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. 2014 May 9:14:209.
doi: 10.1186/1472-6963-14-209.

Improvements in pandemic preparedness in 8 Central American countries, 2008-2012

Lucinda E A Johnson, Wilfrido Clará, Manoj Gambhir, Rafael Chacón-Fuentes, Carlos Marín-Correa, Jorge Jara, Percy Minaya, David Rodríguez, Natalia Blanco, Naomi Iihoshi, Maribel Orozco, Carmen Lange, Sergio Vinicio Pérez, Nydia Amador, Marc-Alain Widdowson, Ann C Moen, Eduardo Azziz-Baumgartner  1
Affiliations

Improvements in pandemic preparedness in 8 Central American countries, 2008-2012

Lucinda E A Johnson et al. BMC Health Serv Res. .

Abstract

Background: In view of ongoing pandemic threats such as the recent human cases of novel avian influenza A(H7N9) in China, it is important that all countries continue their preparedness efforts. Since 2006, Central American countries have received donor funding and technical assistance from the U.S. Centers for Disease Control and Prevention (CDC) to build and improve their capacity for influenza surveillance and pandemic preparedness. Our objective was to measure changes in pandemic preparedness in this region, and explore factors associated with these changes, using evaluations conducted between 2008 and 2012.

Methods: Eight Central American countries scored their pandemic preparedness across 12 capabilities in 2008, 2010 and 2012, using a standardized tool developed by CDC. Scores were calculated by country and capability and compared between evaluation years using the Student's t-test and Wilcoxon Rank Sum test, respectively. Virological data reported to WHO were used to assess changes in testing capacity between evaluation years. Linear regression was used to examine associations between scores, donor funding, technical assistance and WHO reporting.

Results: All countries improved their pandemic preparedness between 2008 and 2012 and seven made statistically significant gains (p < 0.05). Increases in median scores were observed for all 12 capabilities over the same period and were statistically significant for eight of these (p < 0.05): country planning, communications, routine influenza surveillance, national respiratory disease surveillance, outbreak response, resources for containment, community interventions and health sector response. We found a positive association between preparedness scores and cumulative funding between 2006 and 2011 (R2 = 0.5, p < 0.01). The number of specimens reported to WHO from participating countries increased significantly from 5,551 (2008) to 18,172 (2012) (p < 0.01).

Conclusions: Central America has made significant improvements in influenza pandemic preparedness between 2008 and 2012. U.S. donor funding and technical assistance provided to the region is likely to have contributed to the improvements we observed, although information on other sources of funding and support was unavailable to study. Gains are also likely the result of countries' response to the 2009 influenza pandemic. Further research is required to determine the degree to which pandemic improvements are sustainable.

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Figures

Figure 1
Figure 1
Median scores and changes in median scores for pandemic preparedness by capability combined for 8 Central American countries.
Figure 2
Figure 2
Pandemic preparedness scores 2008, 2010 and 2012 and cumulative funding received from 2006 to 2011.
Figure 3
Figure 3
Number of specimens processed and reported to FluNet for seven Central American countries from January 1, 2008 to December 31, 2012.
Figure 4
Figure 4
Pandemic preparedness scores in 2008 and specimens processed as reported to WHO FluNet in 2007 and 2008 (A), 2009 and 2010 (B), 2011 and 2012 (C), respectively.
See this image and copyright information in PMC

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