With widespread use of the Internet, data is often shared between organizations in B2B health care networks. Integrating data across all sources in a health care network would be useful to public health surveillance and provide a complete view of how the overall network is performing. Because of the lack of standardization for a common data model across organizations, matching identities between different locations in order to link and aggregate records is difficult. Moreover, privacy legislation controls the use of personal information, and health care data is very sensitive in nature so the protection of data privacy and prevention of personal health information leaks is more important than ever. Throughout the process of integrating data sets from different organizations, consent (explicitly or implicitly) and/or permission to use must be in place, data sets must be de-identified, and identity must be protected. Furthermore, one must ensure that combining data sets from different data sources into a single consolidated data set does not create data that may be potentially re-identified even when only summary data records are created. In this thesis, we propose new privacy preserving data integration protocols for public health surveillance, identify a set of privacy preserving data integration patterns, and propose a supporting framework that combines a methodology and architecture with which to implement these protocols in practice. Our work is validated with two real world case studies that were developed in partnership with two different public health surveillance organizations.

Não se tem conhecimento preciso da relevância e magnitude das hepatites em nosso país. Os poucos estudos epidemiológicos estão restritos à populações atendidas em serviços de saúde ou a grupos de risco para as hepatites. A vigilância é um instrumento de saúde pública que tem a capacidade de descrever o comportamento das hepatites virais, bem como identificar seus fatores de risco. Um sistema de vigilância das hepatites A, B, C e E foi implantado em Vargem Grande Paulista em abril de 1997 e mantido até setembro de 1999. O objetivo foi analisar aspectos da operacionalização de um sistema de vigilância nas atuais condições de trabalho da Rede Pública de Saúde e sua potencialidade em descrever o comportamento das hepatites nessa comunidade para oferecer subsídios para elaboração e aprimoramento de estratégias de controle. O sistema incluiu a análise de dados obtidos a partir de notificação de casos suspeitos hepatite A, B, C e E entre residentes no município, assim como dados de soroprevalência de marcadores de infecção para esses mesmos vírus numa população formada pelas gestantes inscritas no Serviço Pré-natal do Município. Considerou-se caso suspeito o indivíduo residente no município de Vargem Grande Paulista e para quem, por critérios clínicos, laboratoriais ou epidemiológicos, foi solicitada a determinação dos níveis de bilirrubinas e transaminases. A confirmação dos casos foi realizada pela identificação dos marcadores sorológicos das hepatites A, B, C e E. Foram identificados 125 casos suspeitos, dos quais 41 (32,8 por cento ) foram confirmados como hepatite A, B, C ou E. A incidência de hepatite A foi 21,1/100.000 hab., 69,3/100.000 hab. e 9,3/100.000 hab. para os anos de 1997, 1998 e 1999, respectivamente. Foi detectado um surto de hepatite A em um dos bairros do município envolvendo 18 casos, no primeiro semestre de 1998. A forma predominante de transmissão do vírus durante o surto foi pessoa a pessoa e a faixa etária mais atingida foi de 5 a 9 anos. A incidência de hepatite B foi de 3,5/100.000 hab. e 9,9/100.000 hab. para os anos de 1997 e 1998 respectivamente. Não foi identificado nenhum caso em 1999. A prevalência de