An Evaluation of the Zambia Influenza Sentinel Surveillance System, 2011-2017

Abstract Background Over the past decade, influenza surveillance has been established in several African countries including Zambia. However, information on the on data quality and reliability of established influenza surveillance systems in Africa are limited. Such information would enable countries to assess the performance of their surveillance systems, identify shortfalls for improvement and provide evidence of data reliability for policy making and public health interventions. Methods We used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza surveillance system (ISS) in Zambia during 2011-2017 using 9 attributes: (i) data quality and completeness, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability, (viii) utility, and (ix) sustainability. Each attribute was evaluated using pre-defined indicators. For each indicator we obtained the proportion (expressed as percentage) of the outcome of interest over the total. A scale from 1 to 3 was used to provide a score for each attribute as follows: <60% (as obtained in the calculation above) scored 1 (weak performance); 60-79% scored 2 (moderate performance); ≥80% scored 3 (good performance). An overall score for each attribute and the ISS was obtained by averaging the scores of all evaluated attributes. Results The overall mean score for the ISS in Zambia was 2.6. Key strengths of the system were the quality of data generated (score: 2.9), its flexibility (score: 3.0) especially to monitor viral pathogens other than influenza viruses, its simplicity (score: 2.8), acceptability (score: 3.0) and stability (score: 2.6) over the review period and its relatively low cost ($310,000 per annum). Identified weaknesses related mainly to geographic representativeness (score: 2.0), timeliness (score: 2.5), especially in shipment of samples from remote sites, and sustainability (score: 1.0) in the absence of external funds. Conclusions The system performed moderately well in our evaluation. Key improvements would include improvements in the timeliness of samples shipments and geographical coverage. However, these improvements would result in increased cost and logistical complexity. The ISSS in Zambia is largely reliant on external funds and the acceptability of maintaining the surveillance system through national funds would require evaluation.

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An Evaluation of the Zambia Influenza Sentinel Surveillance System, 2011-2017

10.21203/rs.2.16794/v3 ◽

2019 ◽

Author(s):

paul simusika ◽

Stefano Tempia ◽

Edward Chentulo ◽

Lauren Polansky ◽

Mazyanga Lucy Mazaba ◽

...

Keyword(s):

Data Quality ◽

Surveillance System ◽

Low Cost ◽

Influenza Viruses ◽

Influenza Surveillance ◽

Surveillance Systems ◽

Quality Of Data ◽

African Countries ◽

Control And Prevention ◽

External Funds

Abstract Background Over the past decade, influenza surveillance has been established in several African countries including Zambia. However, information on the on data quality and reliability of established influenza surveillance systems in Africa are limited. Such information would enable countries to assess the performance of their surveillance systems, identify shortfalls for improvement and provide evidence of data reliability for policy making and public health interventions. Methods We used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza surveillance system (ISS) in Zambia during 2011-2017 using 9 attributes: (i) data quality and completeness, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability, (viii) utility, and (ix) sustainability. Each attribute was evaluated using pre-defined indicators. For each indicator we obtained the proportion (expressed as percentage) of the outcome of interest over the total. A scale from 1 to 3 was used to provide a score for each attribute as follows: <60% (as obtained in the calculation above) scored 1 (weak performance); 60-79% scored 2 (moderate performance); ≥80% scored 3 (good performance). An overall score for each attribute and the ISS was obtained by averaging the scores of all evaluated attributes. Results The overall mean score for the ISS in Zambia was 2.6. Key strengths of the system were the quality of data generated (score: 2.9), its flexibility (score: 3.0) especially to monitor viral pathogens other than influenza viruses, its simplicity (score: 2.8), acceptability (score: 3.0) and stability (score: 2.6) over the review period and its relatively low cost ($310,000 per annum). Identified weaknesses related mainly to geographic representativeness (score: 2.0), timeliness (score: 2.5), especially in shipment of samples from remote sites, and sustainability (score: 1.0) in the absence of external funds. Conclusions The system performed moderately well in our evaluation. Key improvements would include improvements in the timeliness of samples shipments and geographical coverage. However, these improvements would result in increased cost and logistical complexity. The ISSS in Zambia is largely reliant on external funds and the acceptability of maintaining the surveillance system through national funds would require evaluation.

