Strengthening influenza surveillance in Timor-Leste: review conducted

As a part of implementing the Global Influenza Strategy 2019-2030, SEARO conducted a joint national and international review of the integrated ILI /SARI surveillance system in Timor-Leste. Recommendations from the review aim to strengthen country capacities for monitoring respiratory pathogens of pandemic potential.

The 75th Southeast Asia Regional Committee endorsed operationalization of the 75th World Health Assembly (WHA) agenda item 17.3 on influenza preparedness. In this regard, the WHO Regional Office for Southeast Asia (SEARO) supports implementation of the Global Influenza Strategy 2019-30. Regional efforts are aimed at strengthening country capacities through technical assistance to national influenza programmes. In view of strengthening influenza like illness (ILI) /severe acute respiratory infection (SARI) surveillance capacity in Timor-Leste, SEARO conducted a joint national and international review from 21 -25 November 2022.

The key objectless of the review were:

  • To review influenza sentinel surveillance (ILI/SARI) in line with global influenza surveillance standards and guidance on end-to-end integration with COVID-19 surveillance;
  • To understand the degree to which integration of influenza surveillance and SARS-CoV-2 monitoring leveraged the ILI/SARI sentinel surveillance system; and
  • To provide recommendations to policymakers and programme managers to ensure sustainability of high quality, integrated sentinel surveillance with the flexibility of using the system for the surveillance of wider respiratory pathogens of epidemic and pandemic potential.

The international reviewers were from the national influenza programmes of Nepal and Bangladesh, the United States Centers for Disease Control and Prevention, and WHO. The reviewers visited two community health centres, two referral hospitals, the Hospital National Guido Valadares and the surveillance department of the Ministry of Health.

The review concluded that the country has a geographically representative ILI/SARI sentinel surveillance system that has been leveraged for integrated monitoring of influenza, SARS-CoV-2, and respiratory syncytial virus. The review highlighted the availability of standard operating procedures, established laboratory and epidemiological linkages, innovative sample transportation systems, digitized dashboards for easy access to data, and a functional data management system.

Among the recommendations for further strengthening surveillance capacity, the following were highlighted as being significant:

  • Ensuring sustainability (including financial) of ILI/SARI surveillance;
  • Developing a plan for utilizing the integrated ILI/SARI sentinel surveillance platform for continued COVID-19 surveillance in the transition or post pandemic period;
  • Conducting a national surveillance review of all sentinel sites with resulting site performance improvement plans; and
  • Establishing a technical working group for implementation, monitoring, and evaluation of the ILI/SARI surveillance system aimed at respiratory pathogens of epidemic and pandemic potential.

Capacity strengthening supported by the PIP Partnership Contribution was cited as an avenue to implement review recommendations on Timor-Leste’s ILI/SARI surveillance system.

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