Establishing seasonal and alert influenza thresholds in Cambodia using the WHO method: implications for effective utilization of influenza surveillance in the tropics and subtropics
Autor: | Takeshi Arashiro, Paul F. Horwood, Sovann Ly, Borann Sar, Vanra Ieng, Katelijn Vandemaele, Amy Parry, Yuzo Arima, Savuth Chin, Seng Heng, Sarah Hamid, Reiko Tsuyuoka |
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Rok vydání: | 2017 |
Předmět: |
Influenzavirus A
0301 basic medicine medicine.medical_specialty lcsh:Medicine Subtropics World Health Organization World health 03 medical and health sciences Reference Values Environmental protection Environmental health Influenza Human Tropical climate Pandemic threshold Humans Medicine Non theme issue Pandemics climate Original Research Tropical Climate business.industry lcsh:Public aspects of medicine Public health lcsh:R WHO method Pandemic influenza virus diseases Tropics lcsh:RA1-1270 General Medicine 030112 virology Influenza Population Surveillance Communicable Disease Control surveillance Health Resources pandemic preparedness Public Health Seasons Cambodia tropical and subtropical regions business |
Zdroj: | Western Pacific Surveillance and Response, Vol 8, Iss 1, Pp 22-32 (2017) Western Pacific Surveillance and Response Journal : WPSAR |
ISSN: | 2094-7313 2094-7321 |
Popis: | Objective: To establish seasonal and alert thresholds and transmission intensity categories for influenza to provide timely triggers for preventive measures or upscaling control measures in Cambodia. Methods: Using Cambodia's influenza-like illness (ILI) and laboratory-confirmed influenza surveillance data from 2009 to 2015, three parameters were assessed to monitor influenza activity: the proportion of ILI patients among all outpatients, proportion of ILI samples positive for influenza and the product of the two. With these parameters, four threshold levels (seasonal, moderate, high and alert) were established and transmission intensity was categorized based on a World Health Organization alignment method. Parameters were compared against their respective thresholds. Results: Distinct seasonality was observed using the two parameters that incorporated laboratory data. Thresholds established using the composite parameter, combining syndromic and laboratory data, had the least number of false alarms in declaring season onset and were most useful in monitoring intensity. Unlike in temperate regions, the syndromic parameter was less useful in monitoring influenza activity or for setting thresholds. Conclusion: Influenza thresholds based on appropriate parameters have the potential to provide timely triggers for public health measures in a tropical country where monitoring and assessing influenza activity has been challenging. Based on these findings, the Ministry of Health plans to raise general awareness regarding influenza among the medical community and the general public. Our findings have important implications for countries in the tropics/subtropics and in resource-limited settings, and categorized transmission intensity can be used to assess severity of potential pandemic influenza as well as seasonal influenza. |
Databáze: | OpenAIRE |
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