Evaluation of 17 years of MERIN (Meningitis and Encephalitis register in Lower Saxony, Germany) surveillance system: participants acceptability survey, completeness and timeliness of data
A Meningitis and Encephalitis Surveillance (MERIN) was implemented in 2003 in Lower Saxony, Germany as an alternative to acute flaccid paralyses surveillance, as the latter did not reach WHO sensitivity criteria. The system provides information on circulating enterovirus (EV) serotypes by focussing...
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| Published in | BMC health services research Vol. 24; no. 1; p. 59 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
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England
BioMed Central Ltd
11.01.2024
BioMed Central BMC |
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| Abstract | A Meningitis and Encephalitis Surveillance (MERIN) was implemented in 2003 in Lower Saxony, Germany as an alternative to acute flaccid paralyses surveillance, as the latter did not reach WHO sensitivity criteria. The system provides information on circulating enterovirus (EV) serotypes by focussing on patients with suspected aseptic meningitis, encephalitis or acute flaccid paralysis and contributes to the national surveillance in documenting polio free status. MERIN is based on voluntary participation of hospitals. Therefore, our evaluation focusses on acceptability of the system's objectives and performance, and identifying areas for improvement.
To assess acceptability, 32 contributing hospitals were invited to an online-based survey (11/2021 to 01/2022) to rate the MERIN objectives, laboratory's performance, their workload, modes of processes and communication. Ideas for improvement were collected in open fields. In addition, data completeness and timeliness of laboratory diagnostics were assessed.
Of 32 hospitals, 21 responded (66% response rate), sending 30 questionnaires, 25 from pediatric and 5 from neurological departments. High levels of satisfaction with the communication (≥ 96%), timeliness (≥ 81%), and distribution of the results (≥ 85%) were reported, 97% of participants judged the required workload as adequate. The median proportion of eligible patients included in MERIN was 75%. Participants gave rapid and reliable diagnostic testing the highest priority (96%), while monitoring of Germany's polio-free status was rated the lowest (61%). Providing medical reports digitally as well as regular updates about circulating EV serotypes were identified as areas for improvement. Data completeness of selected variables ranged from 78.3 to 99.9%. Median time between sample collection and arrival at laboratory was 2 days [IQR 1-3], EV diagnostics via PCR took one day [IQR 0-6] and EV isolation on cell culture 11 days [IQR 10-13].
MERIN is a highly accepted surveillance system. Its quality was enhanced further by addressing the suggested improvements such as regular reports on circulating EV serotypes and facilitating digital access to laboratory results. Our results emphasise the importance of recognizing and considering participants' motivations and expectations, and addressing their priorities, even if this is not the surveillance system's main focus. This approach can be applied to surveillance systems of other non-mandatory notifiable diseases. |
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| AbstractList | Abstract Background A Meningitis and Encephalitis Surveillance (MERIN) was implemented in 2003 in Lower Saxony, Germany as an alternative to acute flaccid paralyses surveillance, as the latter did not reach WHO sensitivity criteria. The system provides information on circulating enterovirus (EV) serotypes by focussing on patients with suspected aseptic meningitis, encephalitis or acute flaccid paralysis and contributes to the national surveillance in documenting polio free status. MERIN is based on voluntary participation of hospitals. Therefore, our evaluation focusses on acceptability of the system’s objectives and performance, and identifying areas for improvement. Methods To assess acceptability, 32 contributing hospitals were invited to an online-based survey (11/2021 to 01/2022) to rate the MERIN objectives, laboratory’s performance, their workload, modes of processes and communication. Ideas for improvement were collected in open fields. In addition, data completeness and timeliness of laboratory diagnostics were assessed. Results Of 32 hospitals, 21 responded (66% response rate), sending 30 questionnaires, 25 