Using Laboratory Test Results for Surveillance During a New Outbreak of Acute Hepatitis in 3-Week- to 5-Year-Old Children in the United Kingdom, the Netherlands, Ireland, and Curaçao: Observational Cohort Study
Abstract BackgroundIn March 2022, a concerning rise in cases of unexplained pediatric hepatitis was reported in multiple countries. Cases were defined as acute hepatitis with serum transaminases >500 U/L (aspartate transaminase [AST] or alanine transaminase [ALT]) in childr...
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JMIR Publications
2024-12-01
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| Series: | JMIR Public Health and Surveillance |
| Online Access: | https://publichealth.jmir.org/2024/1/e55376 |
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| author | Maaike C Swets Steven R Kerr Brian MacKenna Louis Fisher Merel van Wijnen Diederik Brandwagt Paul W Schenk Pieter Fraaij Leonardus G Visser Sebastian Bacon Amir Mehrkar Alistair Nichol Patrick Twomey Philippa C Matthews Malcolm G Semple Geert H Groeneveld Ben Goldacre Iain Jones J Kenneth Baillie |
| author_facet | Maaike C Swets Steven R Kerr Brian MacKenna Louis Fisher Merel van Wijnen Diederik Brandwagt Paul W Schenk Pieter Fraaij Leonardus G Visser Sebastian Bacon Amir Mehrkar Alistair Nichol Patrick Twomey Philippa C Matthews Malcolm G Semple Geert H Groeneveld Ben Goldacre Iain Jones J Kenneth Baillie |
| author_sort | Maaike C Swets |
| collection | DOAJ |
| description |
Abstract
BackgroundIn March 2022, a concerning rise in cases of unexplained pediatric hepatitis was reported in multiple countries. Cases were defined as acute hepatitis with serum transaminases >500 U/L (aspartate transaminase [AST] or alanine transaminase [ALT]) in children aged 16 years or younger. We explored a simple federated data analytics method to search for evidence of unreported cases using routinely held data. We conducted a pragmatic survey to analyze changes in the proportion of hospitalized children with elevated AST or ALT over time. In addition, we studied the feasibility of using routinely collected clinical laboratory results to detect or follow-up the outbreak of an infectious disease.
ObjectiveWe explored a simple federated data analytics method to search for evidence of unreported cases using routinely held data.
MethodsWe provided hospitals with a simple computational tool to enable laboratories to share nondisclosive summary-level data. Summary statistics for AST and ALT measurements were collected from the last 10 years across all age groups. Measurements were considered elevated if ALT or AST was >200 U/L. The rate of elevated AST or ALT test for 3-week- to 5-year-olds was compared between a period of interest in which cases of hepatitis were reported (December 1, 2021, to August 31, 2022) and a prepandemic baseline period (January 1, 2012, to December 31, 2019). We calculated a z
ResultsOur approach of sharing a simple software tool for local use enabled rapid, federated data analysis. A total of 34 hospitals in the United Kingdom, the Netherlands, Ireland, and Curaçao were asked to contribute summary data, and 30 (88%) submitted their data. For all locations combined, the rate of elevated AST or ALT measurements in the period of interest was not elevated (zP=zP
ConclusionsHospital laboratories collect large amounts of data on a daily basis that can potentially be of use for disease surveillance, but these are currently not optimally used. Federated analytics using nondisclosive, summary-level laboratory data sharing was successful, safe, and efficient. The approach holds potential as a tool for pandemic surveillance in future outbreaks. Our findings do not indicate the presence of a broader outbreak of mild hepatitis cases among young children, although there was an increase in elevated AST or ALT values locally in the Netherlands. |
| format | Article |
| id | doaj-art-55c4bb1ae123438492dc535ef9290222 |
| institution | Kabale University |
| issn | 2369-2960 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Public Health and Surveillance |
| spelling | doaj-art-55c4bb1ae123438492dc535ef92902222025-01-27T07:21:45ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602024-12-0110e55376e5537610.2196/55376Using Laboratory Test Results for Surveillance During a New Outbreak of Acute Hepatitis in 3-Week- to 5-Year-Old Children in the United Kingdom, the Netherlands, Ireland, and Curaçao: Observational Cohort StudyMaaike C Swetshttp://orcid.org/0000-0003-0901-9560Steven R Kerrhttp://orcid.org/0000-0002-3643-7859Brian MacKennahttp://orcid.org/0000-0002-3786-9063Louis Fisherhttp://orcid.org/0000-0002-0295-3812Merel van Wijnenhttp://orcid.org/0000-0002-6676-1238Diederik Brandwagthttp://orcid.org/0000-0003-4895-1756Paul W Schenkhttp://orcid.org/0000-0001-8155-9073Pieter Fraaijhttp://orcid.org/0009-0000-2461-0573Leonardus G Visserhttp://orcid.org/0000-0002-3600-9782Sebastian