Background
Methods
Overview of the influenza surveillance system during 2012–2015
Province | City | Sentinel site | Sector | Type of surveillance | Year of inceptiona |
---|---|---|---|---|---|
Kinshasa | Kinshasa | Clinique de Santé RVA | Private | ILI | 2006 |
Kinshasa | Kinshasa | Clinique de Santé Boyambi | Religious | ILI | 2006 |
Kinshasa | Kinshasa | Centre Hospitalier de Kingasani | Religious | ILI and SARI | 2006 |
Kinshasa | Kinshasa | Hôpital Pédiatrique Kalembe-Lembe | Public | ILI and SARI | 2006 |
Kinshasa | Kinshasa | Hôpital Général de Référence de Kinshasa | Public | ILI and SARI | 2006 |
Bas-Congo | Matadi | Hôpital Général de Référence Kinkanda | Public | ILI and SARI | 2011 |
Bas-Congo | Muanda | Hôpital Général de Référence Muanda | Public | ILI and SARI | 2011 |
Katanga | Lubumbashi | Hôpital Général de Référence Kenya | Public | ILI and SARI | 2011 |
Katanga | Lubumbashi | Hôpital Général de Référence Kisanga | Public | ILI and SARI | 2011 |
Kasaï-Oriental | Mbuji-Mayi | Hôpital Général de Référence Dipumba | Public | ILI and SARI | 2012 |
Nord-Kivu | Goma | Centre Hospitalier Charité Maternelle | Religious | ILI and SARI | 2013 |
Evaluation of the influenza surveillance system
Attributes | Number of evaluated indicators | Mean score | Performance |
---|---|---|---|
• Data quality and completeness | 7 | 3.0 | Good |
• Timeliness | 4 | 2.7 | Moderate to good |
• Representativeness | 2 | 2.0 | Moderate |
• Flexibility | 2 | 2.0 | Moderate |
• Simplicity | 12 | 2.9 | Moderate to good |
• Acceptability | 3 | 2.3 | Moderate to good |
• Stability | 7 | 2.4 | Moderate to good |
• Utility | 4 | 2.5 | Moderate to good |
• Overall | 41 | 2.5 | Moderate to good |
Indicator | Calculation/data inputs | Data source | Indicator value | Score |
---|---|---|---|---|
Data quality and completeness | ||||
• Proportion of SARI/ILI cases that meet the case definition | Number of ILI/SARI cases that meet the case definition / Total number of ILI/SARI cases | Case-based database | 97.4% | 3 |
• Proportion of samples from ILI/SARI cases received with accompanying CIF | Number of samples from SARI/ILI cases received with accompanying CIF / Total number of samples received from SARI/ILI cases | Laboratory log book and case-based database | 98.0% | 3 |
• Proportion of forms without at least one inconsistent or missing value for key variablesa | Number of forms without at least one abnormal or missing value / Total number of forms | Case-based database | 97.5% | 3 |
• Proportion of good quality samples received | Number of good quality samples received / Total number of samples received | Case-based database | 97.0% | 3 |
• Proportion of sample with positive RNP results | Number of samples with a positive RNP result / Total number of samples tested | Case-based database | 90.0% | 3 |
• Proportion of sampled ILI/SARI cases with available laboratory results | Number of ILI/SARI cases with available laboratory results / Number of sampled ILI/SARI cases | Case-based database | 99.0% | 3 |
• Proportion of collected variables included in the WHO recommended minimum data collection standard | Number of collected variables within the WHO list / Number of WHO recommended variables. | CIF and WHO guidelines for influenza sentinel surveillance. | 80.8% | 3 |
Timeliness | ||||
• Proportion of SMS sent on time | Number of SMS sent on time / Number of SMS sent | Aggregated data database | 80.0% | 3 |
• Proportion of samples received within 72 h from collection | Number of samples received within 72 h from collection / Number of samples received | Case-based database | 96.3% | 3 |
• Proportion of samples tested within one week from receipt | Number of samples tested within one week from receipt / Number of samples tested | Case-based database | 90.0% | 3 |
• Proportion of weekly reports issued within five days after the end of the reporting period | Number of weekly reports issued within five days after the end of the reporting period / Number of weekly reports issued | Weekly reports audit | 75.0% | 2 |
Representativeness | ||||
• Geographical coverage | Number of provinces covered by the influenza sentinel surveillance network / Total number of provinces | Geographic distribution of sentinel sites. | 45.5% | 1 |
