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Table 4 Challenges described for the four integration mechanisms (n = 29 studies)

From: A systematic review on integration mechanisms in human and animal health surveillance systems with a view to addressing global health security threats

Integration mechanism Challenge References
Interconnectivity Heterogeneity of data sources may affect the results of the system. [78]
Limited knowledge of terms of reference, surveillance procedures, and case definitions. [50]
False positives. [70, 95, 115]
Interoperability Linkage and management of heterogeneous data. [79, 80]
Slow adoption of technologies. [52]
Limited resources. [55, 111]
The installation of systems can be complex and expensive. [80]
Semantic consistency Heterogeneity of data sources may affect the results of the system. [121]
Low compliance with standard operational procedures. [63, 75]
Incomplete integration. [34, 53]
Convergent Poor data management systems. [66, 108]
Limited laboratory capacity. [66, 109, 125]
Different data and reporting policies among participating institutions. [108]
Quantity and complex nature of data. [76]
Organizational and structural barriers. [39, 123]
Incomplete integration. [68, 108]
Limited awareness of the standard case definition of a disease. [36]