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.

First COVID-19 case in Zambia — Comparative phylogenomic analyses of SARS-CoV-2 detected in African countries

“…The epidemic preparedness and response in Zambia remains on high alert for the COVID-19 pandemic and capacity for contact tracing in the community has been built steadily over time due to experience with previous outbreaks such as Lujo haemorrhagic fever and cholera (Paweska et al, 2009;Kapata et al, 2018) as well as ongoing surveillance for influenza and haemorrhagic fever viruses in humans and animals including wildlife (Simulundu et al, 2011;Ogawa et al, 2015;Theo et al, 2012;Changula et al, 2018;Kajihara et al, 2019;Simusika et al, 2020). These activities have contributed to capacity building for the various multidisciplinary teams working in the health facilities including laboratories for infectious diseases and public health emergencies.. Health system strengthening for future outbreaks using the 'One Health' multisectoral approach has also proved to be a key ingredient to mounting an effective response towards prevention of spread of COVID-19.…”