The use of synthesis methods in support of developing a new surveillance initiative

Article type
Authors
Rajic A1, TuĆĄevljak N2, Dutil L1, McEwen S2
1Public Health Agency of Canada, Canada
2University of Guelph, Canada
Abstract
Background: Research synthesis methods can be used to generate evidence-based inputs for policy and decision-making. We describe the use of three research synthesis methods: scoping study, systematic review (SR) and meta-analysis (MA) in support of developing a potential new surveillance program for zoonotic bacteria and antimicrobial resistance on seafood in Canada.

Methods: In consultation with principal stakeholders, a scoping study was conducted to characterize the global primary research investigating zoonotic bacteria, antimicrobial use and antimicrobial resistance. Evidence-maps were evaluated for 8 selected zoonotic bacteria and all finfish, crustacean and mollusc species. SR-MA were prioritised to evaluate retail (point of consumer purchase) prevalence of E. coli, Salmonella, Aeromonas and Vibrio, which had the most underpinning research, on products frequently consumed based on Canadian consumption and import data; salmon, tilapia, shrimpprawns, oystersclamsmussels. Random-effects meta-analyses were conducted on subsets of homogenous data by aquatic species, bacteria, and sampling region when >2 lines of data were available, otherwise summarized by medianrange.

Results: Evidence maps included 1760 relevant papers and SR-MA was prioritized for 56. Pooled prevalence data for Aeromonas, E. coli and Salmonella for retail salmon were 13% (6 to 27%), 2% (0 to 11%) and 0% (0 to 5%) respectively. Many subsets were heterogeneous. The highest proportion of studies reported Vibrio prevalence on clamsoystersmussels ranging from less than 10% to greater than 90%. Overall, there were few studies, and data gaps were identified for some large seafood exporting countries including Canada.

Conclusions: Through the scoping study we have rapidly identified and evaluated the distribution, relevance and overall utility of research pertaining to this broad topic and prioritized focused SR-MA questions relevant to our stakeholders. The data gaps and limitations identified may be used to prioritize future research and the knowledge summaries from the scoping study and SR-MA may be used in the design of targeted, risk-based surveillance, prioritising initial baseline bacteriological surveys and as inputs for risk assessments.