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Evaluation of Neonatal Tetanus Surveillance System in Sana'a city, Yemen (Preprint)

10.2196/preprints.27606 ◽

2021 ◽

Author(s):

Khaled Mohammed Al-Jamrah ◽

Basheer Abdulgalil Al Nabehi ◽

Khaled Abdullah Almoayed ◽

Labiba Saeed Anam ◽

Yousef S Khader

Keyword(s):

Data Quality ◽

Surveillance System ◽

Poor Performance ◽

Neonatal Tetanus ◽

Focal Points ◽

Quality Of Data ◽

Healthcare Facilities ◽

Cdc Guidelines ◽

Usefulness Score ◽

Control And Prevention

BACKGROUND The Neonatal Tetanus Surveillance System (NTSS) in Yemen was established in 2009 to identify high-risk areas, determine trends, and evaluate elimination activities. Since its launch, the NTSS had never been evaluated. OBJECTIVE This study aimed to assess the performance of NTSS and determine its strength and weaknesses to recommend improvements. METHODS The Centers for Disease Control and Prevention (CDC) guidelines were used for evaluating the NTSS. The centrals' stakeholders, districts' surveillance coordinators, and facilities' focal points were interviewed to rate the attributes of the NTSS. The percent scores for attributes were ranked as poor (<60%), average (≥ 60- <80%) and good (≥ 80%. RESULTS The overall usefulness score percent was 38%, which indicates a poor performance. The performance of the NTSS was rated as an average on the flexibility (Score percent: 68%) and acceptability (Score percent: 64%) attributes and was rated as poor on stability (Score percent: 33%), simplicity (Score percent: 57%), and representativeness (Score percent: 39%) attributes. About 65% of investigation forms were filled within 48 hours of notification date. The data quality was poor as 41% of the core variables were missing. CONCLUSIONS The overall performance of the NTSS was poor. Most of the system attributes require improvement such as stability, simplicity, quality of data and completeness of investigation. To improve the performance of NTSS, the followings are recommended: Capacity building of staff (focal points), strengthening NTSS through technical support and government funding to ensure its sustainability, establishing an electronic investigation forms for improving the system data quality, and expansion of the NTSS coverage to include all private healthcare facilities.

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Evaluation of the Influenza Sentinel Surveillance System in the Democratic Republic of Congo, 2012-2015

10.21203/rs.2.10330/v1 ◽

2019 ◽

Author(s):

Pélagie Diambalula Babakazo ◽

Joelle Kabamba-Tshilobo ◽

Emile Okitolonda Wemakoy ◽

Léopold Lubula ◽

Léonie Kitoko Manya ◽

...

Keyword(s):

Data Quality ◽

Surveillance System ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Sentinel Surveillance ◽

World Health ◽

Influenza Surveillance ◽

Surveillance Systems ◽

Republic Of Congo ◽

Sentinel Surveillance System

Abstract Background The World Health Organization recommends periodic evaluations of influenza surveillance systems to identify areas for improvement and provide evidence of data reliability for policymaking. However, data about the performance of established influenza surveillance systems are limited in Africa, including in the Democratic Republic of Congo (DRC). Methods We used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza sentinel surveillance system (ISSS) in DRC during 2012-2015. The performance of the system was evaluated using eight surveillance attributes: (i) data quality and completeness for key variables, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability and (viii) utility. For each attribute, specific indicators were developed and described using quantitative and qualitative methods. Scores for each indicator were as follows: <60% weak performance; 60-79% moderate performance; ≥80% good performance. Results During 2012-2015, we enrolled and tested 4,339 patients with influenza-like illness (ILI) and 2,869 patients with severe acute respiratory illness (SARI) from 11 sentinel sites situated in 5 of 11 provinces. Influenza viruses were detected in 446 (10.3%) samples from patients with ILI and in 151 (5.5%) samples from patients with SARI with higher detection during December-May. Data quality and completeness was >90% for all evaluated indicators. Other strengths of the system were timeliness, representativeness, simplicity, stability and utility that scored >70% each. Flexibility and acceptability had moderate to week performance. It was reported that the ISSS contributed to: (i) a better understanding of the epidemiology, circulating patterns and proportional contribution of influenza virus among patients with ILI or SARI; (ii) acquisition of new key competences related to influenza surveillance and diagnosis; and (iii) continuous education of surveillance staff and clinicians at sentinel sites about influenza. However, due to limited resources no actions were undertaken to mitigate the impact of seasonal influenza epidemics. Conclusions The system performed overall satisfactorily and provided reliable and timely data about influenza circulation in DRC. The simplicity of the system contributed to its stability. A better use of the available data could be made to inform and promote prevention interventions especially among the most vulnerable groups.

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Detecting influenza and emerging avian influenza virus by influenza and pneumonia surveillance systems in a large city in China, 2005 to 2016

BMC Infectious Diseases ◽

10.1186/s12879-019-4405-5 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Xiaorong Guo ◽

Dong Yang ◽

Ruchun Liu ◽

Yaman Li ◽

Qingqing Hu ◽

...

