Development and evaluation of an Electronic School Absenteeism System for Influenza-Like-Illness Surveillance in Hong Kong

Poster Sessions: no. P-299BACKGROUND: School-aged children typically experience the greatest attack rates during influenza epidemics. Outbreak potential has always been a major concern in school settings and continuous monitoring of school absence may serve as a suitable proxy for reflecting the disease activity of influenza among the local student population. Although being increasingly employed in different countries, most surveillance systems using school absenteeism data still relied heavily on manual roll calls and paper-based records for data collection, which limited their timeliness and sustainability. METHOD: Riding on a popular smart-card based electronic attendance tracking system in Hong Kong, an electronic school absenteeism surveillance system was developed for influenza-like-illness surveillance among the school-aged children. Additional backend systems were built for automatic data transfer, cleaning, aggregation, and analysis, and feedback of the generated surveillance intelligence to relevant parties through electronic platform. The performance of this surveillance system was also evaluated according to international guidelines by end-users. RESULTS: A total of 107 local schools (including 66 primary schools and 41 secondary schools) were recruited in our school absenteeism surveillance system, covering a total of 75052 enrolled students. The system successfully captured absence data for two consecutive academic years (2012-2013 and 2013-14) during the study period. An evaluation of the programme performed after its full implementation revealed that the system was simple and well accepted, with satisfactory data quality in terms of completeness, representativeness, timeliness and performance in reflecting an upsurge in disease activity. Influenza-like-illness-specific absence data and data from primary schools were having better surveillance performance in reflecting community influenza activity compared to data on all illnesses and data from secondary schools, respectively. CONCLUSION: Smart-card technology based school absenteeism surveillance system is feasible and represents a potentially efficient tool to enhance existing influenza surveillance system and guide evidence-based health advice and policy development. Future developmental directions should include options to facilitate the continuous capturing of children sickness data during school breaks and holidays, so as to reduce data break and allow for continuous capture of surveillance data especially during epidemic periods