Evaluation of the completeness of the epidemiological surveillance systems for malaria by the Capture-recapture system in the French armies in 1994

Abstract

The Capture-recapture method has been utilized to evaluate the annual incidence of malaria in the French armies in 1994 on the basis of the incidence derived from two regulatory systems, passive and exhaustive, of epidemiological surveillance: the Recueil et l'Exploitation des Données Epidémiologiques des Armées (REDEA) and the Surveillance Epidémiologique du Paladisme (SESP) system. Cases of malaria found by REDEA and SESP in 1994 rose to 480 and 424 respectively. Two hundred and thirty-eight cases were found by both systems. After validating the conditions for the application of the Capture-recapture method (in particular, having verified that the results from REDEA and SESP were probably independent), its utilization allowed us to evaluate the incidence of malaria in the French army in 1994 at 854 cases. The calculated exhaustivity values for REDEA and SESP were 56.2 and 49.6% respectively; 22% of cases were missed by both systems. The exhaustivity values of SESP and REDEA estimated in our study were comparable to those obtained by the Capture-recapture method applied in another legal inquiry into the passive and exhaustive epidemiological surveillance of meningitis and meningococcosis in France in 1989 and 1990. These results show that it is difficult to evaluate the epidemiological importance of a sickness on the results of passive and exhaustive surveillance alone. In 1995, a new system of surveillance was established in the army: a better conducted and more motivated retro-informative system, linked to a better education of medical officers in epidemiological surveillance permitted an improvement in the completeness of the results in the armies.