Abstract
BackgroundInfluenza surveillance helps time prevention and control interventions especially where complex seasonal patterns exist. We assessed influenza surveillance sustainability in Africa where influenza activity varies and external funds for surveillance have decreased.MethodsWe surveyed African Network for Influenza Surveillance and Epidemiology (ANISE) countries about 2011‐2017 surveillance system characteristics. Data were summarized with descriptive statistics and analyzed with univariate and multivariable analyses to quantify sustained or expanded influenza surveillance capacity in Africa.ResultsEighteen (75%) of 24 ANISE members participated in the survey; their cumulative population of 710 751 471 represent 56% of Africa's total population. All 18 countries scored a mean 95% on WHO laboratory quality assurance panels. The number of samples collected from severe acute respiratory infection case‐patients remained consistent between 2011 and 2017 (13 823 vs 13 674 respectively) but decreased by 12% for influenza‐like illness case‐patients (16 210 vs 14 477). Nine (50%) gained capacity to lineage‐type influenza B. The number of countries reporting each week to WHO FluNet increased from 15 (83%) in 2011 to 17 (94%) in 2017.ConclusionsDespite declines in external surveillance funding, ANISE countries gained additional laboratory testing capacity and continued influenza testing and reporting to WHO. These gains represent important achievements toward sustainable surveillance and epidemic/pandemic preparedness.
Highlights
Sentinel surveillance in African countries for viral respiratory infections such as influenza is important for prevention and control, funding for such activities has steadily decreased making its sustainability uncertain
During the sixth ANISE25 meeting in Antananarivo, Madagascar in 2018, we invited ANISE member states to participate in Influenza Surveillance in Africa (InSAFRO), a survey to assess surveillance systems in Africa and their participation in the World Health Organization's (WHO) Global Influenza Surveillance and Response System (GISRS)
Countries with influenza vaccines in the private sector reported an average of 27 797 samples to FluNet vs 13 202 among those without vaccines in the private sector (P < .0001); data about vaccine use in the private sector for Malawi and Mozambique were unavailable for this analysis
Summary
Sentinel surveillance in African countries for viral respiratory infections such as influenza is important for prevention and control, funding for such activities has steadily decreased making its sustainability uncertain. Most African countries who are members of ANISE have previously used their influenza-like illness (ILI) and/or severe acute respiratory infection (SARI) or other respiratory disease surveillance systems to identify and test for the Middle East respiratory syndrome (MERS)[22] and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) These platforms have been critical to the 2019 coronavirus disease (COVID-19) pandemic response in Africa.[23,24] Given the importance of these platforms, we sought to evaluate influenza sentinel surveillance function in Africa from 2011 to 2017,5 after external funding to surveillance in Africa started to decrease and determine if initial investments in capacity-building led to sustainable influenza surveillance. We summarized findings by World Bank income classification and population size[27] to estimate the representativeness of samples collected and tested
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