from pediatric and 5 from neurological departments. High levels of satisfaction with the communication (≥ 96%), timeliness (≥ 81%), and distribution of the results (≥ 85%) were reported, 97% of participants judged the required workload as adequate. The median proportion of eligible patients included in MERIN was 75%. Participants gave rapid and reliable diagnostic testing the highest priority (96%), while monitoring of Germany’s polio-free status was rated the lowest (61%). Providing medical reports digitally as well as regular updates about circulating EV serotypes were identified as areas for improvement. Data completeness of selected variables ranged from 78.3 to 99.9%. Median time between sample collection and arrival at laboratory was 2 days [IQR 1–3], EV diagnostics via PCR took one day [IQR 0–6] and EV isolation on cell culture 11 days [IQR 10–13]. Conclusion MERIN is a highly accepted surveillance system. Its quality was enhanced further by addressing the suggested improvements such as regular reports on circulating EV serotypes and facilitating digital access to laboratory results. Our results emphasise the importance of recognizing and considering participants’ motivations and expectations, and addressing their priorities, even if this is not the surveillance system’s main focus. This approach can be applied to surveillance systems of other non-mandatory notifiable diseases. A Meningitis and Encephalitis Surveillance (MERIN) was implemented in 2003 in Lower Saxony, Germany as an alternative to acute flaccid paralyses surveillance, as the latter did not reach WHO sensitivity criteria. The system provides information on circulating enterovirus (EV) serotypes by focussing on patients with suspected aseptic meningitis, encephalitis or acute flaccid paralysis and contributes to the national surveillance in documenting polio free status. MERIN is based on voluntary participation of hospitals. Therefore, our evaluation focusses on acceptability of the system's objectives and performance, and identifying areas for improvement. To assess acceptability, 32 contributing hospitals were invited to an online-based survey (11/2021 to 01/2022) to rate the MERIN objectives, laboratory's performance, their workload, modes of processes and communication. Ideas for improvement were collected in open fields. In addition, data completeness and timeliness of laboratory diagnostics were assessed. Of 32 hospitals, 21 responded (66% response rate), sending 30 questionnaires, 25 from pediatric and 5 from neurological departments. High levels of satisfaction with the communication (≥ 96%), timeliness (≥ 81%), and distribution of the results (≥ 85%) were reported, 97% of participants judged the required workload as adequate. The median proportion of eligible patients included in MERIN was 75%. Participants gave rapid and reliable diagnostic testing the highest priority (96%), while monitoring of Germany's polio-free status was rated the lowest (61%). Providing medical reports digitally as well as regular updates about circulating EV serotypes were identified as areas for improvement. Data completeness of selected variables ranged from 78.3 to 99.9%. Median time between sample collection and arrival at laboratory was 2 days [IQR 1-3], EV diagnostics via PCR took one day [IQR 0-6] and EV isolation on cell culture 11 days [IQR 10-13]. MERIN is a highly accepted surveillance system. Its quality was enhanced further by addressing the suggested improvements such as regular reports on circulating EV serotypes and facilitating digital access to laboratory results. Our results emphasise the importance of recognizing and considering participants' motivations and expectations, and addressing their priorities, even if this is not the surveillance system's main focus. This approach can be applied to surveillance systems of other non-mandatory notifiable diseases. A Meningitis and Encephalitis Surveillance (MERIN) was implemented in 2003 in Lower Saxony, Germany as an alternative to acute flaccid paralyses surveillance, as the latter did not reach WHO sensitivity criteria. The system provides information on circulating enterovirus (EV) serotypes by focussing on patients with suspected aseptic meningitis, encephalitis or acute flaccid paralysis and contributes to the national surveillance in documenting polio free status. MERIN is based on voluntary participation of hospitals. Therefore, our evaluation focusses on acceptability of the system's objectives and performance, and identifying areas