveillance data between sectors in the UK such as the development of a shared database 9 This would enable the collation and analysis of data to be developed into an ongoing activity, which would improve the timeliness of data availability and enables rapid identification of emerging trends; therefore improving the effectiveness of integrated surveillance (35). Furthermore, this shared database can serve as a resource for risk assessment and generation of evidence for policies to protect animal and human health.…”

“…An example of this is the DANMAP database which collects data from several sources including food and hospital laboratories, slaughter plants, veterinary practises and general practises for people. These data are collected from various microbiological laboratories that use different data formats and therefore these data are imported, merged and cleaned before conducting the data analysis (35,36). At global level, the UK contributes to international surveillance, which was considered by interviewees as beneficial and adding value to the data.…”