Ecologie de la santé humaine : contribution à l'étude et à la surveillance des épidémies de gastro-entérite aigüe d'origine hydrique

Abstract : Waterborne disease outbreaks (WBDO) of acute gastrointestinal illness remain a public health concern in the 21st century in developed countries. Almost all surveillance systems implemented in countries are characterized by underreporting. In France, the improvement of monitoring these events is based on the use of data from the French Health Insurance.The aim of our work was to propose a method to improve the sensitivity and specificity of the detection of WBDO. Three studies were conducted to i) evaluate the ability of French Health Insurance data to describe WBDO ii) apply a method of space-time detection by integrating the exposure to tap water, iii) evaluate the performance of this method.Our work allowed developing a method of space-time detection of WBDO by taking into account geographical units for drinking water networks units with a good sensitivity and positive predictive value. The performances for detection are mainly related to the size of the epidemic. The ability of the data from the French Health Insurance to detect WBDO can be influenced by the health-seeking behavior of people, awareness of the population to the risk of WBDO and the temporal aggregation level of cases of acute gastrointestinal illness.The purpose of our research is to carry out an operational design for the automated detection of WBDO in a purpose of prevention and reduction of health impact.
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Damien Mouly. Ecologie de la santé humaine : contribution à l'étude et à la surveillance des épidémies de gastro-entérite aigüe d'origine hydrique. Sciences agricoles. Université Blaise Pascal - Clermont-Ferrand II, 2016. Français. ⟨NNT : 2016CLF22706⟩. ⟨tel-01479931⟩

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