for improvement. To assess acceptability, 32 contributing hospitals were invited to an online-based survey (11/2021 to 01/2022) to rate the MERIN objectives, laboratory's performance, their workload, modes of processes and communication. Ideas for improvement were collected in open fields. In addition, data completeness and timeliness of laboratory diagnostics were assessed. Of 32 hospitals, 21 responded (66% response rate), sending 30 questionnaires, 25 from pediatric and 5 from neurological departments. High levels of satisfaction with the communication ([greater than or equal to] 96%), timeliness ([greater than or equal to] 81%), and distribution of the results ([greater than or equal to] 85%) were reported, 97% of participants judged the required workload as adequate. The median proportion of eligible patients included in MERIN was 75%. Participants gave rapid and reliable diagnostic testing the highest priority (96%), while monitoring of Germany's polio-free status was rated the lowest (61%). Providing medical reports digitally as well as regular updates about circulating EV serotypes were identified as areas for improvement. Data completeness of selected variables ranged from 78.3 to 99.9%. Median time between sample collection and arrival at laboratory was 2 days [IQR 1-3], EV diagnostics via PCR took one day [IQR 0-6] and EV isolation on cell culture 11 days [IQR 10-13]. MERIN is a highly accepted surveillance system. Its quality was enhanced further by addressing the suggested improvements such as regular reports on circulating EV serotypes and facilitating digital access to laboratory results. BACKGROUNDA Meningitis and Encephalitis Surveillance (MERIN) was implemented in 2003 in Lower Saxony, Germany as an alternative to acute flaccid paralyses surveillance, as the latter did not reach WHO sensitivity criteria. The system provides information on circulating enterovirus (EV) serotypes by focussing on patients with suspected aseptic meningitis, encephalitis or acute flaccid paralysis and contributes to the national surveillance in documenting polio free status. MERIN is based on voluntary participation of hospitals. Therefore, our evaluation focusses on acceptability of the system's objectives and performance, and identifying areas for improvement.METHODSTo assess acceptability, 32 contributing hospitals were invited to an online-based survey (11/2021 to 01/2022) to rate the MERIN objectives, laboratory's performance, their workload, modes of processes and communication. Ideas for improvement were collected in open fields. In addition, data completeness and timeliness of laboratory diagnostics were assessed.RESULTSOf 32 hospitals, 21 responded (66% response rate), sending 30 questionnaires, 25 from pediatric and 5 from neurological departments. High levels of satisfaction with the communication (≥ 96%), timeliness (≥ 81%), and distribution of the results (≥ 85%) were reported, 97% of participants judged the required workload as adequate. The median proportion of eligible patients included in MERIN was 75%. Participants gave rapid and reliable diagnostic testing the highest priority (96%), while monitoring of Germany's polio-free status was rated the lowest (61%). Providing medical reports digitally as well as regular updates about circulating EV serotypes were identified as areas for improvement. Data completeness of selected variables ranged from 78.3 to 99.9%. Median time between sample collection and arrival at laboratory was 2 days [IQR 1-3], EV diagnostics via PCR took one day [IQR 0-6] and EV isolation on cell culture 11 days [IQR 10-13].CONCLUSIONMERIN is a highly accepted surveillance system. Its quality was enhanced further by addressing the suggested improvements such as regular reports on circulating EV serotypes and facilitating digital access to laboratory results. Our results emphasise the importance of recognizing and considering participants' motivations and expectations, and addressing their priorities, even if this is not the surveillance system's main focus. This approach can be applied to surveillance systems of other non-mandatory notifiable diseases. Abstract Background A Meningitis and Encephalitis Surveillance (MERIN) was implemented in 2003 in Lower Saxony, Germany as an alternative to acute flaccid paralyses surveillance, as the latter did not reach WHO sensitivity criteria. The system provides information on circulating enterovirus (EV) serotypes by focussing on patients with suspected aseptic meningitis, encephalitis or acute