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Eurosurveillance, Volume 6, Issue 3, 01 March 2001
Articles
Applied field epidemiology programme in Spain

Citation style for this article: Martinez Navarro JF, Herrera D, Sanchez Barco C. Applied field epidemiology programme in Spain . Euro Surveill. 2001;6(3):pii=220. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=220

J.F. Martinez Navarro, D. Herrera, Candi Sanchez Barco
Programa de Epidemiología Aplicada de Campo, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain


In 1994, the Instituto de Salud Carlos III (ISCIII; Carlos III Health Institute) of the Spanish Ministry of Health and the Consumer (MSC) created the Programa de Epidemiología Aplicada de Campo (PEAC; Applied Field Epidemiology Programme). The programme is managed by the Centro Nacional de Epidemiología (National Epidemiological Centre) in collaboration with the Escuela Nacional de Sanidad (National School of Health), and supported by General Direction for Health and Consumer of MSC and the Health Councils (Consejerías de Sanidad) of the autonomous regions.

The PEAC runs a masters degree programme in applied field epidemiology, in which degrees are conferred by the National School of Health. As PEAC is a national programme, it forms a part of the European Program for Intervention Epidemiology Training (EPIET) and is a member of the Network Training for Epidemiology Public Health Intervention (TEPHINET), the association of 27 regional and national programmes of the acting Intervention Epidemiology Training Programs.

The PEAC shares the same purpose and aims as the Epidemic Intelligence Service (EIS) of the Centers for Disease Control and Prevention (CDC) in the United States, EPIET, and other similar programmes being carried out in countries that are part of TEPHINET. These programmes aim to develop skills in epidemiological procedures, in public health communication, and a culture of serving the population in health activities. Skills are developed through hands-on training, which emphasises practical experience more than theory. The programme works within the framework of Servicios de Salud Pública (Public Health Services) and focuses on the application of disease control measures.

The PEAC trains and certifies people who work in the practical application of public health measures at different levels in Spain. Such people may work in research (mainly in infectious diseases but also health diagnosis and environmental studies) or service. The programme follows current trends in training for public health epidemiology.

Since 1994, 35 people have graduated from the programme and 13 are currently being trained. The programme is one of the strategic components in the reform process underway in disease control in Spain. It has trained and contributed to the improvement of people working at national and regional administrative levels. Applications from people who work in public health control departments, at any level, are given priority.

The programme receives funding from two sources: the ISCIII and the Dirección General de Salud Pública y Consumo, both of which are part of the Ministry of Health and Consumption. Funding terms are set down in an agreement signed by both institutions. From the outset, the programme has trained students from EPIET (Holland, Portugal, and now Germany) and from Latin America (Cuba, Argentina, and the Dominican Republic), priorities among the cooperation activities laid down by the ISCIII.

The training program lasts two years and is a full time activity. The first year of training takes place at the Centro Nacional de Epidemiología (CNE) and the second at the Servicios de Vigilancia Epidemiológica (Public Health Surveillance) of the various autonomous regions and at the CNE. Training is divided into two major sections:

  1. Theory (510 hours) – course on major principles, a workshop entitled ‘An Introduction to Public Health Surveillance’, various modules on advanced methods (epidemiological surveillance, specialised epidemiology, advanced statistics, public health planning, and communication), seminars, and work sessions.
  2. Practice – this section is aimed at developing skills and aptitudes through practical experience in epidemiological surveillance and through other types of training carried out in the field (evaluating the level of surveillance, the ecology, the breakout of epidemics, evaluating health operations). This section also focuses on the development of communication skills - both scientific (publishing epidemiological reports in the Boletín Epidemiológico Semanal [weekly epidemiological bulletin] and writing and presenting a scientific paper) and social.

In six years of existence, the PEAC has been credited with noteworthy accomplishments: 75 epidemic outbreaks have been studied, 67 studies have been carried out on how to evaluate various infectious diseases and how to analyse health conditions in different zones. Sixty-seven articles written by students of the PEAC have been published in various journals, bulletins, and on the internet. Some of the PEAC action programmes have had a direct impact on public health, such as studies of the efficacy of certain vaccines, food poisoning, an infant formula contaminated with lactosa-fermenting Salmonella Virchow and outbreaks of brucellosis in slaughterhouses.

In the past six years the programme has received two awards. One was CDC’s John Snow Award (for best investigative work) in 1997, for case control studies on acute gastroenteritis induced by Campylobacter jejuni in Mallorca. The other was the Merieux Foundation Award, which was awarded for the first time at the first international conference of TEPHINET in Ottawa, Canada, in 2000, for a study of two outbreaks of parotitis and the Rubini strain vaccine, incorporating an evaluation of vaccine efficacy.

When they leave the programme, half of our graduates change their professional activities within the field epidemiological service and are promoted to new positions in fields related to health surveillance or teaching. Seven of our graduates now hold posts within health systems, either in health surveillance or teaching.



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