Keyword(s):

Influenza Virus ◽

Avian Influenza ◽

Avian Influenza Virus ◽

Surveillance System ◽

Large City ◽

Influenza Viruses ◽

Influenza Surveillance ◽

Surveillance Systems ◽

Incident Cases ◽

Death Cases

Abstract Background Detecting avian influenza virus has become an important public health strategy for controlling the emerging infectious disease. Methods The HIS (hospital information system) modified influenza surveillance system (ISS) and a newly built pneumonia surveillance system (PSS) were used to monitor the influenza viruses in Changsha City, China. The ISS was used to monitor outpatients in two sentinel hospitals and to detect mild influenza and avian influenza cases, and PSS was used to monitor inpatients in 49 hospitals and to detect severe and death influenza cases. Results From 2005 to 2016, there were 3,551,917 outpatients monitored by the ISS system, among whom 126,076 were influenza-like illness (ILI) cases, with the ILI proportion (ILI%) of 3.55%. After the HIS was used, the reported incident cases of ILI and ILI% were increased significantly. From March, 2009 to September, 2016, there were 5,491,560 inpatient cases monitored by the PSS system, among which 362,743 were pneumonia cases, with a proportion of 6.61%. Among pneumonia cases, about 10.55% (38,260/362,743) of cases were severe or death cases. The pneumonia incidence increased each year in the city. Among 15 avian influenza cases reported from January, 2005 to September, 2016, there were 26.7% (4/15) mild cases detected by the HIS-modified ISS system, while 60.0% (9/15) were severe or death cases detected by the PSS system. Two H5N1 severe cases were missed by the ISS system in January, 2009 when the PSS system was not available. Conclusions The HIS was able to improve the efficiency of the ISS for monitoring ILI and emerging avian influenza virus. However, the efficiency of the system needs to be verified in a wider area for a longer time span in China.

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Evaluation of the Influenza Sentinel Surveillance System in the Democratic Republic of Congo, 2012-2015

10.21203/rs.2.12209/v3 ◽

2019 ◽

Author(s):

Pelagie Diambalula Babakazo ◽

Joelle Kabamba-Tshilobo ◽

Emile Okitolonda Wemakoy ◽

Léopold Lubula ◽

Léonie Kitoko Manya ◽

...

Keyword(s):

Data Quality ◽

Surveillance System ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Sentinel Surveillance ◽

World Health ◽

Influenza Surveillance ◽

Surveillance Systems ◽

Republic Of Congo ◽

Sentinel Surveillance System

Abstract Background The World Health Organization recommends periodic evaluations of influenza surveillance systems to identify areas for improvement and provide evidence of data reliability for policymaking. However, data about the performance of established influenza surveillance systems are limited in Africa, including in the Democratic Republic of Congo (DRC). Methods We used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza sentinel surveillance system (ISSS) in DRC during 2012-2015. The performance of the system was evaluated using eight surveillance attributes: (i) data quality and completeness for key variables, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability and (viii) utility. For each attribute, specific indicators were developed and described using quantitative and qualitative methods. Scores for each indicator were as follows: <60% weak performance; 60-79% moderate performance; ≥80% good performance. Results During 2012-2015, we enrolled and tested 4,339 patients with influenza-like illness (ILI) and 2,869 patients with severe acute respiratory illness (SARI) from 11 sentinel sites situated in 5 of 11 provinces. Influenza viruses were detected in 446 (10.3%) samples from patients with ILI and in 151 (5.5%) samples from patients with SARI with higher detection during December-May. Data quality and completeness was >90% for all evaluated indicators. Other strengths of the system were timeliness, simplicity, stability and utility that scored >70% each. Representativeness, flexibility and acceptability had moderate performance. It was reported that the ISSS contributed to: (i) a better understanding of the epidemiology, circulating patterns and proportional contribution of influenza virus among patients with ILI or SARI; (ii) acquisition of new key competences related to influenza surveillance and diagnosis; and (iii) continuous education of surveillance staff and clinicians at sentinel sites about influenza. However, due to limited resources no actions were undertaken to mitigate the impact of seasonal influenza epidemics. Conclusions The system performed overall satisfactorily and provided reliable and timely data about influenza circulation in DRC. The simplicity of the system contributed to its stability. A better use of the available data could be made to inform and promote prevention interventions especially among the most vulnerable groups.

