Establishing a national influenza sentinel surveillance system in a limited resource setting, experience of Sierra Leone
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RESEARCH
Open Access
Establishing a national influenza sentinel surveillance system in a limited resource setting, experience of Sierra Leone Senait Kebede1*, Ishata N Conteh2, Christoph A Steffen3, Katelijn Vandemaele4, Isata Wurie5, Wondimagegnehu Alemu2, Fredson Kuti-George2, Foday Dafae6, Amara Jambai6, Ali Ahmed Yahaya7 and Francis Chisaka Kasolo7
Abstract Background: Acute respiratory infections remain a leading cause of morbidity and mortality in Sierra Leone; however, similar to other African countries, little is known regarding the contribution of influenza. Routine influenza surveillance is thus a key element to improve understanding of the burden of acute respiratory infections in Africa. In 2011, the World Health Organization (WHO) funded the Strengthening Influenza Sentinel Surveillance in Africa (SISA) project with the goal of developing and strengthening influenza surveillance in eight countries in sub-Saharan Africa, including Sierra Leone. This paper describes the process of establishing a functional Influenza Sentinel Surveillance (ISS) system in Sierra Leone, a post-conflict resource-poor country previously lacking an influenza monitoring system. Methods: Sierra Leone utilized a systematic approach, including situational assessment, selection of sentinel sites, preparation of implementation plan, adaptation of the standard operating procedures, supervision and training of staff, and monitoring of influenza surveillance activities. The methods used in Sierra Leone were adapted to its specific context, using the Integrated Disease Surveillance and Response (IDSR) strategy as a platform for establishing ISS. Results: The ISS system started functioning in August 2011 with subsequent capacity to contribute surveillance activity data to global influenza databases, FluID and FluNet, demonstrating a functional influenza surveillance system in Sierra Leone within the period of the WHO SISA project support. Several factors were necessary for successful implementation, including a systematic approach, national ownership, appropriate timing and external support. Conclusions: The WHO SISA project demonstrated the feasibility of building a functional influenza surveillance system in Sierra Leone, integrated into existing national IDSR system. The ISS system, if sustained long-term, would provide valuable data to determine epidemiological and virological patterns and seasonal trends to assess the influenza disease burden that will ultimately guide national control strategies.
Background Influenza remains an important global public health concern. Annual influenza epidemics are estimated to account for 3 to 5 million severe illnesses and 250,000 to 500,000 deaths worldwide [1]. Though the burden of influenza is well understood in temperate regions, mainly in the United States and Europe [2-5], data from tropical regions, including Africa, remains insufficiently * Correspondence: [email protected] 1 Independent Consultant, 1163 Hidden Spirit Trail, Lawrenceville, GA 30045, USA Full list of author informatio
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