flaccid paralysis and contributes to the national surveillance in documenting polio free status. MERIN is based on voluntary participation of hospitals. Therefore, our evaluation focusses on acceptability of the system’s objectives and performance, and identifying areas for improvement. Methods To assess acceptability, 32 contributing hospitals were invited to an online-based survey (11/2021 to 01/2022) to rate the MERIN objectives, laboratory’s performance, their workload, modes of processes and communication. Ideas for improvement were collected in open fields. In addition, data completeness and timeliness of laboratory diagnostics were assessed. Results Of 32 hospitals, 21 responded (66% response rate), sending 30 questionnaires, 25 from pediatric and 5 from neurological departments. High levels of satisfaction with the communication (≥ 96%), timeliness (≥ 81%), and distribution of the results (≥ 85%) were reported, 97% of participants judged the required workload as adequate. The median proportion of eligible patients included in MERIN was 75%. Participants gave rapid and reliable diagnostic testing the highest priority (96%), while monitoring of Germany’s polio-free status was rated the lowest (61%). Providing medical reports digitally as well as regular updates about circulating EV serotypes were identified as areas for improvement. Data completeness of selected variables ranged from 78.3 to 99.9%. Median time between sample collection and arrival at laboratory was 2 days [IQR 1–3], EV diagnostics via PCR took one day [IQR 0–6] and EV isolation on cell culture 11 days [IQR 10–13]. Conclusion MERIN is a highly accepted surveillance system. Its quality was enhanced further by addressing the suggested improvements such as regular reports on circulating EV serotypes and facilitating digital access to laboratory results. Our results emphasise the importance of recognizing and considering participants’ motivations and expectations, and addressing their priorities, even if this is not the surveillance system’s main focus. This approach can be applied to surveillance systems of other non-mandatory notifiable diseases. Background A Meningitis and Encephalitis Surveillance (MERIN) was implemented in 2003 in Lower Saxony, Germany as an alternative to acute flaccid paralyses surveillance, as the latter did not reach WHO sensitivity criteria. The system provides information on circulating enterovirus (EV) serotypes by focussing on patients with suspected aseptic meningitis, encephalitis or acute flaccid paralysis and contributes to the national surveillance in documenting polio free status. MERIN is based on voluntary participation of hospitals. Therefore, our evaluation focusses on acceptability of the system's objectives and performance, and identifying areas for improvement. Methods To assess acceptability, 32 contributing hospitals were invited to an online-based survey (11/2021 to 01/2022) to rate the MERIN objectives, laboratory's performance, their workload, modes of processes and communication. Ideas for improvement were collected in open fields. In addition, data completeness and timeliness of laboratory diagnostics were assessed. Results Of 32 hospitals, 21 responded (66% response rate), sending 30 questionnaires, 25 from pediatric and 5 from neurological departments. High levels of satisfaction with the communication ([greater than or equal to] 96%), timeliness ([greater than or equal to] 81%), and distribution of the results ([greater than or equal to] 85%) were reported, 97% of participants judged the required workload as adequate. The median proportion of eligible patients included in MERIN was 75%. Participants gave rapid and reliable diagnostic testing the highest priority (96%), while monitoring of Germany's polio-free status was rated the lowest (61%). Providing medical reports digitally as well as regular updates about circulating EV serotypes were identified as areas for improvement. Data completeness of selected variables ranged from 78.3 to 99.9%. Median time between sample collection and arrival at laboratory was 2 days [IQR 1-3], EV diagnostics via PCR took one day [IQR 0-6] and EV isolation on cell culture 11 days [IQR 10-13]. Conclusion MERIN is a highly accepted surveillance system. Its quality was enhanced further by addressing the suggested improvements such as regular reports on circulating EV serotypes and facilitating digital access to laboratory results. Our results emphasise the importance of recognizing and considering participants' motivations and expectations, and addressing their priorities, even if this is not the surveillance system's main focus. This approach can be applied to surveillance systems of other non-mandatory notifiable diseases. Keywords: Surveillance, Polio-eradication, Evaluation, Enterovirus, Meningitis |
