Well-functioning epidemiological surveillance lowers health care costs

In response to the need to improve the quantitative and qualitative reporting of cases of Invasive Bacterial Diseases (IBD) reported to the National Institute of Public Health of the National Institute of Hygiene - National Research Institute (NIPH-BIP) and the National Reference Center for the Diagnosis of Bacterial Infections of the Nervous System (KOROUN), the project "Epi-IChB - strengthening the existing epidemiological surveillance of invasive bacterial diseases" was created. One of its components is the report "Diagnosis of the functioning of epidemiological surveillance in Poland. Recommendations for systemic changes".

Prof. Anna Skoczynska, head of KOROUN, said that more than a dozen recommendations have been made, and experts have identified three as priorities.

"These are: legal empowerment of the submission of samples to KOROUN, together with the introduction of positive motivators for the submission of biological material samples to KOROUN (certificate, additional points), standardization of the submission process, including, among other things, the introduction of the so-called >>one-stop-shop<< procedure, and the introduction of dedicated training for medical professionals within the framework of the already functioning in-service training mode." - Prof. Skoczynska informed.

The professor stressed that the adoption of these recommendations will translate not only into increased patient safety, but also into the ability to plan adequate immunoprophylactic measures. It will also result in reduced expenditures due to reduced morbidity and the reduction of growing antibiotic resistance and its consequences.

Participants in the conference "Diagnosis of the functioning of epidemiological surveillance in Poland in the area of Invasive Bacterial Diseases (IBD) spoke about the effects of this initiative, along with recommendations for systemic and organizational changes. Recommendations for systemic and organizational changes". A report on this project was also presented at the conference.

According to conference participants, surveillance is getting tighter every year, however, analysis of the data shows a significantly lower number of biological material samples sent to the NRO for laboratory testing, which is important for doctors making prophylactic (vaccine choice) and therapeutic decisions. Experts and decision-makers, reviewing or deciding on immunoprophylaxis at the national level, are also not fully cognizant.

Prof. Iwona Paradowska-Stankiewicz, national consultant for epidemiology, stresses that epidemiological surveillance is one of the main sources of information on the incidence of notifiable and registerable infectious diseases, including invasive bacterial diseases.

"Surveillance information, combined with microbiological data, makes it possible to fully analyze and evaluate the epidemiological situation of these diseases, which in turn is helpful for government decision-making and also allows for evaluation of the surveillance system." - Prof. Paradowska-Stankiewicz said.

Prof. Anna Skoczynska, head of KOROUN, noted that surveillance of invasive diseases provides important information about their etiology and pathogen characteristics, including virulence (virulence of microorganisms) and serological characteristics of antibiotic susceptibility, among others.

"The knowledge thus gained is crucial for identifying and defining targeted preventive measures, including vaccination programs, and evaluating their effects. In turn, up-to-date knowledge of the drug susceptibility of microorganisms makes it possible to create optimal treatment regimens that limit the emergence and spread of antibiotic resistance. Surveillance is therefore a valuable tool necessary for making the right public health decisions." - Prof. Anna Skoczynska pointed out.

Prof. Waleria Hryniewicz, an honorary member of the project's Scientific Council, noted that invasive bacteria are becoming increasingly drug-resistant.

"Invasive-bacterial infections are proceeding at lightning speed. Surveillance should be very much involved in the matter of monitoring and action when it comes to drug resistance. Drug resistance has become the most dangerous threat to public health besides climate change." - Prof. Hryniewicz stressed.

Prof. Teresa Jackowska, president of the Polish Pediatric Society, said that information from the KOROUN is essential in the case of, for example, invasive pneumococcal disease (IPD).

"Of course, cultures and an antibiogram are the basis, but many times a child is previously treated with an antibiotic and we don't have this information. It is worth noting that 30 percent of cases of IChP in children under five are caused by serotype 19A. This is an antibiotic-resistant serotype. Our approach to such a patient must be even more vigilant. It is all the more incomprehensible to me that a vaccine that contains serotype 19A has not been introduced into the Immunization Program. I believe that surveillance should be the basis for responsible decisions on the choice of immunoprophylaxis. Only then will we be able to achieve optimal protection and reduce the number of infections." - Prof. Jackowska assessed.

Prof. Wojciech Fendler, president of the Medical Research Agency, noted that the project is a valuable initiative.

"Without knowing what pathogen caused a given infection, we are operating as if we are in a fog, which reflects on the patient in the first place. That's why these types of projects are crucial to reduce the huge costs of therapy, to enable us to use the wide assortment of drugs we have, to make sure that resistance doesn't build up so quickly, and ultimately to make the number of patients who suffer the consequences of this - smaller and smaller." - Prof. Fendler added.

Prof. Marcin Czech, an epidemiology specialist, called epidemiological surveillance "the eyes and ears of the system."

"Without them we are walking in a fog. When everything works well, no one is interested in it, only specialists. But when something bad happens, the question arises - how do we know about it? It is precisely thanks to epidemiological surveillance. This surveillance has a pharmaco-economic dimension. A well-functioning surveillance is a reduction in health care costs. We are able to allocate limited medical resources where we need to intervene, and we are also able to select vaccines for risk groups." - Prof. Czech pointed out.

News source: PAP MediaRoom