Baconhttp://orcid.org/0000-0002-6354-3454Amir Mehrkarhttp://orcid.org/0000-0002-2098-1278Alistair Nicholhttp://orcid.org/0000-0002-4689-1238Patrick Twomeyhttp://orcid.org/0000-0001-7284-4673Philippa C Matthewshttp://orcid.org/0000-0002-4036-4269Malcolm G Semplehttp://orcid.org/0000-0001-9700-0418Geert H Groeneveldhttp://orcid.org/0000-0001-6529-1396Ben Goldacrehttp://orcid.org/0000-0002-5127-4728Iain Joneshttp://orcid.org/0000-0002-8217-5052J Kenneth Bailliehttp://orcid.org/0000-0001-5258-793X Abstract BackgroundIn March 2022, a concerning rise in cases of unexplained pediatric hepatitis was reported in multiple countries. Cases were defined as acute hepatitis with serum transaminases >500 U/L (aspartate transaminase [AST] or alanine transaminase [ALT]) in children aged 16 years or younger. We explored a simple federated data analytics method to search for evidence of unreported cases using routinely held data. We conducted a pragmatic survey to analyze changes in the proportion of hospitalized children with elevated AST or ALT over time. In addition, we studied the feasibility of using routinely collected clinical laboratory results to detect or follow-up the outbreak of an infectious disease. ObjectiveWe explored a simple federated data analytics method to search for evidence of unreported cases using routinely held data. MethodsWe provided hospitals with a simple computational tool to enable laboratories to share nondisclosive summary-level data. Summary statistics for AST and ALT measurements were collected from the last 10 years across all age groups. Measurements were considered elevated if ALT or AST was >200 U/L. The rate of elevated AST or ALT test for 3-week- to 5-year-olds was compared between a period of interest in which cases of hepatitis were reported (December 1, 2021, to August 31, 2022) and a prepandemic baseline period (January 1, 2012, to December 31, 2019). We calculated a z ResultsOur approach of sharing a simple software tool for local use enabled rapid, federated data analysis. A total of 34 hospitals in the United Kingdom, the Netherlands, Ireland, and Curaçao were asked to contribute summary data, and 30 (88%) submitted their data. For all locations combined, the rate of elevated AST or ALT measurements in the period of interest was not elevated (zP=zP ConclusionsHospital laboratories collect large amounts of data on a daily basis that can potentially be of use for disease surveillance, but these are currently not optimally used. Federated analytics using nondisclosive, summary-level laboratory data sharing was successful, safe, and efficient. The approach holds potential as a tool for pandemic surveillance in future outbreaks. Our findings do not indicate the presence of a broader outbreak of mild hepatitis cases among young children, although there was an increase in elevated AST or ALT values locally in the Netherlands.https://publichealth.jmir.org/2024/1/e55376 |
| spellingShingle | Maaike C Swets Steven R Kerr Brian MacKenna Louis Fisher Merel van Wijnen Diederik Brandwagt Paul W Schenk Pieter Fraaij Leonardus G Visser Sebastian Bacon Amir Mehrkar Alistair Nichol Patrick Twomey Philippa C Matthews Malcolm G Semple Geert H Groeneveld Ben Goldacre Iain Jones J Kenneth Baillie Using Laboratory Test Results for Surveillance During a New Outbreak of Acute Hepatitis in 3-Week- to 5-Year-Old Children in the United Kingdom, the Netherlands, Ireland, and Curaçao: Observational Cohort Study JMIR Public Health and Surveillance |
| title | Using Laboratory Test Results for Surveillance During a New Outbreak of Acute Hepatitis in 3-Week- to 5-Year-Old Children in the United Kingdom, the Netherlands, Ireland, and Curaçao: Observational Cohort Study |
| title_full | Using Laboratory Test Results for Surveillance During a New Outbreak of Acute Hepatitis in 3-Week- to 5-Year-Old Children in the United Kingdom, the Netherlands, Ireland, and Curaçao: Observational Cohort Study |
| title_fullStr | Using Laboratory Test Results for Surveillance During a New Outbreak of Acute Hepatitis in 3-Week- to 5-Year-Old Children in the United Kingdom, the Netherlands, Ireland, and Curaçao: Observational Cohort Study |
| title_full_unstemmed | Using Laboratory Test Results for Surveillance During a New Outbreak of Acute Hepatitis in 3-Week- to 5-Year-Old Children in the United Kingdom, the Netherlands, Ireland, and Curaçao: Observational Cohort Study |
| title_short | Using Laboratory Test Results for Surveillance During a New Outbreak of Acute Hepatitis in 3-Week- to 5-Year-Old Children in the United Kingdom, the Netherlands, Ireland, and Curaçao: Observational Cohort Study |
| title_sort | using laboratory test results for surveillance during a new outbreak of acute hepatitis in 3 week to 5 year old children in the united kingdom the netherlands ireland and curacao observational cohort study |
| url | https://publichealth.jmir.org/2024/1/e55376 |
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