Evaluation of two influenza surveillance systems in South Africa

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dc.contributor.author Budgell, Eric
dc.contributor.author Cohen, Adam L.
dc.contributor.author McAnerney, Johanna M.
dc.contributor.author Walaza, Sibongile
dc.contributor.author Madhi, Shabir A.
dc.contributor.author Blumberg, Lucille H.
dc.contributor.author Dawood, Halima
dc.contributor.author Kahn, Kathleen
dc.contributor.author Tempia, Stefano
dc.contributor.author Venter, Marietjie
dc.contributor.author Chohen, Cheryl
dc.date.accessioned 2015-08-21T10:47:29Z
dc.date.available 2015-08-21T10:47:29Z
dc.date.issued 2015-03-30
dc.description S1 Table. Minimum data collection standards [12] for ILI and SARI surveillance. en_ZA
dc.description S2 Table. Influenza cases detected by subtype from SARI and ILI surveillance programmes (2009–2012), South Africa. en_ZA
dc.description S3 Table. SARI and ILI case definitions used for screening and enrolment by the SARI and Viral Watch surveillance programmes respectively, South Africa, 2009–2012. en_ZA
dc.description.abstract 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. en_ZA
dc.description.librarian am2015 en_ZA
dc.description.sponsorship The National Institute for Communicable Diseases of the National Health Laboratory Service and was supported in part by funds from the United States Centers for Disease Control and Prevention (CDC), Atlanta, Georgia Preparedness and Response to Avian and Pandemic Influenza in South Africa (Cooperative Agreement Number: U51/IP000155-04). en_ZA
dc.description.uri http://www.plosone.org en_ZA
dc.identifier.citation Budgell E, Cohen AL, McAnerney J, Walaza S, Madhi SA, Blumberg L, et al. (2015) Evaluation of Two Influenza Surveillance Systems in South Africa. PLoS ONE 10(3): e0120226. DOI: 10.1371/journal.pone.0120226. en_ZA
dc.identifier.issn 1932-6203
dc.identifier.other 10.1371/journal.pone.0120226
dc.identifier.uri http://hdl.handle.net/2263/49434
dc.language.iso en en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights © 2015 Budgell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.subject Severe acute respiratory illness en_ZA
dc.subject Viral watch en_ZA
dc.subject South Africa en_ZA
dc.subject Influenza-like illness (ILI) en_ZA
dc.subject World Health Organization (WHO) en_ZA
dc.subject South Africa (SA) en_ZA
dc.title Evaluation of two influenza surveillance systems in South Africa en_ZA
dc.type Article en_ZA


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