Canadian forces evaluation of the EPINATO Health Surveillance System in Bosnia-Herzegovina.

The Canadian Forces (CF) adopted the EPINATO surveillance system in 1996 to monitor disease and injury morbidity in deployed settings. The Directorate of Force Health Protection, CF Health Services Group initiated an evaluation of EPINATO in Task Force Bosnia-Herzegovina in August 2003. Two methods were used to assess coding reliability: a chart audit and Sick Parade Register review. Stakeholder interviews were conducted evaluating data flow, reporting structure, and key system attributes. Reliability (K, 95% confidence interval) was good in 4 of 24 categories--sexually transmitted diseases, K = 0.75 (0.50, 1.00); eye disorders, K = 0.51 (0.15, 0.88); ears/nose/ throat, K = 0.51 (0.33, 0.69); lower respiratory infections, K = 0.49 (95% confidence interval 0.34, 0.65)-but otherwise was poor. EPINATO is not an effective, reliable tool for CF deployment health surveillance. An improved health surveillance system is required to ensure disease and injury aberrations are detected and optimal preventive programs and policies are in place for deployed CF military members.