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Update on CSTE International Surveillance Assessments

Posted By Rachelle Boulton, MSPH, Utah Department of Public Health, Friday, August 18, 2017
Updated: Thursday, August 17, 2017
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CDC’s Influenza Division uses cooperative agreements, paired with technical assistance, to assist Ministries of Health in countries throughout the world in establishing and improving capacity for sustainable epidemiologic and virologic influenza surveillance programs. Ensuring these systems generate useful, reliable data consistently involves routine assessment of how well they are functioning, identification of problems and assistance in solving those problems. CSTE frequently collaborates with CDC and the Association of Public Health Laboratories (APHL) to conduct international influenza surveillance assessments using standardized reporting tools that capture information, such as how potential influenza cases are identified at sentinel sites; how epidemiologic data and laboratory specimens are collected; how surveillance staff manage, analyze and report data; and how data quality is monitored. Following these assessments, detailed reports that provide recommendations for improvement in laboratory and epidemiologic surveillance are shared with the countries. Recently, Rachelle Boulton of the Utah Department of Health (DOH) completed two consecutive international influenza surveillance assessments in Sri Lanka and Maldives. Rachelle has graciously agreed to contribute a blog post on her experience during this opportunity.

I had the opportunity to represent CSTE on three international influenza surveillance assessments. I traveled to Uganda in June 2016 and most recently to Sri Lanka and the Maldives in May 2017. For each assessment, I was accompanied by the CDC Project Officer and an APHL representative conducting a concurrent influenza laboratory capacity assessment. Each of my assessments lasted four to five days, and I spend the majority of my time with the epidemiology surveillance staff. Each country begins influenza surveillance with varying amounts of existing resources and infrastructure, and each country encounters vastly different challenges throughout the process of building and maintaining influenza surveillance. One of my favorite components of the assessments is the site visits to hospitals and clinics that see patients and collect epidemiologic and laboratory data. I am always impressed with the enthusiasm, dedication and ingenuity of the surveillance staff and their clinical and laboratory partners to build and maintain high-quality influenza surveillance systems for their country.

My favorite part of my most recent trip to the Maldives was the opportunity to put down the clipboard, step out of the role of the assessor and work in depth with the data alongside surveillance staff. We worked together to develop several charts and graphs that demonstrated influenza trends in the Maldives, discussed how these figures could be compiled into different reports to tell a comprehensive and meaningful story, and identify future data collection and analysis goals.

I have thoroughly enjoyed my time spent in Uganda, Sri Lanka and the Maldives, and I look forward to future opportunities to contribute to international efforts to strengthen global influenza surveillance capacity.

Additional Information:
CDC’s Influenza Division International Program
WHO’s Global Influenza Programme Surveillance and Monitoring
CDC’s Influenza Division International Program Evaluation and Capacity Review Tools
Improved Global Capacity for Influenza Surveillance. Emerg Infect Dis. 2016;22(6):993-1001.

Pictured: Rachelle Boulton (second from left) joins assessors and surveillance staff in Sri Lanka.

Pictured: Meeting the Maldivian Minister of Health in the Maldives

Pictured: The pediatric inpatient ward at Tororo General Hospital in Uganda, Africa

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