Alarm threshold levels of meningitis outbreak in Hamadan province (2010- 2012)

authors:

avatar Mohammad Fariadras 1 , avatar Manoochehr Karami 2 , * , avatar Nader Esmailnasab 3 , avatar Abbas Moghimbeigi 4 , avatar Hastyar Pazhouhi 5

Dept. of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
Social Determinant of Health Research Center and Department of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
Dept. of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Kurdistan, Iran
Modeling of Non-communicable Diseases Research Center and Department of Biostatistics, Hamadan University of Medical Sciences, Hamadan, Iran
Dept. of Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran
Journal of Kermanshah University of Medical Sciences: Vol.19, issue 5; e69840
published online: November 19, 2015
article type: Original Article
received: May 17, 2015
accepted: November 03, 2015
DOI: https://doi.org/10.22110/jkums.v19i5.2310

how to cite: Fariadras M, Karami M, Esmailnasab N, Moghimbeigi A, Pazhouhi H. Alarm threshold levels of meningitis outbreak in Hamadan province (2010- 2012). J Kermanshah Univ Med Sci. 2015;19(5):e69840. https://doi.org/10.22110/jkums.v19i5.2310.

Abstract

Background: The surveillance systems need to define the levels of alarm threshold for early detection of outbreak. The purpose of this study was to determine the threshold levels of meningitis outbreak in Hamadan province, Iran.
Methods: The suspected cases of meningitis that were reported through meningitis surveillance form 2010 to 2012 were investigated in this study. Explainable patterns of the syndromic data of fever and neurological symptoms were removed by Generalized Linear Model. The upper limits of cumulative sum (CUSUM) algorithm were used to estimate the alarm threshold levels of meningitis outbreak. The seasonal pattern of dynamic alarm thresholds was defined using the data obtained from different seasons.
Results: The fixed alarm threshold levels according to standardized CUSUM, i.e. 1.5 to 2 standard deviations from the mean, were equal to the occurrence of more than 3 and 4 suspected cases of meningitis, respectively. The corresponding values for dynamic levels based on the upper control limit of CUSUM were 2.6 to 3.2 cases for different seasons. In other words, 3 cases were considered to be a discrete scale for suspected cases of meningitis.
Conclusion: Due to the seasonality pattern of meningitis, dynamic levels of alarm threshold should be determined according to the seasons and months of year.

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