hepatite C foi 3,5/100.000 hab. em 1997 e 9,9/100.000 hab. em 1998. Não foi calculada a incidência de hepatite C, porque não foi possível determinar se a infecção pelo VHC era recente ou não com os testes utilizados. A incidência de hepatite E foi 3,5/100.000 hab., 3,3/100.000 hab. e 3,1/100.000 hab. para 1997, 1998 e 1999. Entre as 793 gestantes que participaram do estudo, a prevalência de anti-VHA foi de 94,7 por cento , de anti-HBc 4,9 por cento , de HBsAg 0,1 por cento , de anti-VHC 0,6 por cento , e anti-VHE 0,8 por cento . Os resultados indicaram que Vargem Grande Paulista apresentou alta endemicidade para hepatite A e baixa endemicidade para hepatite B. A prevalência de hepatite C foi semelhante à encontrada em outros estudos. A prevalência e incidência da hepatite E mostrou que o vírus circulou na região. Os dados demonstraram que o sistema de vigilância pode contribuir com informações importantes no comportamento das hepatites virais no município, oferecendo subsídios para a elaboração de estratégia de prevenção e controle dessas infecções. / A surveillance system of the hepatitis A, B, C and E was implanted in Vargem Grande Paulista In April, 1997 and maintained to September, 1999. The present study was implanted in order to analyze aspects of the surveillance system operation in the current conditions of the Public Health Service and its potentiality in describing the behavior of the hepatitis in that community to be used for elaboration and improvement of control strategies. The system included the analysis of data obtained of the notification of hepatitis A, B, C and E cases among the residents of the Municipal District, as well data of seroprevalence markers in a population formed by the pregnants registered in the Prenatal Service. The system considered suspected case the resident in Vargem Grande Paulista for who was requested the determination of the bilirubin and aminotransferases levels, by clinical, laboratory or epidemiologic criteria. The confirmation of the cases was accomplished by the identification of the hepatitis A, B, C and E serologic markers. Of the 125 suspected cases identified, 41 (32.8 per cent ) were confirmed as hepatitis A, B, C or E. The incidence of hepatitis A was 21.1 per 100,000 population, 69.3 per 100,000 and 9.3 per 100,000 for the years of 1997, 1998 and 1999, respectively. In the first semester of 1998, it was detected a hepatitis A outbreak in one of the neighborhoods, involving 18 cases. The predominant form of transmission, during the outbreak, was person to person and the 5 to 9 age-group was the most affected. The hepatitis B incidence was 3.5 per 100,000 and 9.9 per 100,000 pop. for the years of 1997 and 1998, respectively. It was not identified any case in 1999. The hepatitis C prevalence was 3.5 per 100,000 in 1997 and 9.9 per 100,000 in 1998 and its incidence was not calculated because it was not possible to determine if the HCV infection was recent or not with the used tests. The hepatitis E incidence was 3.5 per 100,000, 3.3 per 100,000 and 3.1 per 100,000 for 1997, 1998 and 1999, respectively. Among the 793 pregnants, the anti-HAV prevalence was 94.7 per cent , anti-HBc 4.9 per cent , HBsAg 0.1 per cent , anti-HCV 0.6 per cent and anti-HEV 0.8 per cent . The results indicated that Vargem Grande Paulista presented high endemicity for hepatitis A and lower for hepatitis B. The hepatitis C prevalence was similar to other studies. The hepatitis E prevalence and incidence showed that the virus circulated in the area. The data demonstrate that the surveillance system can contribute with important information to understand the behavior of the viral hepatitis to the Municipal District, can be subsidies for the elaboration of prevention and control strategy.

