Evaluation of selected aspects of influenza surveillance system and describing influenza surveillance data collected during 2014-2018 of district general hospital Matara, Sri Lanka


  • Nayana Y. Samaraweera Health Services Office, Paramulla, Matara, Sri Lanka




Influenza surveillance, Pandemic preparedness, Cross sectional analytical study


Background: Influenza is one of the diseases which have the pandemic potential. Influenza surveillance as part of the pandemic preparedness activities was initiated in Sri Lanka in 2005. This study would help in evaluating, strengthening influenza surveillance system of DGH Matara, and taking targeted preventive measures and contribute to more efficient resource allocation in the future.

Methods: This was a cross sectional analytical study.

Results: Case definitions for ILI and SARI used were consistent with the epidemiology unit Sri Lanka prescribed definitions. Though the site collected data on cases daily and sampled weekly, sampling technique was not random. Respiratory specimen collection, packaging, storage and transport were consistent with the guidelines of epidemiology Unit, Sri Lanka. Refrigerator temperature monitoring, analyzing surveillance data on site as well as supervisory visits made by central level were not satisfactory. No clear pattern of ILI and SARI was observed among different age groups during 2014-2018. Influenza viral activity was detected except for “untyped” from respiratory samples sent by DGH, Matara during 2014-2018. Pandemic preparedness by the site was not at optimal level.

Conclusions: Representativeness of data obtained from respiratory specimen collection and data analyzing were not satisfactory. Temperature monitoring inside storage refrigerators of the site was not possible as no written records were available. Supervision from the central level was not satisfactory.

Author Biography

Nayana Y. Samaraweera, Health Services Office, Paramulla, Matara, Sri Lanka

Health Department

Consultant Community Physician


Bellos A, Mulholland K, O'Brien KL, Qazi SA, Gayer M, Checchi F. The burden of acute respiratory infections in crisis-affected populations: a systematic review. Conflict and health. 2010;4(1):1-2.

World Health Organization. Review of the 2010-2011 winter influenza season, northern hemisphere. Weekly Epidemiological Record=Relevé épidémiologique hebdomadaire. 2011;86(22):222-7. Available at: https://www.who.int/publications/i/item/who-wer-8622-222-227. Accessed on 15 January 2020.

Epidemiology Unit, Ministry of Healthcare and Nutrition, Sri Lanka. Report for Web. 2012;7(4):1. Available at http://www.epid.gov.lk/web/attachments/article/180/Surveillance%20introduction.pdf. Accessed on 15 January 2020.

Epidemiology Unit, Ministry of Healthcare and Nutrition, Sri Lanka. Background on AI and PI. 2015. Available at: https://www.epid.gov.lk/web/attachments/article/180/Background%20on%20AI&PI.pdf Accessed 15 January 2020.

Centers for Disease Control and Prevention, Atlanta, USA. International Influenza Surveillance Assessment Tool. 2017:13. Available at: https://www.cdc.gov/flu/pdf/international/cdc_flu_surveillance_tool_508.pdf. Accessed on 12 April 2020.

Stata Corp LLC 4905 Lakeway Drive, College Station, Texas 77845-4512 USA; 2021. Available at: https://www.stata.com. Accessed 15 January 2021.

World Health Organization. WHO Regional Office for Europe guidance for sentinel influenza surveillance in humans. World Health Organization. Regional Office for Europe; 2011. Available at https://apps.who.int/iris/bitstream/handle/10665/107265/E92738.pdf?sequence=1. Accessed 15 January 2020.

Budgell E. Evaluation of two influenza surveillance systems in South Africa. PLoS One. 2015;10(3):e0120226.

Shaw Stewart PD, Bach JL. Temperature dependent viral tropism: understanding viral seasonality and pathogenicity as applied to the avoidance and treatment of endemic viral respiratory illnesses. Reviews in Med Virol. 2021’e2241.

Tomlinson J. Using clinical supervision to improve the quality and safety of patient care: a response to Berwick and Francis. BMC Medical Education. 2015;15(1):1-8.

World Health Organization. Module 4: Supportive supervision. Training for mid-level managers.2008. https://www.who.int/immunization/documents/MLM_module4.pdf. Accessed on 02 January 2022.

Centers for Disease Control and Prevention, Atlanta, USA. Interim Guidance on Specimen Collection, Processing, and Testing for Patients with Suspect Influenza A (H3N2) v Virus Infection. Available at https:// https://www.cdc.gov/flu/swineflu/variant/h3n2v-testing.htm. Accessed on 02 January 2022.






Original Research Articles