| ArticleNumber | 59 |
| Audience | Academic |
| Author | Mertens, Elke Holle, Ina Monazahian, Masyar Dreesman, Johannes Łuczyńska, Anna Baillot, Armin Beyrer, Konrad Rettenbacher-Riefler, Sophie |
| Author_xml | – sequence: 1 givenname: Anna surname: Łuczyńska fullname: Łuczyńska, Anna organization: Department for Microbiology, Infection Protection, Hospital Hygiene and Epidemiology of Infectious Diseases, Public Health Agency of Lower Saxony, Hanover, Lower Saxony, Germany – sequence: 2 givenname: Konrad surname: Beyrer fullname: Beyrer, Konrad organization: Department for Microbiology, Infection Protection, Hospital Hygiene and Epidemiology of Infectious Diseases, Public Health Agency of Lower Saxony, Hanover, Lower Saxony, Germany – sequence: 3 givenname: Ina surname: Holle fullname: Holle, Ina organization: Department for Microbiology, Infection Protection, Hospital Hygiene and Epidemiology of Infectious Diseases, Public Health Agency of Lower Saxony, Hanover, Lower Saxony, Germany – sequence: 4 givenname: Armin surname: Baillot fullname: Baillot, Armin organization: Department for Microbiology, Infection Protection, Hospital Hygiene and Epidemiology of Infectious Diseases, Public Health Agency of Lower Saxony, Hanover, Lower Saxony, Germany – sequence: 5 givenname: Masyar surname: Monazahian fullname: Monazahian, Masyar organization: Department for Microbiology, Infection Protection, Hospital Hygiene and Epidemiology of Infectious Diseases, Public Health Agency of Lower Saxony, Hanover, Lower Saxony, Germany – sequence: 6 givenname: Johannes surname: Dreesman fullname: Dreesman, Johannes organization: Department for Microbiology, Infection Protection, Hospital Hygiene and Epidemiology of Infectious Diseases, Public Health Agency of Lower Saxony, Hanover, Lower Saxony, Germany – sequence: 7 givenname: Elke surname: Mertens fullname: Mertens, Elke organization: Department for Microbiology, Infection Protection, Hospital Hygiene and Epidemiology of Infectious Diseases, Public Health Agency of Lower Saxony, Hanover, Lower Saxony, Germany – sequence: 8 givenname: Sophie surname: Rettenbacher-Riefler fullname: Rettenbacher-Riefler, Sophie email: sophie.rettenbacher-riefler@nlga.niedersachsen.de organization: Department for Microbiology, Infection Protection, Hospital Hygiene and Epidemiology of Infectious Diseases, Public Health Agency of Lower Saxony, Hanover, Lower Saxony, Germany. sophie.rettenbacher-riefler@nlga.niedersachsen.de |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38212779$$D View this record in MEDLINE/PubMed |
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| References | TK Fischer (10482_CR21) 2022; 22 10482_CR1 10482_CR4 C Calba (10482_CR10) 2015; 15 10482_CR6 K Keeren (10482_CR5) 2021 10482_CR8 RR German (10482_CR9) 2001; 50 Enterovirus surveillance guidelines (10482_CR3) 2015 H Harvala (10482_CR16) 2018; 101 L Bubba (10482_CR22) 2020; 20 CC Holm-Hansen (10482_CR23) 2017; 23 GC Umeh (10482_CR2) 2018; 18 C Calba (10482_CR18) 2015; 122 M-J Wu (10482_CR19) 2022; 7 F Kreuter (10482_CR20) 2008; 72 K Schulz (10482_CR12) 2016; 12 C Calba (10482_CR11) 2016; 11 F Goutard (10482_CR13) 2022 AM Auer (10482_CR17) 2011; 11 C Ramers (10482_CR14) 2000; 283 K Beyrer (10482_CR7) 2002; 64 CC Robinson (10482_CR15) 2002; 21 |
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| SubjectTerms | Cell culture Child Communication Data collection Diagnostic tests Encephalitis Encephalitis - epidemiology Enterovirus Enterovirus Infections - diagnosis Enterovirus Infections - epidemiology Evaluation Germany - epidemiology Hospital patients Humans Laboratories Meningitis Meningitis - diagnosis Meningitis - epidemiology Pathogens Pediatrics Polio-eradication Poliomyelitis Poliomyelitis - epidemiology Population Surveillance - methods Questionnaires Sentinel health events Serology Statistics Surveillance Surveillance equipment Surveys and Questionnaires Workloads |
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| Title | Evaluation of 17 years of MERIN (Meningitis and Encephalitis register in Lower Saxony, Germany) surveillance system: participants acceptability survey, completeness and timeliness of data |
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