La surveillance de l’activité physique et des comportements sédentaires, et la question de leur mesure, sont primordiales dans un contexte où les sociétés modernes favorisent l’augmentation de l’incidence de nombreuses maladies associées à un mode de vie sédentaire. Objectif : L’objectif de cette thèse était d’approfondir les connaissances sur la surveillance et la mesure de l’activité physique et des comportements sédentaires. Méthodes : Quatre études ont été réalisées. Deux travaux analysent et discutent le système français de surveillance de l’activité physique et des comportements sédentaires des adultes et des jeunes. Une étude teste les propriétés psychométriques du questionnaire mondial sur la pratique d’activités physiques (GPAQ). Enfin, une revue de la littérature analyse le contenu des questionnaires disponibles pour mesurer les comportements sédentaires. Résultats : Les deux études portant sur la surveillance observent un manque d’homogénéité et de constance dans le choix des outils de mesure qui limite le suivi de l’évolution des pratiques. L’étude sur le GPAQ révèle des résultats, en termes de reproductibilité et de validité, similaires aux valeurs habituellement observées. Enfin, la revue de littérature a mis en évidence que les questionnaires mesurant les comportements sédentaires présentent des différences en termes de population cible, période de rappel, nombre d’item, et caractéristiques des comportements sédentaires mesurés. Conclusion : Des recommandations ont été formulées afin d’améliorer la mesure et la surveillance de l’activité physique et des comportements sédentaires en France / Physical activity and sedentary behaviors are major health determinants and are being surveyed worldwide. Objective: The aim of this thesis was to contribute to the surveillance and measurement of physical activity and sedentary behaviors. Method: This thesis includes four studies. The first study analyzes and discusses the present situation of French national surveillance studies. The second study presents the results from the first French report card on physical activity for children and adolescents. The third study discusses the validity and reliability properties of the French version of the Global Physical Activity Questionnaire (GPAQ). The fourth study examines the content of questionnaires measuring sedentary behaviors. Results: Studies 1 and 2 reported measurement issues impairing the overall data quality, inter-study comparisons and survey of changes over time. The study of GPAQ reported limited but acceptable reliability and validity for the measurement of physical activity and sedentary time in France. Finally, the systematic review on sedentary behaviors questionnaires reported large differences in the population targeted (ex: adults, youth, elderly), recall frame (ex: previous day, last 7 days, last month), the number of item (from 1 to more than 100), and the sedentary behaviors characteristics measured (from only sitting time to up to 27 sedentary behaviors). Conclusion: The work realized during this thesis allows the formulation of recommendations to improve the surveillance of physical activity and sedentary behaviors in France

A Vigilância à Saúde se constitui como Modelo Assistencial com potencial para a reorganização dos processos de trabalho, a partir da análise de problemas de saúde de grupos sociais de determinado território, valendo-se da intersetorialidade e da participação popular. Neste sentido, o presente estudo teve como objetivo, geral, identificar e analisar a estruturação das ações de vigilância no âmbito da Atenção Básica à Saúde em uma região de saúde. Para tanto, foram entrevistados gerentes de Unidades Básicas de Saúde, da Supervisão de Vigilância Epidemiológica e trabalhadores responsáveis pela Vigilância Epidemiológica de Unidades Básicas de Saúde da Supervisão Técnica de Saúde do Butantã, no Município de São Paulo, totalizando 14 sujeitos. As entrevistas, realizadas no período de fevereiro a abril de 2006, foram gravadas e transcritas na íntegra, sendo resguardadas as devidas precauções éticas. O material foi analisado segundo técnica apropriada de análise de discurso, no marco teórico materialista histórico e dialético dos conceitos de processos de trabalho e saúde-doença. A vigilância epidemiológica constituiu-se como a prática predominante, incluindo seus instrumentos de trabalho tradicionais. Os principais agentes desse trabalho são a enfermeira, que mais se detém no gerenciamento das ações; os auxiliares de enfermagem, voltados para a intervenção sobre os processos de adoecimento; e os agentes comunitários de saúde em ações no âmbito extra-muros. O trabalho se apresentou fragmentado, com ações pontuais, restritas ao evento (a doença ou o surto), sem alcançar a prevenção da saúde e com tendência à alienação do trabalhador. Por outro lado, verificou-se, principalmente, que os profissionais interpretavam a vigilância à saúde de duas formas: pela ampliação do objeto da vigilância epidemiológica e integrando-se a assistência à informação em saúde; e como prática que organiza o serviço, considerando-se a unidade dialética indivíduo/coletivo que habita o território adstcrito à Unidade Básica de Saúde. Esta ultima ainda contempla a participação da população na detecção de problemas e no planejamento das ações, assim como a intersetorialidade, para alcançar a promoção da saúde. A contradição entre o conteúdo dos depoimentos e a prática da vigilância à saúde foi evidente em todas unidades investigadas. Foram identificados como limitantes para a implementação da vigilância à saúde, a precariedade de estrutura para o trabalho, incluindo a insuficiência quantitativa de recursos humanos, assim como em relação à qualificação profissional apropriada; a precariedade de recursos materiais e físicos; além da falta de incentivo político-gerencial e de participação da população para operar as ações de vigilância no