The mandatory reporting system for HIV infection and AIDS relies on the submission of information via the e-DO application.

Diagnoses of HIV infection must be reported independently by each reporting party (clinician and laboratory technician) in the e-DO application. Both types of reports are necessary; they are not redundant because the information requested from laboratory technicians and clinicians is different and complementary. AIDS diagnoses are reported solely by the clinician.

As part of HIV virological surveillance (based on the voluntary participation of the patient and the laboratory technician), laboratory technicians send a serum sample (residue from the tube used for the diagnosis) on filter paper to the National HIV Reference Center, accompanied by a copy of their report, printed from the e-DO application. The CNR performs additional tests on this sample and enters the results directly into e-DO.

The Regional Health Agency (ARS) can view the reports entered by reporters and monitor the surveillance system’s performance (number of reports per month, overall or by report type or by the reporter’s practice location, etc.).

Santé publique France, along with the ARS, accesses the reports submitted by reporters, compiles reports concerning the same patient into a virtual file, contacts the reporter if necessary to obtain further details, and follows up with reporters who have not submitted their portion of the report.

Once in the e-DO application, the reporter selects the tuberculosis report they wish to submit (TM, ITL, treatment outcome) and fills out the report form directly online. The process takes just a few minutes. Once the form is completed, the reporter sends the report to the ARS electronically, with a single click of the mouse. All other stakeholders involved in tuberculosis surveillance can participate in this reporting system within e-DO. The main roles include validating the report by filing it in a case (ARS), verifying the information and, if necessary, requesting additional information (CLAT), entering biological data (testing laboratories), and validating multidrug-resistant tuberculosis cases (CNR-MyRMA). Teams at Santé publique France at the national and regional levels can extract data and perform preliminary analyses (during the year) or final analyses after the national file has been validated. These analyses can be conducted routinely once a year, or during the year, for example, at the request of an ARS. The calculated indicators provide public authorities with information on the epidemiology of tuberculosis in France and enable the transmission of these data to international bodies (ECDC, WHO). Although it is still possible to report using the “paper” form, the objective of e-DO is the complete digitization of the system to simplify the process and access to it, improve the quality and completeness of the data, enhance responsiveness by replacing paper-based transmission with electronic transmission, and, finally, reduce the workload associated with filling out and entering forms by the various stakeholders in the reporting process.

Since 2019 for regional health agencies and starting in 2022 for reporters, tuberculosis reporting is done online via the e-DO application.

• Download the tutorial: HIV/AIDS Reporting Criteria

Tuberculosis:

• Any confirmed case of tuberculosis (positive culture for M. tuberculosis OR positive microscopy (BAAR+) with a positive PCR for M. tuberculosis) or probable case (clinical and/or radiological signs consistent with tuberculosis AND a physician’s decision to treat the patient with standard antituberculosis therapy)

Treatment outcome:

• Any case of active tuberculosis reported within 12 months of the start of treatment or diagnosis

Tuberculosis infection (ITL):

• Child/adolescent under 18 years of age with no clinical or radiological signs of tuberculosis but with a positive 5U tuberculin skin test (>10 mm, or >15 mm if BCG-vaccinated, or an increase of 10 mm compared to a tuberculin skin test performed within the past 2 years) OR a positive result on an interferon-gamma release assay (IGRA)

e-DO is the application designed for the mandatory online reporting of HIV infection, AIDS, and tuberculosis. Regardless of the type of report, e-DO can be accessed via the single link http://www.e-do.fr/.

Once registered, the reporter has access to their account and can choose to submit an HIV/AIDS or tuberculosis report, as well as access a number of features, such as responding to a request for additional information or adding information to a report that has already been submitted.

Your CPS card must be connected to your computer, and you must know the associated PIN.

