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The necessity of sentinel sites
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C-EnterNet:
Sentinel sites, or localized networks enabling coordinated investigation into potential sources and reservoirs of pathogens dangerous to the community, are key to C-EnterNet's design. This design facilitates
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multi-jurisdictional collaboration;
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informed estimations of pathogen risk in Canadian communities; and
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strengthening of the public health system in Canada through partnership, education and integration of activities.
Each of C-EnterNet's sentinel sites will include a Canadian community that is serviced by at least one public health unit. Systematic data collection and analysis in each site will include active sampling of people with infectious enteric disease, as well as the water, agriculture and retail food in the community, as potential sources of the diseases. Integration of activities and collaboration within the site will permit the highest quality and quantity of samples - as well as overall cost efficiency - to enable scientific advancements such as improved source attribution methods.
Sentinel surveillance systems involve a limited number of selected reporting sites (communities), from which the information collected may be extended to the general population. A concentration of resources in the defined sites produces a rich source of information, producing more accurate final estimates than those normally available from broader national surveillance programs.
Sentinel site criteria
Sentinel sites generate results that are representative of the broader population - which makes C-EnterNet's approach very effective and highly cost-efficient. Canadian communities that meet specific criteria may be selected as sentinel sites. Basic criteria established by the C-EnterNet team and endorsed by its 27-member scientific advisory committee include
- a population of 300 000 to 1 000 000 residents;
- an urban/rural mix representative of major geographic areas of Canada ;
- private and public health laboratory capacity;
- innovation in local public health and water services; and
- willingness to participate
Selection of the pilot site
The Region of Waterloo, Ontario, was selected as the pilot sentinel site in 2005. It has been operational since June 2005 under a unique partnership with Region of Waterloo Public Health (ROWPH), and with funding from
- Agriculture and Agri-Food Canada (AAFC);
- the Public Health Agency of Canada (PHAC); and
- the Ontario Ministry of Agriculture, Food and Rural Affairs (OMAFRA).
With ongoing funding, this site will continue to operate, after the pilot stage, as one of up to five sentinel sites within C-EnterNet's planned network.