sentido ampliado. Conclui-se que, no nível local, reside um potencial para transformar a organização do trabalho em saúde, atendendo-se às necessidades de saúde da população, através do Modelo da Vigilância à Saúde, a partir do trabalho em equipe e da integração da assistência à informação em saúde. Para tanto, é imprescindível a participação ativa e aliada dos trabalhadores e usuários de saúde, bem como a implantação da Educação Permanente em Saúde no âmbito das Supervisões Técnicas de Saúde para se alavancar e acompanhar esse processo / The Health Surveillance is constituted as an Assistance Model with potential to reorganize work processes, from the analysis of health problems of social groups in a specific territory, using the intersectoriality and the population participation. In this sense, the present study aimed, in general, to identify and analyze the structure of surveillance actions in the scope of Basic Health Attention in a determined region for health care. For doing so, managers of Health Basic Units, Epidemiologic Surveillance Supervision and workers responsible for Epidemiologic of Health Care Units from the Health Technical Supervision of Butantã were interviewed in the city of Sao Paulo, making up 14 subjects. The interviews were made between February and April 2006, recorded and completely transcript, keeping the ethical precautions. The material was analyzed according to appropriate technique of discourse analysis, in the historic materialist theoretical mark and dialectic of concepts of health-disease and the processes of work. The epidemiological surveillance is seen as predominant practice, including its instruments of traditional work. The main agents in this work are the nurses, who mostly manage these acts; the nursing auxiliaries, turned to the intervention on the sickening process; and the health community agents in actions of outreach scope. Their work was found fragmented, with punctual actions restricted to the event (the illness or outbreak), without achieving health prevention and tended to alienate the worker. On the other hand, it was verified, mainly, that providers interpreted health surveillance in two ways: by the amplification of the object of epidemiologic surveillance and integrate it to assistance of health information, and a practice that organizes the service, considering itself as an individual/collective dialectics unit that resides the territory enlisted in the Basic health Unit. The latter still contemplates the participation of the population in detecting the problems and planning the actions, as well as intersectoriality to attain health promotion. The contradiction between statement content and the practice of health surveillance was evident in all the units searched. The precariousness of work structure, including the quantitative insufficiency of human resources, as well as related to the appropriateness of professional qualification; the precariousness of physical and material resources were all identified as barriers to implement health surveillance; besides the lack of management-political funding and the participation of the population to develop surveillance actions in a broad sense. It can be concluded that, in a local level, there is a potential to change the organization of health work, meeting the health needs of the population through a Health Surveillance Model, by teamwork and the integration of assistance in health information. For doing that, it’s imperative the active and allied participation of health workers and their users, as well as the implementation of Permanent Education in Health in the scope of Health Technical Supervisions to get it on and follow up this process

Prevention and slowing the progression, of chronic diseases ( such as cancer, heart disease, arthritis, diabetes, asthma, osteoporosis, dementia and incontinence ), and influencing risk factors and health behaviours of a population, relies on the best available data - driven evidence. The quality of measurement techniques to collect representative population health survey and surveillance data is, as a consequence, brought under scrutiny. The presentation of this thesis is the culmination of 17 years work that has been focused on contributing to improving public health in South Australia. It is premised on the understanding that continual epidemiological assessment using representative population health surveys can deliver evidence - based information needed by health policy makers, health planners and health promoters to make appropriate, timely and efficient evidence - based decisions. The objective of the portfolio of published papers was to demonstrate the contribution to producing quality data - driven evidence using population surveys through rigour in collecting self - reported data, diversifying surveillance data collection methods and facilitating collaboration. This portfolio presents papers that have addressed a range of methodological and chronic disease and risk factor epidemiological issues. In terms of demonstrating rigour the publications have addressed the bias associated with non - response, the methodological rigour inherent in face - to - face surveys, the differences in estimates that can occur based on mode of administration, the science of telephone surveying and the importance of good questionnaire design to produce valid and meaningful data. The literature presented has also demonstrated the first South Australian population - wide prevalence survey dealing with the consequences of domestic violence and associated issues ( for males and females ) in the community, and in doing so, demonstrated the use of the telephone to collect large - scale data in Australia on domestic violence and associated factors in the population. In addition, the first time the importance of undertaking an array of methodological precautions during the data collection phase associated with collecting