Islam Md Ariful, Hassan Md Zakiul, Akhtar Zubair, Bhuiya Saju, Shuvo Tanzir Ahmed, Ghosh Probir Kumar, Al Jubayer Biswas Md Abdullah, Rahman Mustafizur, Jubair Mohammad, Begum Mst Noorjahan, Karim Yeasir, Rahman Mohammed Ziaur, Hossain Mohammad Enayet, Morshed Khan Mohammad Niaz, Shirin Tahmina, Rubaid Anwar Shah Niaz Md, Alam Ahmed Nawsher, Rahman Sarker Mohammad Ferdous, Khan Jony Manjur Hossain, Rahman Mahbubur, Rahman Mahmudur, Aleem Mohammad Abdul, Chowdhury Fahmida
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh.
School of Population Health, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia.
Lancet Reg Health Southeast Asia. 2025 Aug 21;41:100657. doi: 10.1016/j.lansea.2025.100657. eCollection 2025 Oct.
There is limited global evidence on whether influenza sentinel surveillance platforms can be effectively adapted for long-term SARS-CoV-2 monitoring in low-resource contexts. We explored the utility of the hospital-based influenza sentinel surveillance (HBIS) platform for monitoring SARS-CoV-2 in Bangladesh by comparing SARS-CoV-2 detection in HBIS platform with national COVID-19 platform and assessing how its integration into influenza surveillance aligns with national trends.
From March 2020 to December 2024, we analysed data from patients with severe acute respiratory infection (SARI) and influenza-like illness (ILI) enrolled in HBIS. Socio-demographic and clinical data were recorded, and nasopharyngeal and oropharyngeal swabs were tested for influenza and SARS-CoV-2 using rRT-PCR. Whole-genome sequencing was performed on a subset of SARS-CoV-2-positive samples. Data from national COVID-19 platform were obtained from the Directorate General of Health Services, Bangladesh, and were compared with HBIS platform data using epidemic curves and Pearson correlation analysis.
Among 25,366 (SARI: 20,226; ILI: 5140) patients, 13.0% (3310) tested positive for influenza, 6.6% (1680) for SARS-CoV-2, and 0.2% (43) were co-infected. SARS-CoV-2 positivity in HBIS (6.8%), including 0.2% co-infections, was lower than the national average (13.1%), but showed a strong correlation with national trends (Pearson = 0.86, P < 0.001). Sequencing of 234 SARS-CoV-2 strains detected the beta and delta variants in April and May 2021, respectively, and omicron subvariants circulating from 2022 to 2024, aligning with the national COVID-19 platform.
SARS-CoV-2 positivity trends in HBIS platform closely aligned with the national COVID-19 platform, demonstrating its potential as a sustainable platform for COVID-19 monitoring. Our findings underscore the feasibility of influenza sentinel surveillance as an early warning system for future COVID-19 outbreaks or other respiratory viruses of pandemic concern in Bangladesh and similar settings.
Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA (U01GH002259).
关于流感哨点监测平台能否在资源匮乏的环境中有效适用于长期监测严重急性呼吸综合征冠状病毒2（SARS-CoV-2），全球证据有限。我们通过比较医院流感哨点监测（HBIS）平台与国家新冠病毒监测平台对SARS-CoV-2的检测情况，并评估将其纳入流感监测与国家趋势的契合度，来探索HBIS平台在孟加拉国监测SARS-CoV-2的效用。
2020年3月至2024年12月，我们分析了纳入HBIS的严重急性呼吸道感染（SARI）和流感样疾病（ILI）患者的数据。记录了社会人口统计学和临床数据，并使用逆转录实时聚合酶链反应（rRT-PCR）检测鼻咽和口咽拭子中的流感病毒和SARS-CoV-2。对一部分SARS-CoV-2阳性样本进行了全基因组测序。国家新冠病毒监测平台的数据来自孟加拉国卫生服务总局，并使用流行曲线和Pearson相关性分析与HBIS平台数据进行比较。
在25366名患者（SARI：20226名；ILI：5140名）中，13.0%（3310名）流感检测呈阳性，6.6%（1680名）SARS-CoV-2检测呈阳性，0.2%（43名）为合并感染。HBIS中SARS-CoV-2阳性率（6.8%），包括0.2%的合并感染率，低于全国平均水平（13.1%），但与全国趋势显示出强烈相关性（Pearson相关系数 = 0.86，P < 0.001）。对234株SARS-CoV-2菌株进行测序，分别在2021年4月和5月检测到贝塔和德尔塔变异株，以及2022年至2024年流行的奥密克戎亚变异株，与国家新冠病毒监测平台情况一致。
HBIS平台中SARS-CoV-2阳性率趋势与国家新冠病毒监测平台密切一致，表明其作为新冠病毒监测可持续平台的潜力。我们的研究结果强调了流感哨点监测作为孟加拉国及类似环境中未来新冠病毒爆发或其他大流行关注的呼吸道病毒早期预警系统的可行性。
美国佐治亚州亚特兰大疾病控制与预防中心（U01GH002259）
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