Background The World Health Organization (WHO) recommends periodic evaluations of influenza surveillance systems to identify areas for improvement and provide evidence of data reliability for policymaking. However, data on the performance of established influenza surveillance systems are limited in Africa, including Tanzania. We aimed to assess the usefulness of the Influenza surveillance system in Tanzania and to ascertain if the system meets its objectives, including; estimating the burden of disease caused by the Influenza virus in Tanzania and identifying any circulating viral strains with pandemic potential. Methodology From March to April 2021, we collected retrospective data through a review of the Tanzania National Influenza Surveillance System electronic forms for 2019. Furthermore, we interviewed the surveillance personnel about the system’s description and operating procedures. Case definition (ILI-Influenza Like Illness and SARI-Severe Acute Respiratory Illness), results, and demographic characteristics of each patient were obtained from the Laboratory Information System (Disa*Lab) at Tanzania National Influenza Center. The United States Centers for disease control and prevention updated guidelines for evaluating public health surveillance systems were used to evaluate the system’s attributes. Additionally, the system’s performance indicators (including turnaround time) were obtained by evaluating Surveillance system attributes, each being scored on a scale of 1 to 5 (very poor to excellent performance). Results A total of 1731 nasopharyngeal and oropharyngeal samples were collected from each suspected influenza case in 2019 from fourteen (14/14) sentinel sites of the influenza surveillance system in Tanzania. Laboratory-confirmed cases were 21.5% (373/1731) with a predictive value positive of 21.7%. The majority of patients (76.1%) tested positive for Influenza A. Thirty-seven percent of patients’ results met the required turnaround time, and 40% of case-based forms were incompletely filled. Although the accuracy of the data was good (100%), the consistency of the data was below (77%) the established target of ≥ 95%. Conclusion The overall system performance was satisfactory in conforming with its objectives and generating accurate data, with an average performance of 100%. The system’s complexity contributed to the reduced consistency of data from sentinel sites to the National Public Health Laboratory of Tanzania. Improvement in the use of the available data could be made to inform and promote preventive measures, especially among the most vulnerable population. Increasing sentinel sites would increase population coverage and the level of system representativeness.
Background Hepatitis B virus (HBV) infection continues to be a global public health problem. As of 2019, there were 296 million people chronically infected with HBV, resulting in nearly 1 million deaths from decompensated cirrhosis or hepatocellular carcinoma. The seroprevalence of HBV infection among pregnant women in Tanzania was reported to range between 3.8 and 8.03%. However, data on HBV infection in HIV-infected pregnant women is limited. We aimed to determine the seroprevalence and associated risk factors for HBV infection among HIV-infected pregnant women in selected health facilities in the Mtwara region. This was a health facility-based quantitative cross-sectional study conducted for three months (from February to April 2022). A structured questionnaire was used to collect information from the study participants. A total of 4 ml of blood was collected for HBV screening and confirmatory tests using rapid diagnostic tests and automated Enzyme-Linked Immunosorbent Assay (ELISA) tests, respectively. The logistic regression model was used to identify significant variables for HBV infection. Results Two hundred and twenty (n = 220) pregnant women living with HIV were enrolled in this study, with a median age of 32.7 years (Interquartile range (IQR) 27.6–37.6). The seroprevalence of HBV, chronic, and acute HBV infections were 10.5%, 10.0%, and 0.5%, respectively. We found that the multiparous women [aOR 11.99: 95% CI 1.11–129.01, p = 0.040], being infected with syphilis [aOR 27.65: 95% CI 9.07–84.30, p < 0.001], and having HIV viral load of 1000 copies/ml and above [aOR 16.00: 95% CI 1.70–150.63, p = 0.015], are factors independently associated with HBV infection. Conclusions The overall seroprevalence of HBV infection among pregnant women was 10.5%, which is high endemicity. Furthermore, the study revealed that having more than four children, a high HIV-1 viral load of ≥ 1000cp/ml, and being infected with syphilis are significant risk factors associated with HBV infection among pregnant women living with HIV in the Mtwara region.
Background Globally, seasonal epidemics are estimated to result about 3 to 5 million cases of severe illness, and about 290 000 to 650 000 respiratory deaths yearly. In order to facilitate early detection of Avian Influenza (AI), Tanzania through the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) initiated a sentinel surveillance system in 2008, for determining the disease burden and detect any new strain capable of causing pandemic.: Objectives:To assess the usefulness of the system, its attributes as well as to ascertain if the system meets its objectives. Methodology: Data were collected through review of documents and interview of key stakeholders involved on the entire cascade of the system. Case definition (ILI and SARI), results and demographic characteristics of each patient were obtained from Laboratory Information System at National Influenza Laboratory (NIL). The system attributes were evaluated using Centre for disease prevention and control updated guidelines for evaluating public health surveillance system (2007)- Morbidity and Mortality Weekly Report (MMWR). Results : A total of 1731 samples were collected from influenza suspects in 2019 from sixteen sentinel sites where 52.7% were male. Laboratory confirmed cases were 21% (363/1731) with PVP of 21%. Most patients detected for influenza A; those presented with ILI symptoms were more likely to have influenza B than those with SARI. 55% met the TAT, 40% of case-based forms were incomplete filled, data consistency was poor with 23% discrepancy. Data accuracy was good with an average performance of 100%. Conclusion and recommendations: The System has met its objectives regarding that it is useful, sensitive, flexible, stable, well representative and able to generate accurate data by the average performance of 100%, which entails to a realistic estimation for the burden of influenza disease in the country.
Background: Influenza is the major public health of concern that accounts for up to one million of total health related global death annually. Objectives: To determine epidemiological trend and associated demographic factors for influenza cases in Tanzania from 2016 to 2019. Methodology: The cross-section study design was conducted using secondary data obtained from laboratory information system from 2016 to 2019. Logistic regression model was used to check the significant predictors for influenza. Results: A total of 7260 samples were collected between 2016 to 2019 from clients with median age of 4 years [IQR=25; 26-1], most samples were from patients aged under five years. Most samples (19%) collected from Mwananyamala hospital. Overall sample collection was lower in 2016, but increased from 2017 to 2019. Trend shows strong evidence of correlation between SARI and ILI case definition on influenza positivity (r=0.78[0.60-0.799]). Laboratory confirmed cases was 17% with higher prevalence of influenza A [12% (881/7260)] as compared to influenza B [5% (373/7260)]. We observed the seasonality of influenza where higher number of cases occurred in rainy and cold seasons (January to June) than the rest of other months. When bivariate and multivariate logistic regression was done, the factors of age, case definition type and sentinel site were significantly associated with influenza positivity (p<0.05). Patients who presented with SARI were more likely to have influenza as compared to those who had ILI symptoms (aOR 0.75, 95% CI [0.64-0.89], P=0.001). Those who presented with ILI symptoms were more likely to be detected for influenza B as compared to those with SARI. Conclusion and recommendations Having known the seasonality of the disease apprise the proper allocation of resources for the surveillance activities. Since Influenza viruses may have pandemic potential, surveillance and data review activities are inevitable to create epidemiological awareness for prompt public health action.
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