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Measles Surveillance Attributes Assessment Based on The Puskesmas Surveilance Officers’ Perception in Surabaya

Jurnal Berkala Epidemiologi ◽

10.20473/jbe.v2i2.2014.171-183 ◽

2014 ◽

Vol 2 (2) ◽

pp. 171

Author(s):

Bilqis Elfira Maharani ◽

Arief Hargono

Keyword(s):

Data Quality ◽

Predictive Value ◽

Surveillance System ◽

Health Department ◽

Surveillance Systems ◽

Descriptive Research ◽

Control And Prevention ◽

Technical Guide ◽

The Republic ◽

The Stability

ABSTRACTMeasles is one of infectious diseases that potentially lead to death when complications occur. Based on the data from East Java Health Department, Surabaya is the area where the most measles cases occur in East Java and increase in the last three years. As one of measles controlling efforts, surveillance has been expected to provide qualified data and information as the basis for any decision making for a treatment or intervention. Therefore, an evaluation is needed in order to assure the effectiveness and efficiency of the surveillance application in achieving the goals. This study is a descriptive research aiming at evaluating the attributes of measles epidemiology surveillance system in Surabaya on 2012. The evaluation was done by assessing the attributes of surveillance then compared to Technical Guide for Measles Surveillance 2012, The Decree of The Health Ministry of The Republic of Indonesia No.1116/MENKES/SK/VIII/2003 On Guide for Conducting Surveillance System of Health Epidemiology and Guidelines for Evaluating Surveillance Systems from Center for Disease Control and Prevention 2001. The data collection method employed interview and observation or study documentation. The respondents of this study were 39 surveillance officers at 39 Puskesmas in Health Department Surabaya working area. The variabels of this study were simplicity, flexibility, data quality, acceptability, sensitivity, predictive value positive, representativeness, timeliness, and stability. The results of this study showed that the simplicity is complicated. The flexibility from CBMS is not flexible whereas the flexibility from EWARS is flexible. The data quality, acceptability, sensitivity and representativeness are low. The predictive value positive has not been able to be scored. The stability is high and the timeliness is punctual.Keywords: surveillance, evaluation, attribute, measles

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Evaluation of the Influenza Sentinel Surveillance System in the Democratic Republic of Congo, 2012-2015

10.21203/rs.2.12209/v1 ◽

2019 ◽

Author(s):

Pelagie Diambalula Babakazo ◽

Joelle Kabamba-Tshilobo ◽

Emile Okitolonda Wemakoy ◽

Léopold Lubula ◽

Léonie Kitoko Manya ◽

...

Keyword(s):

Data Quality ◽

Surveillance System ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Sentinel Surveillance ◽

World Health ◽

Influenza Surveillance ◽

Surveillance Systems ◽

Republic Of Congo ◽

Sentinel Surveillance System

Abstract Background The World Health Organization recommends periodic evaluations of influenza surveillance systems to identify areas for improvement and provide evidence of data reliability for policymaking. However, data about the performance of established influenza surveillance systems are limited in Africa, including in the Democratic Republic of Congo (DRC). Methods We used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza sentinel surveillance system (ISSS) in DRC during 2012-2015. The performance of the system was evaluated using eight surveillance attributes: (i) data quality and completeness for key variables, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability and (viii) utility. For each attribute, specific indicators were developed and described using quantitative and qualitative methods. Scores for each indicator were as follows: <60% weak performance; 60-79% moderate performance; ≥80% good performance. Results During 2012-2015, we enrolled and tested 4,339 patients with influenza-like illness (ILI) and 2,869 patients with severe acute respiratory illness (SARI) from 11 sentinel sites situated in 5 of 11 provinces. Influenza viruses were detected in 446 (10.3%) samples from patients with ILI and in 151 (5.5%) samples from patients with SARI with higher detection during December-May. Data quality and completeness was >90% for all evaluated indicators. Other strengths of the system were timeliness, representativeness, simplicity, stability and utility that scored >70% each. Flexibility and acceptability had moderate to week performance. It was reported that the ISSS contributed to: (i) a better understanding of the epidemiology, circulating patterns and proportional contribution of influenza virus among patients with ILI or SARI; (ii) acquisition of new key competences related to influenza surveillance and diagnosis; and (iii) continuous education of surveillance staff and clinicians at sentinel sites about influenza. However, due to limited resources no actions were undertaken to mitigate the impact of seasonal influenza epidemics. Conclusions The system performed overall satisfactorily and provided reliable and timely data about influenza circulation in DRC. The simplicity of the system contributed to its stability. A better use of the available data could be made to inform and promote prevention interventions especially among the most vulnerable groups.

