biostudies-literatureHegde STResearch and Policy for Infectious Disease DynamicsFIC NIH HHSNational Science Foundation/NIH Ecology and Evolution of Infectious DiseasesNational Institutes of HealthNIHRAPIDD1219-1227https://www.ebi.ac.uk/biostudies/studies/S-EPMC6693802biostudies-literatureUnknown48(4)<h4>Background</h4>Understanding the true burden of emergent diseases is critical for assessing public-health impact. However, surveillance often relies on hospital systems that only capture a minority of cases. We use the example of Nipah-virus infection in Bangladesh, which has a high case-fatality ratio and frequent person-to-person transmission, to demonstrate how healthcare-seeking data can estimate true burden.<h4>Methods</h4>We fit logistic-regression models to data from a population-based, healthcare-seeking study of encephalitis cases to characterize the impact of distance and mortality on attending one of three surveillance hospital sites. The resulting estimates of detection probabilities, as a function of distance and outcome, are applied to all observed Nipah outbreaks betweenInternational journal of epidemiologyUsing healthcare-seeking behaviour to estimate the number of Nipah outbreaks missed by hospital-based surveillance in Bangladesh.PMC66938022R01-TW005869R01 TW00586907–015-0712–52200Daszak PLuby SPSazzad HMSNichol STHossain MJHegde STRahman MKlena JDGurley ESSalje HfalseUsing healthcare-seeking behaviour to estimate the number of Nipah outbreaks missed by hospital-based surveillance in Bangladesh.<h4>Background</h4>Understanding the true burden of emergent diseases is critical for assessing public-health impact. However, surveillance often relies on hospital systems that only capture a minority of cases. We use the example of Nipah-virus infection in Bangladesh, which has a high case-fatality ratio and frequent person-to-person transmission, to demonstrate how healthcare-seeking data can estimate true burden.<h4>Methods</h4>We fit logistic-regression models to data from a population-based, healthcare-seeking study of encephalitis cases to characterize the impact of distance and mortality on attending one of three surveillance hospital sites. The resulting estimates of detection probabilities, as a function of distance and outcome, are applied to all observed Nipah outbreaks between2019-01-01T00:00:00Z2019 Aug2025-04-05T15:17:50.182Z2025-04-05T15:17:50.182ZS-EPMC66938023097780310.1093/ije/dyz057