SALGINTR: Development and Evaluation of a Digital Participatory Surveillance System to Monitor Influenza-like Illness in Türkiye Based on Self-Reported Data from A Physician Cohort

Date

2026-9-2

Author

Öntaş, Eray

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Influenza sentinel surveillance is laboratory-anchored but narrow in coverage, slow and costly to run. We developed SALGINTR, a physician-based digital participatory system in which physicians self-report their own weekly influenza-like illness (ILI), and evaluated it against the national sentinel stream (combined influenza+SARS-CoV-2 positivity) over the 2025/26 season (33 weeks) in Türkiye. Physicians filed a weekly symptom report through a secure workflow, recording an aetiological cluster for each symptomatic week by their own clinical diagnosis; consecutive weeks carrying the same cluster were consolidated into episodes. Individual-level determinants were estimated with shared-frailty Andersen-Gill recurrent-event models on pre-specified adjustment sets. Of 304 registered physicians, 248 (81.6%) reported at least one week, contributing 4,729 person-weeks and 497 ILI episodes; cumulative attack rate 77.4%. ILI risk fell with age (HR=0.85 per decade, 95%CI 0.75-0.97) and rose with a school-age child in the household (HR=1.33, 1.02-1.72) and with prior-seasons ILI frequency (HR=1.36 per level, 1.11-1.67). Smoothed weekly viral-systemic (A-cluster) positivity discriminated epidemic weeks (AUC=0.77, 0.57-0.95). Across the pre-specified early-warning window it agreed with sentinel surveillance (r=0.64, 0.37-0.92). Alarm concordance across a six-detector ensemble was substantial in that window (κ=0.890, sensitivity 0.875, PPV 1.00; κ=0.835 across the season). On the raw scale the pre-epidemic coefficient was close to the attenuation ceiling the two streams’ reliabilities permit. No lead over the sentinel was identifiable. A low-cost (100 USD) physician panel tracked the season in near-real time and agreed with sentinel surveillance where the design allows, supporting participatory reporting as a complement to, not a replacement for, laboratory-anchored networks.

Subject Keywords

participatory surveillance, influenza-like illness, syndromic surveillance, sentinel surveillance, Moving Epidemic Method, digital epidemiology, Türkiye

URI

https://hdl.handle.net/11511/120679

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Graduate School of Informatics, Thesis