title: Assessing the sensitivity and representativeness of the Belgian Sentinel Network of Laboratories using test reimbursement data.
abstract: BACKGROUND
  The Belgian Sentinel Network of Laboratories (SNL) was created in 1983 in order to monitor trends in infectious diseases. Given the evolution of the surveillance system, such as the waivers, fusions and adhesions of laboratories over time, it is important to evaluate whether the SNL is still fit for purpose. This study aims to evaluate aspects of the sensitivity and representativeness of the SNL by means of a test coverage analysis.
  
  
  METHODS
  We estimated test coverage of the SNL using the ratio of reimbursed tests performed by participating laboratories to the total number of tests performed between 2007 and 2012, for 12 (groups of) pathogens. We further evaluated the geographical difference coverage of the SNL at regional and provincial levels.
  
  
  RESULTS
  We found that test coverage of the SNL was stable over time and close to, or greater than, 50 % for the 12 (groups of) pathogens studied. These results hold for the three regions of Belgium but not for all provinces. We showed that some provinces had a low test coverage for some pathogens and that test coverage was more variable over time at provincial level.
  
  
  CONCLUSIONS
  This sensitivity and representativeness study based on test coverage suggests that the SNL is capable to describe trend and to monitor changes in the 12 (groups of) pathogens studied both at national and regional levels. Therefore, the SNL is useful to contribute to estimate the burden of disease and to inform preventive measures. It should however be reinforced to allow to be used as an alert system at provincial level.
authors: WIV-ISP (Scientific Institute of Public Health), Avenue de la Couronne, 310, 1050 Brussels, Belgium ; Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK.
authors: Nicolas
authors: N
authors: Berger
authors: WIV-ISP (Scientific Institute of Public Health), Avenue de la Couronne, 310, 1050 Brussels, Belgium.
authors: Gaetan
authors: G
authors: Muyldermans
authors: WIV-ISP (Scientific Institute of Public Health), Avenue de la Couronne, 310, 1050 Brussels, Belgium.
authors: Yves
authors: Y
authors: Dupont
authors: WIV-ISP (Scientific Institute of Public Health), Avenue de la Couronne, 310, 1050 Brussels, Belgium.
authors: Sophie
authors: S
authors: Quoilin
keywords: Coverage; Epidemiology; Representativeness; Sentinel network; Surveillance system