Evaluation of the Italian sentinel surveillance system for acute viral hepatitis (SEIEVA) Silvia Longhi

A reliable surveillance system is the key to establishing connections between the epidemiological situation and the planning, monitoring and evaluation of public health interventions. Periodic evaluation of surveillance systems is essential to verify whether they are operating efficiently. In Italy, viral hepatitis is a statutorily notifiable disease and cases are reported to the notification system of the Ministry of Health. In addition, a voluntary sentinel surveillance system, named SEIEVA, coordinated by the National Institute of Health, has been active since 1985 to promote monitoring and control of acute viral hepatitis infections at both local and national levels. The aim of the present study was to assess the performance of SEIEVA, from the years 2007 to 2010, in accurately monitoring viral hepatitis cases in Italy. A literature review was performed to identify system attributes to be evaluated and to select the appropriate indicators for measuring sensitivity, representativeness, data quality, and timeliness of the system. During the study period 5,851 acute viral hepatitis cases were notified to SEIEVA. More than half of the observed cases were attributable to hepatitis A virus (HAV) (51.8%) and 33.9% to hepatitis B (HBV). Overall, 64.6% of reports had data on all relevant serological markers and the representativeness of the system was 71.7%. Complete information on gender, age and city of residence was available for 91.9% of reports. Data on major risk factors for HAV were available for 96.7% of cases, while risk factors for HBV were available in only 84.0%. Information on date of diagnosis and date of interview of the patients was available for 5.812 reports (99.3%). Statistically significant differences in sensitivity and representativeness were observed between geographical areas, with higher values reported for both attributes in central Italy. In addition, a significantly higher percentage of cases reported in central Italy had complete information on risk factors for HBV and HCV, vaccination status and outcome of infection. Monitoring and evaluation of the SEIEVA system was critical to assessing its performance by providing evidence of the validity of the data and identifying areas where surveillance needs to be strengthened. Key messages A reliable surveillance system is the key to establishing connections between the epidemiological situation and the planning, monitoring and evaluation of public health interventions. Monitoring and evaluation of the SEIEVA was critical to assessing its performance by providing evidence of the validity of the data and identifying areas where surveillance needs to be strengthened.