title: Estimating incidence of bacterial meningitis with capture-recapture method, Lazio Region, Italy.
abstract: To estimate the incidence of bacterial meningitis in the Lazio Region, including the city of Rome, and to assess the quality of the surveillance systems, we adopted a multiple-capture model by merging cases from three sources available in 1995-1996: the Notifiable Disease Surveillance (NDS) system, the Special Hospital Surveillance (SHS) system and the Hospital Discharge (HD) registry. A medical record revision was carried out to confirm the cases of bacterial meningitis. A total of 199 individuals was classified as probable or confirmed cases of bacterial meningitis in 1995-1996. In this period, the incidence of reported meningitis was 3.8/100,000 (population = 5,209,633). The log-linear model yielded a total estimated number of 236 cases (95% confidence interval (CI): 206-306), the estimate of incidence reaching the value of 4.5/100,000. Hospital Discharge registry showed the highest sensitivity (77%), the SHS system the highest positive predictive value (83%). In 1997-1998, the meningitis surveillance was integrated with an additional laboratory-based source and yielded 326 cases, with an incidence of reported cases of 6.3/100,000. Laboratory surveillance, involving 115 (92%) public hospitals and 84 (57%) private clinics, contributed 35 (27%) cases in addition to those notified to NDS (n = 130). Multiple-capture models, in our experience could estimate the bacterial meningitis incidence with a very good approximation. In order to improve both sensitivity and positive predictive value of surveillance, hospital and public health sources should be integrated with laboratory-based system.
authors: Department of Epidemiology, Agency for Public Health, Lazio, Italy. malinf1@asplazio.it
authors: A
authors: A
authors: Faustini
authors: V
authors: V
authors: Fano
authors: M
authors: M
authors: Sangalli
authors: S
authors: S
authors: Ferro
authors: L
authors: L
authors: Celesti
authors: P
authors: P
authors: Contegiacomo
authors: V
authors: V
authors: Renzini
authors: C A
authors: CA
authors: Perucci
mesh_terms: D016022:Case-Control Studies; D016001:Confidence Intervals; D003628:Database Management Systems; D018563:Disease Notification / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016014:Linear Models; D008498:Medical Record Linkage; D016920:Meningitis, Bacterial / Q000453:epidemiology*; D010351:Patient Discharge / Q000706:statistics & numerical data; D011159:Population Surveillance / Q000379:methods*; D011237:Predictive Value of Tests; D012042:Registries; D012307:Risk Factors; D012680:Sensitivity and Specificity