Establishing a web-based integrated surveillance system for early detection of infectious disease epidemic in rural China: a field experimental study

This is a field experimental study. The experimental tool is an innovative electronic surveillance system, combining syndromic surveillance with the existing case report surveillance in four selected counties in China. In the added syndromic surveillance, three types of data are collected including patients' major symptoms from health clinics, pharmaceutical sales from pharmacies and absenteeism information from primary school. In order to evaluate the early warning capability of the new added syndromic surveillance, the timelines and validity of the alert signals will be analyzed in comparison with the traditional case reporting system. The acceptability, feasibility and economic evaluation of the whole integrated surveillance system will be conducted in a before and after study design.Although syndromic surveillance system has mostly been established in developed areas, there are opportunities and advantages of developing it in rural China. The project will contribute to knowledge, experience and evidence on the establishment of an integrated surveillance system, which aims to provide early warning of disease epidemics in developing countries.In recent years, the continuous appearances of infectious diseases epidemic have attracted significant attention in China as well as in other countries over the world. In 2003, SARS firstly emerged in southern China, and then spread rapidly to the other parts in China and also in the world, resulting in the worldwide SARS epidemic. It was reported there were 5327 cases and 349 deaths in China by the end of 2003 [1]. By 5 March 2008, 30 human avian influenza cases and 20 deaths had been reported in mainland China, after the first human case was reported in 2003 [2]. In 2009 since the first imported H1N1 case was reported on May 11, the confirmed cases were consecutively reported and spread rapidly among the nation. As of Mar 31, 2010, more than 127,000 confirmed cases and 800 deaths had been reported from 31 provinces [3]. Sin