Maldives national influenza programme: influenza factsheet 2019

Maldives Influenza Surveillance – Landscape Analysis 2019 INFLUENZA FACTSHEET 2019 MALDIVES National Influenza Programme Basic information (2019) Total population 338 4341 Children <5 years of age 35 7121 Under-5 mortality rate (per 1000 live births) 7.91 Life expectancy at birth (years) 78.42 Provinces/divisions/regions/zones 3 Districts 22 (20 atolls, 2 cities) Total health expenditure (% of GDP) 9.51 Income level (World Bank) Upper middle3 1https://www.who.int/southeastasia/health-topics/immunization 2https://www.who.int/gho/publications/world_health_statistics/2020/en/ 3https://data.worldbank.org/ Influenza Like Illness (ILI) Surveillance Type of ILI surveillance Sentinel Sites involved in ILI surveillance Hospitals (outpatients) Clinical case definition used for ILI case ascertainment WHO 2014 Is laboratory confirmation sought in ILI cases? Yes, 10 cases per week Number of ILI surveillance sites 5 Number of states/districts covered by the surveillance system 3 (Northern, Central and Southern) % of the population covered by the surveillance system - Denominator used for ILI surveillance - Reporting frequency to the national level Weekly How are the data reported? Case-based notification (only a proportion of ILI cases) Form of the reporting tool Via the Influenza Surveillance Form Severe Acute Respiratory Infection (SARI) Surveillance Type of SARI surveillance Sentinel Sites involved in SARI surveillance Hospitals (inpatients) Clinical case definition used for SARI case ascertainment WHO 2014 Is laboratory confirmation sought in SARI cases? Yes, all SARI cases Number of SARI surveillance sites 5 Number of states/districts covered by the surveillance system 3 (Northern, Central and Southern) % of the population covered by the surveillance system - Denominator used for SARI surveillance - Reporting frequency to the national level Weekly How are the data reported? Case-based notification (all SARI cases) Form of the reporting tool Via Influenza Surveillance Form Influenza Surveillance – Landscape Analysis 2019 Maldives Intensive Care Unit (ICU) surveillance Does the country have surveillance for influenza in the ICU? Yes (covered by SARI surveillance) Is laboratory confirmation sought in ICU cases? Yes Is case-based information collected? Yes Mortality surveillance Is timely all-cause mortality data (i.e. within one month) available in the country? No Virological surveillance Does the country have virological surveillance? Yes Type of virological surveillance Sentinel – If sentinel, number of sites involved 5 Is epidemiological case information collected? Yes – If yes, are the laboratory results linked with epidemiological data? Yes (both types of data are entered to the Influenza Surveillance Database) Average number of virological samples processed per week 20 Are samples processed from ILI or SARI surveillance systems? Yes, from both systems Does the country have virus isolation capacity? No Does the country have RT-PCR capacity? Yes – laboratories that perform RT-PCR 1 laboratory – RT-PCR laboratories that report to NIC - Does the country use rapid diagnostic testing for influenza surveillance? No Does the country have sequencing capacity? No Does the country test for other respiratory viruses? Yes Virological data (FluNet) 0 20 40 60 80 100 0 20 40 60 80 100 120 140 1 5 9 13 17 21 25 29 33 37 41 45 49 1 5 9 13 17 21 25 29 33 37 41 45 49 1 5 9 13 17 21 25 29 33 37 41 45 49 2017 2018 2019 % P os itiv e Nu mb er of ca se s A/H1N1pm09 A/H1N1 A/H3N2 A/H5N1 A (Unsubtyped) B Yamagata B Victoria B (Unsubtyped) % Positive Plotted in R (ggplot2). Data source: FluMART, available at http://apps.who.int/flumart/ Maldives Influenza Surveillance – Landscape Analysis 2019 National Influenza Centre Does the country have a National Influenza Centre (NIC) or national laboratory? No Assays routinely performed at the NIC or national laboratory RT-PCR Does the NIC have – Virus isolation capability – Antigenic characterisation capability – Antiviral susceptibility testing capability – Sequencing capability No No No No Does the NIC test for other respiratory viruses? Yes Does the country have a quality control plan? In progress Does the country follow national biosafety and biosecurity policy guidelines? Yes Does the country forward samples to a WHO Collaborating Centre (CC)? Yes – US CDC , Atlanta, USA – How often? Twice per year Reporting Frequency of national reports Monthly Are epidemiological and virological data integrated? Yes, both types of data Reported via a website? No Does the country report to FluID? – Year of beginning of reporting – Frequency of reporting No Not Applicable Not Applicable Does the country report to FluNet? – Year of beginning of reporting – Frequency of reporting Yes 2016 Weekly Are there fixed outbreak thresholds? Yes Level at which data are stored, managed and analysed National Has formal training on data reporting and analysis been provided to surveillance and laboratory staff? – If yes, when? – Has a training session been planned? If yes, when? Yes 2017 No Vaccination Does the country have a formal seasonal influenza vaccination policy? No Has seasonal influenza been introduced in the public sector? – Year introduced – Recommended risk groups – Vaccination period – Northern/Southern hemisphere vaccine ? – Vaccine type Yes 2017 People >65y, people with chronic conditions, lung and heart disorders, children <5y, immunocompromised people, pregnant women All year Southern Trivalent, quadrivalent Is seasonal influenza offered in the private sector? – Only offered to particular risk groups? – Vaccination period – Northern/Southern hemisphere vaccine ? – Vaccine type - - - - - Is vaccine offered to Hajj and Umrah pilgrims? Yes, via the national programme Vaccine production capacity No Influenza Surveillance – Landscape Analysis 2019 Maldives For technical information, please contact: Dr Pushpa Ranjan Wijesinghe, Programme Area Manager (Infectious Hazard Management). Email: wijesinghep@who.int Pandemic preparedness Does the country have a National Influenza Pandemic Preparedness Plan? – Year developed – Year last updated Yes 2005 2017 Has the country performed simulation exercises? Yes, table top, functional exercises Are there laboratory testing strategies in place for different phases of an influenza pandemic? Yes Are there surge capacity plans? No, but intend to develop Does the pandemic preparedness plan include a detailed National Pandemic Vaccine Deployment Plan? – Are there priority groups? Mentioned in the National Influenza Pandemic preparedness Plan but a more detailed plan is necessary People >65y, people with chronic conditions, lung and heart disorders, children <5y, immunocompromised people, pregnant women