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Measles Surveillance Attributes Assessment Based on The Puskesmas Surveilance Officers’ Perception in Surabaya

Jurnal Berkala Epidemiologi ◽

10.20473/jbe.v2i22014.171-183 ◽

2014 ◽

Vol 2 (2) ◽

pp. 171

Author(s):

Bilqis Elfira Maharani ◽

Arief Hargono

Keyword(s):

Data Quality ◽

Predictive Value ◽

Surveillance System ◽

Health Department ◽

Surveillance Systems ◽

Descriptive Research ◽

Control And Prevention ◽

Technical Guide ◽

The Republic ◽

The Stability

ABSTRACTMeasles is one of infectious diseases that potentially lead to death when complications occur. Based on the data from East Java Health Department, Surabaya is the area where the most measles cases occur in East Java and increase in the last three years. As one of measles controlling efforts, surveillance has been expected to provide qualified data and information as the basis for any decision making for a treatment or intervention. Therefore, an evaluation is needed in order to assure the effectiveness and efficiency of the surveillance application in achieving the goals. This study is a descriptive research aiming at evaluating the attributes of measles epidemiology surveillance system in Surabaya on 2012. The evaluation was done by assessing the attributes of surveillance then compared to Technical Guide for Measles Surveillance 2012, The Decree of The Health Ministry of The Republic of Indonesia No.1116/MENKES/SK/VIII/2003 On Guide for Conducting Surveillance System of Health Epidemiology and Guidelines for Evaluating Surveillance Systems from Center for Disease Control and Prevention 2001. The data collection method employed interview and observation or study documentation. The respondents of this study were 39 surveillance officers at 39 Puskesmas in Health Department Surabaya working area. The variabels of this study were simplicity, flexibility, data quality, acceptability, sensitivity, predictive value positive, representativeness, timeliness, and stability. The results of this study showed that the simplicity is complicated. The flexibility from CBMS is not flexible whereas the flexibility from EWARS is flexible. The data quality, acceptability, sensitivity and representativeness are low. The predictive value positive has not been able to be scored. The stability is high and the timeliness is punctual.Keywords: surveillance, evaluation, attribute, measles

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Evaluation of the Influenza Sentinel Surveillance System in the Democratic Republic of Congo, 2012-2015

10.21203/rs.2.12209/v2 ◽

2019 ◽

Author(s):

Pelagie Diambalula Babakazo ◽

Joelle Kabamba-Tshilobo ◽

Emile Okitolonda Wemakoy ◽

Léopold Lubula ◽

Léonie Kitoko Manya ◽

...

Keyword(s):

Data Quality ◽

Surveillance System ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Sentinel Surveillance ◽

World Health ◽

Influenza Surveillance ◽

Surveillance Systems ◽

Republic Of Congo ◽

Sentinel Surveillance System

Abstract Background The World Health Organization recommends periodic evaluations of influenza surveillance systems to identify areas for improvement and provide evidence of data reliability for policymaking. However, data about the performance of established influenza surveillance systems are limited in Africa, including in the Democratic Republic of Congo (DRC). Methods We used the Centers for Disease Control and Prevention guidelines to evaluate the performance of the influenza sentinel surveillance system (ISSS) in DRC during 2012-2015. The performance of the system was evaluated using eight surveillance attributes: (i) data quality and completeness for key variables, (ii) timeliness, (iii) representativeness, (iv) flexibility, (v) simplicity, (vi) acceptability, (vii) stability and (viii) utility. For each attribute, specific indicators were developed and described using quantitative and qualitative methods. Scores for each indicator were as follows: <60% weak performance; 60-79% moderate performance; ≥80% good performance. Results During 2012-2015, we enrolled and tested 4,339 patients with influenza-like illness (ILI) and 2,869 patients with severe acute respiratory illness (SARI) from 11 sentinel sites situated in 5 of 11 provinces. Influenza viruses were detected in 446 (10.3%) samples from patients with ILI and in 151 (5.5%) samples from patients with SARI with higher detection during December-May. Data quality and completeness was >90% for all evaluated indicators. Other strengths of the system were timeliness, representativeness, simplicity, stability and utility that scored >70% each. Flexibility and acceptability had moderate to week performance. It was reported that the ISSS contributed to: (i) a better understanding of the epidemiology, circulating patterns and proportional contribution of influenza virus among patients with ILI or SARI; (ii) acquisition of new key competences related to influenza surveillance and diagnosis; and (iii) continuous education of surveillance staff and clinicians at sentinel sites about influenza. However, due to limited resources no actions were undertaken to mitigate the impact of seasonal influenza epidemics. Conclusions The system performed overall satisfactorily and provided reliable and timely data about influenza circulation in DRC. The simplicity of the system contributed to its stability. A better use of the available data could be made to inform and promote prevention interventions especially among the most vulnerable groups.

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