Strengthening timely detection and reporting of unusual respiratory events from health facilities in Yaoundé, Cameroon.

Karen A Alroy,Gwladys Monamele,Bienvenu Etogo,Alain Georges Etoundi,Elise Seukap,Henri Manga,Richard Njouom,Dorine Tseuko,Chanceline Bilounga Ndongo,Sebastien Kenmoe,Luc Christian Gwom,Carolle Yanique Tayimetha,Brett Whitaker,Arunmozhi Balajee,Alexey Clara,Omer Pasi

doi:10.1111/irv.12684

Abstract

BackgroundThe International Health Regulations state that early detection and immediate reporting of unusual health events is important for early warning and response systems.ObjectiveTo describe a pilot surveillance program established in health facilities in Yaoundé, Cameroon in 2017 which aimed to enable detection and reporting of public health events.MethodsCameroon’s Ministry of Health, in partnership with the US Centers for Disease Control and Prevention, Cameroon Pasteur Center, and National Public Health Laboratory, implemented event‐based surveillance (EBS) in nine Yaoundé health facilities. Four signals were defined that could indicate possible public health events, and a reporting, triage, and verification system was established among partner organizations. A pre‐defined laboratory algorithm was defined, and a series of workshops trained health facilities, laboratory, and public health staff for surveillance implementation.ResultsFrom May 2017 to January 2018, 30 signals were detected, corresponding to 15 unusual respiratory events. All health facilities reported a signal at least once, and more than three‐quarters of health facilities reported ≥2 times. Among specimens tested, the pathogens detected included Klebsiella pneumoniae, Moraxella catarrhalis, Streptococcus pneumoniae, Haemophilus influenza, Staphylococcus aureus, Pneumocystis jiroveci, influenza A (H1N1) virus, rhinovirus, and adenovirus.ConclusionsThe events detected in this pilot were caused by routine respiratory bacteria and viruses, and no novel influenza viruses or other emerging respiratory threats were identified. The surveillance system, however, strengthened relationships and communication linkages between health facilities and public health authorities. Astute clinicians can play a critical role in early detection and EBS is one approach that may enable reporting of emerging outbreaks and public health events.

Highlights

In May 2016, an outbreak of avian influenza A (H5N1) virus “H5N1” occurred among poultry in Yaoundé, the capital city of Cameroon
The other surveillance system was an indicator‐based sentinel surveillance for influenza, coordinated by the Centre Pasteur du Cameroun (CPC), Cameroon's national influenza center, where 16 hospitals utilize the World Health Organization (WHO) standard case definitions for severe acute respiratory infection (SARI) and/or influenza‐like illness (ILI) to detect possible influenza cases.[4,5,6]
Cameroon's Ministry of Health (MOH) implemented event‐based surveillance (EBS) in Yaoundé to enable rapid detection and notification of emerging respiratory events, and to the best of the authors’ knowledge, this is the first report that focuses on EBS implementation with healthcare facilities providing the primary source of data

Summary

Introduction

In May 2016, an outbreak of avian influenza A (H5N1) virus “H5N1” occurred among poultry in Yaoundé, the capital city of Cameroon. The MOH's Division for the Fight against Disease, Epidemics and Pandemics (Direction de la Lutte Contre la Maladie, les Epidémies et les Pandémies [DLMEP]) coordinates a national surveillance platform for integrated disease surveillance and response (IDSR), where cases of priority diseases are counted weekly and registered at the national level.[3] Each health facility is expected to routinely report aggregate IDSR data and immediately notify DLMEP if a suspected outbreak occurs. Objective: To describe a pilot surveillance program established in health facilities in Yaoundé, Cameroon in 2017 which aimed to enable detection and reporting of public health events. Methods: Cameroon’s Ministry of Health, in partnership with the US Centers for Disease Control and Prevention, Cameroon Pasteur Center, and National Public Health Laboratory, implemented event‐based surveillance (EBS) in nine Yaoundé health facilities. The surveillance system, strengthened relationships and communication linkages between health facilities and public health authorities

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