data on sensitive health issues on the telephone was demonstrated in Australia as was the assessment of the bias obtained in health estimates dependent upon which telephone - based sample was used. In demonstrating the need for diversity in data collection the research submitted within this thesis has demonstrated the range of telephone surveying development issues and challenges in Australia and the benefits and the value of both face - to - face and telephone as survey data collection tools in Australia. The publications also made a significant contribution to the literature in the survey methodology area, in particular, within the systematic error in questionnaire design, the measurement error in BMI self - reported measurements, validity of self - reported height and weight, and the overall CATI methodology area. Epidemiological collaborative research in particular in the areas of social capital, HRT, mental health, suicide ideation, osteoporosis, interpersonal violence, chronic disease epidemiology and risk factor epidemiology was demonstrated. As a consequence of my research, surveying populations about their health is now entrenched into public health and health service sectors in SA. Rigour in collecting self - reported data, diversifying survey and surveillance data collection methods and facilitating collaboration, has produced quality date - driven evidence for South Australia. / Thesis (Ph.D.)--University of Adelaide, School of Medicine, Discipline of Medicine, 2006.

With widespread use of the Internet, data is often shared between organizations in B2B health care networks. Integrating data across all sources in a health care network would be useful to public health surveillance and provide a complete view of how the overall network is performing. Because of the lack of standardization for a common data model across organizations, matching identities between different locations in order to link and aggregate records is difficult. Moreover, privacy legislation controls the use of personal information, and health care data is very sensitive in nature so the protection of data privacy and prevention of personal health information leaks is more important than ever. Throughout the process of integrating data sets from different organizations, consent (explicitly or implicitly) and/or permission to use must be in place, data sets must be de-identified, and identity must be protected. Furthermore, one must ensure that combining data sets from different data sources into a single consolidated data set does not create data that may be potentially re-identified even when only summary data records are created. In this thesis, we propose new privacy preserving data integration protocols for public health surveillance, identify a set of privacy preserving data integration patterns, and propose a supporting framework that combines a methodology and architecture with which to implement these protocols in practice. Our work is validated with two real world case studies that were developed in partnership with two different public health surveillance organizations.

For the last several decades, sequential change point problems have been studied in both the theoretical area (sequential analysis) and the application area (industrial SPC). In the conventional application, the baseline process is assumed to be stationary, and the shift pattern is a step function that is sustained after the shift. However, in biosurveillance, the underlying assumptions of problems are more complicated. This thesis investigates several issues in biosurveillance such as non-homogeneous populations, spatiotemporal surveillance methods, and correlated structures in regional data. The first part of the thesis discusses popular surveillance methods in sequential change point problems and off-line problems based on count data. For sequential change point problems, the CUSUM and the EWMA have been used in healthcare and public health surveillance to detect increases in the rates of diseases or symptoms. On the other hand, for off-line problems, scan statistics are widely used. In this chapter, we link the method for off-line problems to those for sequential change point problems. We investigate three methods--the CUSUM, the EWMA, and scan statistics--and compare them by conditional expected delay (CED). The second part of the thesis pertains to the on-line monitoring problem of detecting a change in the mean of Poisson count data with a non-homogeneous population size. The most common detection schemes are based on generalized likelihood ratio statistics, known as an optimal method under Lodern's criteria. We propose alternative detection schemes based on the weighted likelihood ratios and the adaptive threshold method, which perform better than generalized likelihood ratio statistics in an increasing population. The properties of these three detection schemes are investigated by both a theoretical approach and numerical simulation. The third part of the thesis investigates spatiotemporal surveillance based on likelihood ratios. This chapter proposes a general framework for spatiotemporal surveillance based on likelihood ratio statistics over time windows. We show that the CUSUM and other popular likelihood ratio statistics are the special cases under such a general framework. We compare the efficiency of these surveillance methods in spatiotemporal cases for detecting clusters of incidence using both Monte Carlo simulations and a real example. The fourth part proposes multivariate surveillance methods based on likelihood ratio tests in the presence of spatial correlations. By taking advantage of spatial correlations, the proposed methods can perform better than existing surveillance methods by providing the faster and more accurate detection. We illustrate the application of these methods with a breast cancer case in New Hampshire when observations are spatially correlated.