Authentication for the app relies on healthcare professional cards (CPS) or other cards in the CPS family (CPA, CPE, etc.). These electronic cards, issued by the Digital Health Agency (ANS), verify the identity of healthcare professionals (ANS. CPS Portal. Available at: https://esante.gouv.fr/securite/cartes-et-certificats/CPS.

They are automatically distributed by the ANS to all healthcare professionals registered with the Orders of Physicians, Pharmacists, Midwives, and Dental Surgeons. Cards must be ordered from the ANS for non-medical healthcare professionals employed by a healthcare facility or an authorized entity (e.g., Santé publique France, ARS, etc.) who need to log in to the e-DO application.

Using CPS family cards requires the prior installation of a card reader on the user’s computer.

For more information and legal texts, see the bottom of this page.

Each user must create an account and provide a valid email address.

Each account is associated with one or more profiles. For example, for the reporting entity, the profile may be that of a clinician or a biologist. A surveillance partner (CNR, CLAT) has its own profile that allows it to access specific features, as do non-reporting entities (SpFrance, ARS).

When creating an account, the screen offers three registration options depending on the desired profile (reporting entity, partner, or non-reporting entity).

Once the account and profile have been created, users can begin using e-DO. A user may then create additional profiles (for example, if they work at two different locations).

After creating an account, a user may authorize another person to submit reports in e-DO on their behalf. For example, a clinical trial technician or a resident may submit reports on behalf of the head of the department, provided that the head of the department has authorized them to do so.

As an e-DO user, in accordance with the provisions of Articles 39 and 40 of Law No. 78-17 of January 6, 1978, on Information Technology, Data Files, and Civil Liberties, you may access and modify your personal data directly through your account; you may also deactivate your account.

Reporters

The app allows users to enter and submit reports of HIV infection and AIDS directly to health authorities. Reporters have access to a "draft" feature that lets them start their report and continue it within a 12-month period. The first step in the reporting process is to generate an anonymity code, which is stored in the app for 12 months. No personally identifiable patient data is recorded. Reporters have access to submitted reports for 12 months. In the event of missing information or inconsistencies in the submitted reports, communication between Santé publique France epidemiologists and reporters takes place via e-DO.

Regional Health Agencies (ARS) and Santé publique France

Reports submitted by laboratory technicians and clinicians via the app are immediately available to both the ARS and Santé publique France. Authorized staff at the ARS can view reports submitted by reporters practicing in their region for 12 months.

CNR for HIV

The CNR receives a serum sample on filter paper from the laboratory technician. The CNR has access to all reports submitted by laboratory technicians, allowing it to enter the results of its additional tests directly into e-DO, linking these results to the laboratory technician’s report.

Santé publique France

Santé publique France has access to the reports as soon as the reporter clicks “send,” can, if necessary, send requests for additional information to reporters via e-DO, can follow up with co-reporters when only one of the two parts (laboratory technician or clinician) has been submitted, consolidates HIV/AIDS reports concerning the same patient into a virtual patient record, and generates exports from the received reports and created patient records.

Reporters

The e-DO application allows users to enter and directly submit a tuberculosis report (TM, ITL, treatment outcome) to regional health authorities (ARS). The "draft" feature allows users to start a report and continue it within 12 months. Submitted reports remain visible in the reporter’s account for 5 years. Other actions that can be performed by a reporter include searching for reports, submitting additional information, and entering treatment outcomes at the request of the ARS or CLAT.

Other stakeholders in surveillance

Regional Health Agencies (ARS)

When a report is sent to the ARS, it files it in a case file and, in doing so, assigns it to a CLAT in the region, which is notified by email. Thus, for each case entered into e-DO, a case file is created into which all reports for that person will subsequently be integrated: additional information, treatment outcome. Each file, which is unique to a patient, has a unique file number and an anonymization code. A file may therefore contain multiple reports. This file can be modified by the ARS and the CLAT to correct information or add additional details.

