title: Assessment of the French National Health Insurance Information System as a tool for epidemiological surveillance of malaria.
abstract: OBJECTIVE
  Epidemiological surveillance of malaria in France is based on a hospital laboratory sentinel surveillance network. There is no comprehensive population surveillance. The objective of this study was to assess the ability of the French National Health Insurance Information System to support nationwide malaria surveillance in continental France.
  
  
  METHODS
  A case identification algorithm was built in a 2-step process. First, inclusion rules giving priority to sensitivity were defined. Then, based on data description, exclusion rules to increase specificity were applied. To validate our results, we compared them to data from the French National Reference Center for Malaria on case counts, distribution within subgroups, and disease onset date trends.
  
  
  RESULTS
  We built a reusable automatized tool. From July 1, 2013, to June 30, 2014, we identified 4077 incident malaria cases that occurred in continental France. Our algorithm provided data for hospitalized patients, patients treated by private physicians, and outpatients for the entire population. Our results were similar to those of the National Reference Center for Malaria for each of the outcome criteria.
  
  
  CONCLUSIONS
  We provided a reliable algorithm for implementing epidemiological surveillance of malaria based on the French National Health Insurance Information System. Our method allowed us to work on the entire population living in continental France, including subpopulations poorly covered by existing surveillance methods.
  
  
  CONCLUSIONS
  Traditional epidemiological surveillance and the approach presented in this paper are complementary, but a formal validation framework for case identification algorithms is necessary.
authors.affiliation: French Armed Forces Center for Epidemiology and Public Health, Marseille, France.
authors.forename: François
authors.initials: F
authors.lastname: Delon
authors.affiliation: French Armed Forces Center for Epidemiology and Public Health, Marseille, France.|UMR 912: INSERM-IRD-Aix-Marseille University, Marseille, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Mayet
authors.affiliation: National Reference Center for Malaria, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Thellier
authors.affiliation: National Reference Center for Malaria, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Kendjo
authors.affiliation: French Armed Forces Center for Epidemiology and Public Health, Marseille, France.|French Military Health Service Academy, Paris, France.
authors.forename: Rémy
authors.initials: R
authors.lastname: Michel
authors.affiliation: Central Directorate of the French Military Health Service, Paris, France.
authors.forename: Lénaïck
authors.initials: L
authors.lastname: Ollivier
authors.affiliation: Department of Computer Science, Biostatistics and Public Health, Georges Pompidou European Hospital, Paris, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Chatellier
authors.affiliation: National Military Social Security Fund, Toulon, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Desjeux
mesh_terms: D000465:Algorithms; D000962:Antimalarials / Q000627:therapeutic use; D016208:Databases, Factual; D005602:France / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D009313:National Health Programs; D062486:Public Health Surveillance / Q000379:methods*
chemical_list: D000962:Antimalarials
keywords: France/epidemiology; National health programs; administrative databases; malaria/epidemiology; public health surveillance