[Truncated abstract] Gastroenteritis is frequently associated with a food or water borne source and the investigation of such cases is undertaken to identify potential sources of infection. Where contaminated food or water are identified as the source of infection/intoxication, action may be taken to limit or prevent further people being affected, and in so doing limit costs to the health care system. This study was undertaken to determine if there is a more effective and efficient way to collect information from patients with certain enteric illnesses. This was based on a trial process of posting self-administered questionnaires with a reply-paid return envelope to the patient and compared with the existing process where local government Environmental Health Officers interview the patient and provide a report to the Department of Health. A limiting factor in the existing process is the time lapse between the onset of illness and follow-up by Environmental Health Officers (EHOs), which results in difficulties in contacting the patient and obtaining a dietary history. Furthermore, the existing system is resource intense, requiring officers to individually interview patients either in person or by telephone. The study was of those patients living in the Perth metropolitan area whose doctor notified the Department of Health that the patient had contracted any of three notifiable enteric illnesses (campylobacterosis, giardiasis or salmonellosis), and the patient was not part of a known outbreak and was assessed as not requiring urgent follow-up. The trial process was used for patients living in five local government areas and the return rate, timeliness of return and completeness of questionnaires in the trial process was compared with the reports returned under the existing process of investigation and reporting by EHOs from 24 metropolitan local government areas that were not part of the trial process. An estimate of the potential costs to local government and the Department of Health was undertaken for both the existing and trial processes of collecting information from patients. A survey of local government EHOs in the metropolitan area was also undertaken to assess the perception of EHOs about roles and responsibilities in the follow-up investigation, the use of the Enteric Disease Investigation Report (EDIR) and the limitations that they identified in the current investigation process.

abstract: Public health surveillance is a special case of the general problem where counts (or rates) of events are monitored for changes. Modern data complements event counts with many additional measurements (such as geographic, demographic, and others) that comprise high-dimensional covariates. This leads to an important challenge to detect a change that only occurs within a region, initially unspecified, defined by these covariates. Current methods are typically limited to spatial and/or temporal covariate information and often fail to use all the information available in modern data that can be paramount in unveiling these subtle changes. Additional complexities associated with modern health data that are often not accounted for by traditional methods include: covariates of mixed type, missing values, and high-order interactions among covariates. This work proposes a transform of public health surveillance to supervised learning, so that an appropriate learner can inherently address all the complexities described previously. At the same time, quantitative measures from the learner can be used to define signal criteria to detect changes in rates of events. A Feature Selection (FS) method is used to identify covariates that contribute to a model and to generate a signal. A measure of statistical significance is included to control false alarms. An alternative Percentile method identifies the specific cases that lead to changes using class probability estimates from tree-based ensembles. This second method is intended to be less computationally intensive and significantly simpler to implement. Finally, a third method labeled Rule-Based Feature Value Selection (RBFVS) is proposed for identifying the specific regions in high-dimensional space where the changes are occurring. Results on simulated examples are used to compare the FS method and the Percentile method. Note this work emphasizes the application of the proposed methods on public health surveillance. Nonetheless, these methods can easily be extended to a variety of applications where counts (or rates) of events are monitored for changes. Such problems commonly occur in domains such as manufacturing, economics, environmental systems, engineering, as well as in public health. / Dissertation/Thesis / Ph.D. Industrial Engineering 2010