The CLAT

The CLAT has access to the file assigned to it by the ARS and can “act” on it: modify it, transfer it to another ARS or another CLAT, or request additional information from the reporter. Each person using e-DO within a CLAT creates a profile that is shared among all users of that CLAT, allowing them to share information and manage the patient collaboratively. A CLAT physician can also create a reporting profile to report cases (which is not possible with a CLAT profile). Thus, a CLAT physician can have multiple profiles for different roles. This is also the case for reporters, who can create multiple profiles when they work, for example, in different locations.

The National Tuberculosis Reference Center (CNR-MyRMA)

The CNR also has access to e-DO. Like Santé publique France, it has access to non-identifying data, unlike the ARS and CLATs, which have access to indirectly identifiable data, allowing them to manage the patient. This indirectly identifiable data is retained for 5 years, whereas for reporters and the CNR, non-identifying data remains visible in their e-DO space for 5 years. The CNR plays a fundamental role in confirming MDR tuberculosis: it is notified when an MDR report has been classified by the ARS. By accessing e-DO, it confirms (or does not confirm) this MDR tuberculosis. When this is done, the CLAT and ARS are informed, which allows them to notify the reporting entity.

Mycobacteriology laboratories

Mycobacteriology laboratories have access to e-DO and can report a patient or enter results from microscopic examination, PCR, culture, genotyping, or phenotypic susceptibility testing for first-line anti-tuberculosis drugs.

Santé publique France

Santé publique France has access to the reports (indirectly identifiable) and individual data files (indirectly identifiable), which it can export and analyze. An automated email notifies the national level of SpFrance whenever tuberculosis is reported in a child under 2 years of age or severe tuberculosis (meningeal or miliary) is reported in a child under 15 years of age. This system allows for real-time monitoring of the incidence of tuberculosis in young children and the impact of the suspension of mandatory BCG vaccination on the epidemiology of pediatric tuberculosis.

• Tutorials:

  • HIV/AIDS:

    • HIV/AIDS Reporting Criteria

    • General Information

    • Create an account, a profile, or an authorization

    • Submit a report (for clinicians)

    • Submit a report (for the laboratory technician)

    • Respond to a follow-up

    • Respond to a request for additional information

    • Edit a report (for the reporter)

    • Edit a report (for ARS and regional units of Santé publique France)

    • LaboVIH (for the biologist)

  • Tuberculosis:

    • Create an account with a profile

    • Submit a report

    • File a report in a case

    • Transfer a file or a report

    • Edit a case and request additional information

    • Follow up on the status of a case

    • Export data and generate a report

• Videos for reporters:

  • Tuberculosis (playlist of 8 videos available)

• Frequently Asked Questions:

  • HIV/AIDS

  • Tuberculosis

• Procedures and informational messages

  • Tuberculosis:

    • e-DO Tuberculosis Training | New Format

    • Email links in e-DO messages

    • Treatment Outcome Reports

    • Data Cleaning and Completeness

    • Variable dictionary

    • Classification of "difficult" cases in e-DO

    • Classification of treatment outcomes by the ARS

If the online support documents (FAQs, tutorials, etc.) have not helped you resolve your issues, you can contact the e-DO Info Service at the e-DO Info Service number:

• e-DO Brochure: HIV/AIDS Edition

• e-DO brochure: Tuberculosis version

• Decision 2015-344 of October 6, 2015 (authorization request No. 1818160). National Commission for Information Technology and Civil Liberties.

• Order amending the model notification form set forth in Annex 29 of the Order of August 22, 2011, regarding the mandatory reporting of infectious diseases and other diseases mentioned in Article D.3113-7 of the Public Health Code.

• DGS Instruction of July 4, 2016, regarding the rollout of the e-DO application for the online reporting of HIV/AIDS infection.

• Order of February 17, 2021, amending the tuberculosis reporting form and setting the retention period for identifying data at 5 years.

• DGS Directive of July 1, 2021, and the 4 annexes announcing the launch of online tuberculosis reporting.