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Evaluation of a Standardized Morbidity Surveillance Form for Use during Disasters Caused by Natural Hazards

Published online by Cambridge University Press:  05 May 2011

Amy H. Schnall
Affiliation:
Centers for Disease Control and Prevention (CDC), Division of Environmental Hazards and Health Effects, Health Studies Branch, Atlanta, Georgia USA
Amy F. Wolkin
Affiliation:
Centers for Disease Control and Prevention (CDC), Division of Environmental Hazards and Health Effects, Health Studies Branch, Atlanta, Georgia USA
Rebecca Noe
Affiliation:
Centers for Disease Control and Prevention (CDC), Division of Environmental Hazards and Health Effects, Health Studies Branch, Atlanta, Georgia USA
Leslie B. Hausman
Affiliation:
CDC, Division of Foodborne, Waterborne & Environmental Diseases, Enteric Diseases Epidemiology Branch, Atlanta, Georgia USA
Petra Wiersma
Affiliation:
CDC, Epidemic Intelligence Service, Atlanta, Georgia USA Georgia Division of Public Health, Atlanta, Georgia USA
Karl Soetebier
Affiliation:
Georgia Division of Public Health, Office of Epidemiology, Evaluation, and Health Information, Atlanta, Georgia USA
Susan T. Cookson
Affiliation:
CDC, Division of Global Disease Detection & Emergency Respponse, International Emergency and Refugee Health Branch, Atlanta, Georgia USA
Corresponding
E-mail address:

Abstract

Introduction: Surveillance for health outcomes is critical for rapid responses and timely prevention of disaster-related illnesses and injuries after a disaster-causing event. The Disaster Surveillance Workgroup (DSWG) of the US Centers for Disease Control and Prevention developed a standardized, single-page, morbidity surveillance form, called the Natural Disaster Morbidity Surveillance Individual Form (Morbidity Surveillance Form), to describe the distribution of injuries and illnesses, detect outbreaks, and guide timely interventions during a disaster.

Problem: Traditional data sources can be used during a disaster; however, supplemental active surveillance may be required because traditional systems often are disrupted, and many persons will seek care outside of typical acute care settings. Generally, these alternative settings lack health surveillance and reporting protocols. The need for standardized data collection was demonstrated during Hurricane Katrina, as the multiple surveillance instruments that were developed and deployed led to varied and uncoordinated data collection methods, analyses, and morbidity data reporting. Active, post-event surveillance of affected populations is critical for rapid responses to minimize and prevent morbidity and mortality, allocate resources, and target public health messaging.

Methods: The CDC and the Georgia Department of Public Health (GDPH) conducted a study to evaluate a Morbidity Surveillance Form to determine its ability to capture clinical presentations. The form was completed for each patient evaluated in an emergency department (ED) during triage from 01 August, 2007 through 07 August, 2007. Data from the form were compared with the ED discharge diagnoses from electronic medical records, and kappa statistics were calculated to assess agreement.

Results: Nine hundred forty-nine patients were evaluated, 41% were male and 57% were Caucasian. According to the forms, the most common reasons for seeking treatment were acute illness, other (29%); pain (12%); and gastrointestinal illness (8%). The frequency of agreement between discharge diagnoses and the form ranged from 3 to 100%. Kappa values ranged from 0.23–1.0, with nine of the 12 categories having very good or good agreement.

Conclusion: With modifications to increase sensitivity for capturing certain clinical presentations, the Morbidity Surveillance Form can be a useful tool for capturing data needed to guide public health interventions during a disaster. A validated collection instrument for a post-disaster event facilitates rapid and standardized comparison and aggregation of data across multiple jurisdictions, thus, improving the coordination, timeliness, and accuracy of public health responses. The DSWG revised the Morbidity Surveillance Form based on information from this study.

Type
Original Research
Copyright
Copyright Schnall © World Association for Disaster and Emergency Medicine 2011

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Evaluation of a Standardized Morbidity Surveillance Form for Use during Disasters Caused by Natural Hazards
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