News on human influenza surveillance in the Central African Republic

The National Reference Centre for Influenza (CNRG - Institut Pasteur de Bangui) brought together 23 actors involved in epidemiological influenza surveillance in a training and restitution workshop for the first quarter of 2019. The meeting was attended by the Head of the Integrated Disease Surveillance and Public Health Emergency Management Department, Dr Maurice Bawa and Dr Ernest Kalthan, Head of the Epidemiological Surveillance and Public Health Emergency Management Department. Both are newly appointed as a result of the movement in the senior ranks of the Department of Public Health and Health Personnel this year.

The workshop was facilitated by the Director of the National Influenza Reference Centre Dr Emmanuel Nakoune and the biostatician Brice Yambiyo of the Epidemiology Department of the Institut Pasteur de Bangui. It brought together doctors and laboratory technicians from the 5 sentinel sites (Bangui Pediatric Complex, St Joseph's Health Centre, Pissa Health Centre, Boali Health Centre and Bossembelé District Hospital).

With the exception of the Pissa sentinel site, all the managers in charge of sentinel sites were renewed, so this meeting was an opportunity for a first exchange with these new actors in the surveillance network. In addition to the technical presentations and discussions, Dr. Maurice Bawa reported on his mission to the regional workshop on influenza epidemiological surveillance, held from February 4 to 8, 2019 in Brazzaville.

Central African Republic within the global influenza virological surveillance network

WHO has identified the Central African Republic as a country with the capacity to make a virological diagnosis of influenza. As a result, an epidemiological surveillance network for influenza viruses, now comprising 5 sentinel sites, has been in place for 10 years. Its activity consists essentially in collecting biological material from patients (swabs of nasal or pharyngeal secretions) for the detection of the virus by cell and molecular culture techniques. The CNRG transmits the isolated viruses twice a year to WHO to assess their interest in the annual vaccine formulation.

Epidemiological data still incomplete

In the Central African Republic, the surveillance system was not national until 2018. In fact, the data collected are not representative of the entire Central African territory and the country is still far from being able to estimate the severity, burden and seasonality of influenza.

Mortality due to influenza, as a primary or secondary cause in cases of bacterial superinfection, particularly in patients with precarious general condition, is not yet known, given the small number of confirmed cases and the multitude of possible differential diagnoses.

From the above, it appears necessary to combine syndromic and virological surveillance to better assess the level of circulation of influenza viruses in CAR, identify their types and subtypes and describe the other respiratory viruses present. Until then, only one of the five sentinel sites monitored pathogens involved in Severe Acute Respiratory Infections (SARI).

To improve virological surveillance, WHO has developed operational data analysis platforms (FluNet and FluId) in CAR in 2017 and 2018 respectively. Two others, PISA and BoD, are being tested to assess the severity of influenza and estimate its burden.

This article was first published by the Institut Pasteur de Bangui and translated in English by Afriscitech.


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