5a - Temporal relationships between the sentinel community acute respiratory infection (CARI) programme and routine respiratory surveillance systems in Scotland: Exploring the potential for forecasting.
Fireside Abstracts
Information
Background : The community acute respiratory infection (CARI) programme is a surveillance system covering around a fifth of the Scottish population, and monitors respiratory pathogen activity across 180 sentinel general practice (GP) sites. The near real-time data from CARI could be used to notify secondary care (SC) providers of potential changes to infection activity. This study examines how temporal variations in CARI infection activity relate to trends in all routine testing (community and hospital), and emergency hospital admissions (EHA).
Methods : Over a 30-week period in 2023-24, age-specific population trends for CARI swab positivity (proportion of swabs testing positive for a pathogen, %), were compared with subsequent routine testing rates (RTR) and EHA for specific pathogens. RTR and EHA were captured from the electronic communication of surveillance in Scotland (ECOSS) database. The presence of visually observed weekly lags between CARI and other surveillance systems was validated using autoregressive integrated moving average (ARIMA) models. Associations are presented as regression coefficients (β).
Results : Over the 2023-24 season, 57% of all CARI swabs (n=23,878) tested positive for at least one pathogen. In certain age groups, changes in CARI swab positivity preceded changes in RTR (range β=0.033 to 1.39, p<0.04) and EHA (range β=0.01 to 1.22, p<0.03). Strongest associations with the previous week's swab positivity were observed in the 1 to 4 age group testing positive for Respiratory syncytial virus (RTR β=1.39, EHA β=1.22, p<0.001), influenza (RTR β=0.47, EHA β=0.79, p<0.001) and seasonal coronavirus (RTR β=0.43, EHA β=0.24, p<0.001).
Conclusions : Sentinel GP data might serve as a critical advance warning tool for infection activity and hospital admissions. CARI provides an opportunity to inform timely, actionable information to support public health decision-making and healthcare planning.
