Evaluation of Two Influenza Surveillance Systems in South Africa

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Budgell, Eric ; Cohen, Adam L. ; McAnerney, Jo ; Walaza, Sibongile ; Madhi, Shabir A. ; Blumberg, Lucille ; Dawood, Halima ; Kahn, Kathleen ; Tempia, Stefano ; Venter, Marietjie ; Cohen, Cheryl
• Description:
  Background
  
  The World Health Organisation recommends outpatient influenza-like illness (ILI) and inpatient severe acute respiratory illness (SARI) surveillance. We evaluated two influenza surveillance systems in South Africa: one for ILI and another for SARI.
  
  Methodology
  
  The Viral Watch (VW) programme has collected virological influenza surveillance data voluntarily from patients with ILI since 1984 in private and public clinics in all 9 South African provinces. The SARI surveillance programme has collected epidemiological and virological influenza surveillance data since 2009 in public hospitals in 4 provinces by dedicated personnel. We compared nine surveillance system attributes from 2009–2012.
  
  Results
  
  We analysed data from 18,293 SARI patients and 9,104 ILI patients. The annual proportion of samples testing positive for influenza was higher for VW (mean 41%) than SARI (mean 8%) and generally exceeded the seasonal threshold from May to September (VW: weeks 21–40; SARI: weeks 23–39). Data quality was a major strength of SARI (most data completion measures >90%; adherence to definitions: 88–89%) and a relative weakness of the VW programme (62% of forms complete, with limited epidemiologic data collected; adherence to definitions: 65–82%). Timeliness was a relative strength of both systems (e.g. both collected >93% of all respiratory specimens within 7 days of symptom onset). ILI surveillance was more nationally representative, financially sustainable and expandable than the SARI system. Though the SARI programme is not nationally representative, the high quality and detail of SARI data collection sheds light on the local burden and epidemiology of severe influenza-associated disease.
  
  Conclusions
  
  To best monitor influenza in South Africa, we propose that both ILI and SARI should be under surveillance. Improving ILI surveillance will require better quality and more systematic data collection, and SARI surveillance should be expanded to be more nationally representative, even if this requires scaling back on information gathered.
  
  
• Subjects:
  Research Article
• Source:
  PLoS One. 10(3).
• Pubmed ID:
  25822719
• Pubmed Central ID:
  PMC4379032
• Document Type:
  Journal Article
• Funding:
  U51/IP000155-04/IP/NCIRD CDC HHS/United States
• Volume:
  10
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:a1b778bbf4e9e855a9b37b86a844ae88e81dda9cad90971b2fbc87e242544f33
• Download URL:
  https://stacks.cdc.gov/view/cdc/29511/cdc_29511_DS1.pdf
• File Type:
  [PDF - 1.02 MB ]