Wolfe Caitlin M, Hamblion Esther L, Dzotsi Emmanuel K, Mboussou Franck, Eckerle Isabelle, Flahault Antoine, Codeço Claudia T, Corvin Jaime, Zgibor Janice C, Keiser Olivia, Impouma Benido
Health Emergency Information and Risk Assessment, Health Emergencies Programme, World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo.
University of South Florida College of Public Health, Tampa, Florida, United States of America.
PLoS One. 2021 Feb 25;16(2):e0245457. doi: 10.1371/journal.pone.0245457. eCollection 2021.
The WHO African region frequently experiences outbreaks and epidemics of infectious diseases often exacerbated by weak health systems and infrastructure, late detection, and ineffective outbreak response. To address this, the WHO Regional Office for Africa developed and began implementing the Integrated Disease Surveillance and Response strategy in 1998.
This systematic review aims to document the identified successes and challenges surrounding the implementation of IDSR in the region available in published literature to highlight areas for prioritization, further research, and to inform further strengthening of IDSR implementation.
A systematic review of peer-reviewed literature published in English and French from 1 July 2012 to 13 November 2019 was conducted using PubMed and Web of Science. Included articles focused on the WHO African region and discussed the use of IDSR strategies and implementation, assessment of IDSR strategies, or surveillance of diseases covered in the IDSR framework. Data were analyzed descriptively using Microsoft Excel and Tableau Desktop 2019.
The number of peer-reviewed articles discussing IDSR remained low, with 47 included articles focused on 17 countries and regional level systems. Most commonly discussed topics were data reporting (n = 39) and challenges with IDSR implementation (n = 38). Barriers to effective implementation were identified across all IDSR core and support functions assessed in this review: priority disease detection; data reporting, management, and analysis; information dissemination; laboratory functionality; and staff training. Successful implementation was noted where existing surveillance systems and infrastructure were utilized and streamlined with efforts to increase access to healthcare.
These findings highlighted areas where IDSR is performing well and where implementation remains weak. While challenges related to IDSR implementation since the first edition of the technical guidelines were released are not novel, adequately addressing them requires sustained investments in stronger national public health capabilities, infrastructure, and surveillance processes.
世界卫生组织非洲区域经常经历传染病的暴发和流行，而卫生系统和基础设施薄弱、检测滞后以及疫情应对不力往往会加剧这种情况。为应对这一问题，世界卫生组织非洲区域办事处于1998年制定并开始实施综合疾病监测与应对战略。
本系统评价旨在记录已发表文献中有关该区域实施综合疾病监测与应对战略所取得的成功和面临的挑战，以突出需要优先处理的领域、进一步研究的方向，并为进一步加强综合疾病监测与应对战略的实施提供参考。
使用PubMed和Web of Science对2012年7月1日至2019年11月13日期间以英文和法文发表的同行评议文献进行系统评价。纳入的文章聚焦于世界卫生组织非洲区域，并讨论了综合疾病监测与应对战略的使用和实施、该战略的评估或综合疾病监测与应对框架所涵盖疾病的监测。使用Microsoft Excel和Tableau Desktop 2019对数据进行描述性分析。
讨论综合疾病监测与应对战略的同行评议文章数量仍然较少，47篇纳入文章聚焦于17个国家和区域层面的系统。最常讨论的主题是数据报告（n = 39）和综合疾病监测与应对战略实施过程中遇到的挑战（n = 38）。在本次评价所评估的所有综合疾病监测与应对核心功能和支持功能中均发现了有效实施的障碍：重点疾病检测；数据报告、管理和分析；信息传播；实验室功能；以及人员培训。在利用和简化现有监测系统及基础设施并努力增加医疗服务可及性的地方，注意到了成功实施的情况。
这些研究结果突出了综合疾病监测与应对战略表现良好的领域以及实施仍然薄弱的领域。自第一版技术指南发布以来，与综合疾病监测与应对战略实施相关的挑战并非新鲜事，但要充分应对这些挑战，需要持续投资以加强国家公共卫生能力、基础设施和监测流程。
