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. 2019 Jun 6;19(1):694.
doi: 10.1186/s12889-019-7035-3.

Evaluation of the influenza-like illness surveillance system in Tunisia, 2012-2015

Rihab Yazidi  1   2 , Wafa Aissi  3   4 , Hind Bouguerra  5 , Mariem Nouira  6 , Ghassen Kharroubi  6 , Latifa Maazaoui  7 , Mokhtar Zorraga  7 , Naima Abdeddaiem  7 , Sadok Chlif  6 , Awatef El Moussi  8 , Mohamed Ali Ben Hadj Kacem  8 , Mohamed Ali Snoussi  9   6 , Wissem Ghawar  9   6 , Makram Koubaa  10 , Lauren Polansky  11 , Margaret McCarron  11 , Mohamed Boussarsar  12   13   14 , Khaled Menif  15 , Slim Amine  8 , Jalila Ben Khelil  16 , Mounir Ben Jemaa  10 , Jihene Bettaieb  9   6 , Nissaf Bouafif Ben Alaya  5   7 , Afif Ben Salah  17   18   19
Affiliations

Evaluation of the influenza-like illness surveillance system in Tunisia, 2012-2015

Rihab Yazidi et al. BMC Public Health. .

Abstract

Background: This study was initiated to evaluate, for the first time, the performance and quality of the influenza-like illness (ILI) surveillance system in Tunisia.

Methods: The evaluation covered the period of 2012-2015 and used different data sources to measure indicators related to data quality and completeness, representativeness, timeliness, simplicity, acceptability, flexibility, stability and utility.

Results: During the evaluation period, 485.221 ILI cases were reported among 6.386.621 outpatients at 268 ILI sentinel sites. To conserve resources, cases were only enrolled and tested for influenza during times when the number of patients meeting the ILI case definition exceeded 7% (10% after 2014) of the total number of outpatients for the week. When this benchmark was met, five to 10 patients were enrolled and sampled by nasopharyngeal swabs the following week. In total, The National Influenza Center (NIC) received 2476 samples, of which 683 (27.6%) were positive for influenza. The greatest strength of the system was its representativeness and flexibility. The timeliness of the data and the acceptability of the surveillance system performed moderately well; however, the utility of the data and the stability and simplicity of the surveillance system need improvement. Overall, the performance of the Tunisian influenza surveillance system was evaluated as performing moderately well for situational awareness in the country and for collecting representative influenza virologic samples.

Conclusions: The influenza surveillance system in Tunisia provided pertinent evidence for public health interventions related to influenza situational awareness. To better monitor influenza, we propose that ILI surveillance should be limited to sites that are currently performing well and the quality of data collected should be closely monitored and improved.

Keywords: Evaluation; Health system; ILI; Influenza; Surveillance; Tunisia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Structure of the influenza-like illness (ILI) surveillance system in Tunisia
Fig. 2
Fig. 2
Seasonal influenza virus detection by type and subtype in Tunisia, 2012–2015
See this image and copyright information in PMC

References

    1. Gessner BD, Shindo N, Briand S. Seasonal influenza epidemiology in sub-Saharan Africa: a systematic review. Lancet Infect Dis. 2011;11(3):223–235. doi: 10.1016/S1473-3099(11)70008-1. - DOI - PubMed
    1. Declich S, Carter AO. Public health surveillance: historical origins, methods and evaluation. Bull World Health Organ. 1994;72(2):285–304. - PMC - PubMed
    1. Ortiz JR, Neuzil KM, Victor JC, Wald A, Aitken ML, Goss CH. Influenza-associated cystic fibrosis pulmonary exacerbations. Chest. 2010;137(4):852–860. doi: 10.1378/chest.09-1374. - DOI - PMC - PubMed
    1. Western Pacific Region Global Influenza Surveillance and Response System Epidemiological and virological characteristics of influenza in the Western Pacific region of the World Health Organization, 2006-2010. PLoS One. 2012;7(5):e37568. doi: 10.1371/journal.pone.0037568. - DOI - PMC - PubMed
    1. World Health Organization . WHO global influenza preparedness plan: the role of WHO and recommendations for national measures before and during pandemics. Geneva: World Health Organization; 2005.

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