Evaluation of Ethiopian Influenza Sentinel Surveillance System

Background: Ethiopia conducts influenza sentinel surveillance since 2008 in eight sites through the coordination of Ethiopian Public Health Institute although little is known whether the system meets its objective. Hence, this evaluation is conducted to evaluate the sentinel surveillance attributes, purposes and its operation system. Method: A cross-sectional descriptive study was conducted from February 15-30, 2017 in all eight Sentinel sites. Data were collected using US-CDC updated surveillance guideline and Interview with influenza sentinel surveillance focal persons, regional public health emergency officers and national surveillance officers. Case based reports of influenza like illness and severe acute respiratory illness were also reviewed. Secondary data were collected from the national public health emergency management center based at EPHI. We analyzed and compiled the data. Results: Not all the visited health facilities have posted the ILI and SARI cases definition. None of the sentinel sites have been reporting influenza data to their next higher level but to the national PHEM (NIL). All focal persons have responded that they are expected to do so. Data is only being analyzed by national PHEM. Supportive supervision was done this month (February, 2017) since 2014. Laboratory feedback (test result) has been provided irregularly since May 2016 by the national influenza laboratory to sentinel sites and respective regional PHEM. All of focal persons have taken training on influenza surveillance. The positive predictive value (PPV) was 21.35% (n=4922). Among a total of 5,097 case based reports from 2008-2016, 47 (0.9%) age variable, 385 (7.5%) temperature variable, and 103 (2%) date of specimen collection were not filled. Conclusion: Although focal persons are satisfied with the forms and procedures involved, they are not filling formats properly as expected and reporting regularly as scheduled neither to the national PHEM nor to the next higher level. The influenza sentinel surveillance system has proven to be useful in providing virological data used to characterize and monitor influenza trends in Ethiopia. Continuous supportive supervision should be in placed using checklist to increase the quality of data. Data should be continuously analyzed and feedback should be given periodically to health care provider and partners.