• Inclusion of all age groups | Age distribution of cases SARI/ILI (median, minimum and maximum) | Case based database | Med.: 15 Y Min.: 0 Y Max.: 89 Y | 3 |
Flexibility | ||||
• Proportion of samples tested for pathogens other than influenza | Number of samples tested for pathogens other than influenza / Number of samples tested for influenza | Case-based database | 37.3% | 1 |
• Number of syndromes surveyed with the influenza surveillance system | Total, respiratory, gastro-intestinal and malaria admissions/consultations reported in the aggregated data form | Aggregated data database | Qualitative assessment | 3 |
Indicator | Calculation/data inputs | Data source | Indicator valuea | Score |
---|---|---|---|---|
Simplicity | ||||
• Perception of surveillance staff on identification of casesb | Number of surveillance staff within each reported category / Number of surveillance staff interviewed | Questionnaire survey among surveillance staff at sentinel sites | VD: 0.0% D: 0.0% E: 82.9% VE: 17.1% | 3 |
• Perception of surveillance staff on obtaining consentb | Number of surveillance staff within each reported category / Number of surveillance staff interviewed | Questionnaire survey among surveillance staff at sentinel sites | VD: 0.0% D: 8.6% E: 71.4% VE: 20.0% | 3 |
• Perception of surveillance staff on filling the CIFb | Number of surveillance staff within each reported category / Number of surveillance staff interviewed | Questionnaire survey among surveillance staff at sentinel sites | VD: 0.0% D: 2.9% E: 80.0% VE: 17.1% | 3 |
• Perception of surveillance staff on sample collectionb | Number of surveillance staff within each reported category / Number of surveillance staff interviewed | Questionnaire survey among surveillance staff at sentinel sites | VD: 0.0% D: 5.7% E: 80.0% VE: 14.3% | 3 |
• Perception of surveillance staff on sample collectionb | Number of surveillance staff within each reported category / Number of surveillance staff interviewed | Questionnaire survey among surveillance staff at sentinel sites | VD: 0.0% D: 0.0% E: 79.4% VE: 20.6% | 3 |
• Perception of surveillance staff on packaging and storage of samplesb | Number of surveillance staff within each reported category / Number of surveillance staff interviewed | Questionnaire survey among surveillance staff at sentinel sites | VD: 0.0% D: 0.0% E: 82.4% VE: 17.6% | 3 |
• Perception of surveillance staff on completing the screening/enrollment logbookb | Number of surveillance staff within each reported category / Number of surveillance staff interviewed | Questionnaire survey among surveillance staff at sentinel sites | VD: 0.0% D: 0.0% E: 82.4% VE: 17.6% | 3 |
• Perception of surveillance staff on sending weekly SMS of aggregated datab | Number of surveillance staff within each reported category / Number of surveillance staff interviewed | Questionnaire survey among surveillance staff at sentinel sites | VD: 0.0% D: 6.3% E: 71.9% VE: 21.9% | 3 |
• Time to enroll a SARI/ILI case from the identification to the sample packagingc | Number of surveillance staff within each reported category (< 30 min, 30–60 min, > 60 min) / Number of surveillance staff interviewed | Questionnaire for surveillance staff at sentinel sites | < 30: 48.6% 30–60: 40.0% > 60: 11.4% | 2 |
• Perception of INRB laboratory staff on completing the laboratory registerc | Number of lab staff within each reported category / Number of laboratory staff interviewed | Questionnaire survey among laboratory staff at INRB | VD: 0.0% D: 0.0% E: 66.7% VE: 33.3% | 3 |
• Perception of INRB laboratory staff to implement testing proceduresc | Number of lab staff within each reported category / Number of laboratory staff interviewed | Questionnaire survey among laboratory staff at INRB | VD: 0.0% D: 0.0% E: 100.0% VE: 0.0% | 3 |
• Time to implement all steps of analysis of laboratory testingb | Number of laboratory staff within each reported category (< 30 min, 30–60 min, > 60 min) / Number of laboratory staff interviewed | Questionnaire survey among laboratory staff at INRB | < 30: 0.0% 30–60: 100.0% > 60: 0.0 | 3 |
Data analysis
Results
Implementation of sentinel surveillance and questionnaire survey
Evaluation of the surveillance system