Made available in DSpace on 2016-06-07T17:12:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-02-25. Added 1 bitstream(s) on 2016-06-07T17:16:39Z : No. of bitstreams: 1 000864325.pdf: 2275659 bytes, checksum: f41330c86206305561653bc7b4a076b6 (MD5) / Recursos humanos para a detecção, investigação e resposta às emergências são fundamentais e de difícil treinamento. O Field Epidemiology Training Program (FETP) é um modelo de treinamento em serviço, que fora iniciado nos EUA, e existe em mais de 57 países. Esse estudo objetiva descrever os programas de treinamentos FETP da Argentina, Brasil, Colômbia e Peru, bem como, seus respectivos graduados, a fim de identificar pontos em comum e avaliar a sua contribuição nas respostas a possíveis emergências em saúde pública. Realizou-se dois estudos de corte transversal: um inquérito com coordenadores dos programas de FETP e outro com graduados dos referidos programas. Os quatro coordenadores responderam ao questionário e seus respectivos programas abordam: competências nas áreas de análise de situação de saúde, bioestatística, comunicação em saúde, analise econômica, cobertura vacinal, gestão e liderança, informática aplicada a saúde, uso de laboratório para saúde pública e biossegurança, ensino e tutoria dos profissionais, preparação para desastres, priorização de agravos e eventos transmissíveis e não transmissíveis e vigilância em saúde. Somente profissionais formados na área da saúde podem participar do treinamento, com exceção do programa colombiano. As atividades principais a serem desenvolvidos durante o treinamento são: investigar e redigir relatório de surto ou emergências em saúde pública, avaliar sistema de vigilância em saúde e realizar um estudo planejado. Com exceção da Argentina, os programas tiveram interrupção de seleção de turmas. A proporção de respostas dos graduados ao questionário foi de 75% (275) e a formação acadêmica mais frequente foi medicina com exceção do treinamento brasileiro. A melhora na qualificação, variou de 83% a 95% e o reconhecimento profissional, de 84% a 65%. Menor proporção foi relatada para o reconhecimento financeiro que variou de 46%... / Human resources for the detection, investigation and response to public health emergencies are essential and difficult to train. The Field Epidemiology Training Program (FETP) model started in USA in the 1950's and today exists in more than 57 countries. This study aims to describe the FETP training of Argentina, Brazil, Colombia and Peru, as well as their graduates in order to identify common characteristics and to evaluate its contribution in the responses to potential public health emergencies. We conducted two cross-sectional studies: a survey with program coordinators and other with graduates of these programs. The four coordinators answered the survey and all programs address competencies related to: health situation analysis; biostatistics; health communication, prevention and effectiveness, vaccine coverage, management and leadership, informatics applied to health, laboratory use for public health and biosafety, education and mentoring of professionals, disasters preparedness, diseases and communicable and non-communicable events prioritizing, in addition to public health surveillance. Only health professionals can participate in the training, except for the Colombian program. The deliverables to be developed during the training are: investigate and write outbreak or public health emergency report, evaluate a public health surveillance system and perform a planned study. With exception of the Argentinean program, the other programs had years without new selections. The proportion of graduates' responses to the questionnaire was 75% (275) and the most common academic education was medicine, with the exception of the Brazilian program. The improvement in the quality ranged from 95% to 83% and professional recognition, from 84% to 65%. Lower proportion was reported to financial recognition, which ranged from 46% to 29%. Anyway, about 80% reported that the program meets its objectives. Currently, the majority of graduates (55% to ...