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WHO: Rotavirus surveillance network requires additional resources
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Nearly half of WHO’s Global Rotavirus Surveillance Network sites met 2008 criteria for documenting disease presence and describing disease epidemiology, but only slightly more than one-third of countries in the network had introduced rotavirus vaccine nationwide, according to a recent MMWR report.
To evaluate surveillance network performance during 2011 and 2012, WHO administered questionnaires to obtain country-level expert and Ministry of Health staff opinions on the value of surveillance data; reviewed laboratory networks and data management systems; evaluated use of rotavirus surveillance data; and conducted an internal review of WHO activities and funding distribution.
During 2011 and 2012, 169 sites in 55 countries reported rotavirus surveillance data to WHO for both years. Seventy-nine (47%) sites in 37 countries met reporting and testing inclusion criteria for data analysis, including 80% of sites eligible for GAVI Alliance support. Thirty-five percent of the 37 countries with sites that met inclusion criteria introduced rotavirus vaccine nationwide.
The median monthly percentage of eligible children enrolled in surveillance was 93%. Among 75,353 children tested between January 2011 and December 2012, the mean percentage of rotavirus detection was 36%. Of these, infants, aged 6 to 11 months, accounted for 42% of positive results. The most common rotavirus genotypes during 2009 to 2012 were G1P(8), G2P(4), G3P([8), G4P(8) and G9P(8).
The review team concluded sites met 2008 objectives for documenting presence of disease, description of disease epidemiology, used surveillance as a platform for special studies, and used data for policy decisions. However, the team noted a lack of standardized data formats and incomplete linkage of clinical and laboratory data limited the network’s ability to conduct real-time performance monitoring and analyses, according to the report.
As a result of the systematic review, WHO’s Strategic Advisory Group of Experts on Immunizations recommend the following:
- Revision of surveillance objectives to align more closely with current and future vaccine introduction landscape;
- Further standardization to ensure the generation of credible, well-defined data by linking clinical and laboratory data and real-time monitoring of system performance;
- Sharing of standardized, case-based data at all levels;
- Development of performance measures and agreements on sentinel site eligibility for ongoing participation in the network, standards for reference laboratories, and WHO roles in support of the network; and,
- Additional human and financial resources to strengthen networks.
“Implementation of the strategic review recommendations will improve the network’s functions and ability to integrate with other surveillance platforms, and will provide higher quality surveillance data for use in decisions related to vaccine introduction and vaccination program sustainability,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
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