Data quality and completeness
Timeliness
Representativeness
Flexibility
Simplicity
Acceptability
Indicator | Calculation/data inputs | Data source | Indicator value | Score |
---|---|---|---|---|
Acceptability | ||||
• Proportion of surveillance staff that is satisfied with the weekly bulletinsa | Number of surveillance staff within each reported category [not satisfied (NS), poorly satisfied (PS), satisfied (S), very satisfied (VS)] / Number of surveillance staff interviewed | Questionnaire for surveillance staff at sentinel sites | NS: 0.0% PS: 0.0% S: 30.0% VS: 70.0% | 3 |
• Proportion of surveillance staff that is satisfied with supervision and feedbacka | Number of surveillance staff within each reported category [not satisfied (NS), poorly satisfied (PS), satisfied (S), very satisfied (VS)] / Number of surveillance staff interviewed | Questionnaire for surveillance staff at sentinel sites | NS: 0.0% PS: 17.6% S: 44.1% VS: 38.2% | 3 |
• Proportion of time allocated to influenza surveillance activities per weeka | Number of hours allocated to influenza surveillance activities per week / Number of working hour per week | Questionnaire for surveillance staff at sentinel sites | 48.3% | 1 |
Stability | ||||
• Frequency of lack of data collection formsa,c | Number of surveillance sites within each reported category [never (0), once per year (1), 2–3 times per year (2–3), ≥4 times per year(≥4)] / Number of surveillance sites | Questionnaire for surveillance staff at sentinel sites | 0: 100.0% 1: 0.0% 2–3: 0.0% ≥4: 0.0% | 3 |
• Frequency of lack of sampling materiala | Number of surveillance sites within each reported category [never (0), once per year (1), 2–3 times per year (2–3), ≥4 times per year(≥4)] / Number of surveillance sites | Questionnaire for surveillance staff at sentinel sites | 0: 72.7% 1: 27.3% 2–3: 0.0% ≥4: 0.0% | 2 |
• Frequency of lack of credits for SMSa | Number of surveillance sites within each reported category [never (0), once per year (1), 2–3 times per year (2–3), ≥4 times per year(≥4)] / Number of surveillance sites | Questionnaire for surveillance staff at sentinel sites | 0: 100.0% 1: 0.0% 2–3: 0.0% ≥4: 0.0% | 3 |
• Frequency at which the transport of samples was delayeda | Number of surveillance sites within each reported category [never (N), seldom (S), often (O), regularly (R)] / Number of surveillance sites | Questionnaire for surveillance staff at sentinel sites | N: 0.0% S: 90.9% O: 9.1% R: 0.0% | 2 |
• Frequency at which the refrigerators of the sentinel sites were not functionala | Number of surveillance sites within each reported category [never (N), seldom (S), often (O), regularly (R)] / Number of surveillance sites | Questionnaire for surveillance staff at sentinel sites | N: 100.0% S: 0.0% O: 0.0% R: 0.0% | 3 |
• Frequency at which a power failure, including the generator, occurred at the surveillance sitesa | Number of surveillance sites within each reported category [never (N), seldom (S), often (O), regularly (R)] / Number of surveillance sites | Questionnaire for surveillance staff at sentinel sites | N: 0.0% S: 9.1% O: 18.2% R: 72.7% | 1 |
• Proportion of sentinel sites with at least one member of staff trained in sentinel surveillance procedures during the last one yeara | Number of sentinel sites with at least one trained member of staff / Number of surveillance sites | Questionnaire for surveillance staff at sentinel sites | 100.0% | 3 |
Utility | ||||
• Number of decisions taken by the INRB and/or the DLM based on influenza sentinel surveillance resultsb,d | N/A | Questionnaire survey for DLM and INRB | 4 | 2 |
• Proportion of surveillance staff that receive the following reports: (i) Virological surveillance report, (ii) Syndromic surveillance report, (iii) Influenza bulletina | Number of surveillance staff that receive reports / Number of surveillance staff | Questionnaire for surveillance staff at sentinel sites | 77.1% | 2 |
• Estimation of burden of influenza-associated illness using surveillance data | Not applicable | Publication on burden of influenza-associated ILI and SARI. | 1 [13] | 3 |
• Contribution to influenza Regional/Global studies | Not applicable | Publications on Regional/Global studies with DRC influenza data | 3 |