Nepal national influenza programme: influenza factsheet 2019

Nepal Influenza Surveillance – Landscape Analysis 2019 INFLUENZA FACTSHEET 2019 NEPAL National Influenza Programme Basic information (2019) Total population 29 136 8081 Children <5 years of age - Under-5 mortality rate (per 1000 live births) 30.792 Life expectancy at birth (years) 70.83 Provinces/divisions/regions/zones 7 Districts 77 Total health expenditure (% of GDP) 5.84 Income level (World Bank) Lower middle3 1https://data.worldbank.org/indicator/SP.POP.TOTL?locations=NP 2https://www.who.int/data/gho/data/countries/country-details/GHO/nepal?countryProfi leId=a0b1f4ef-20c7-4ed8-ad1f-bae31926cf86 3https://data.worldbank.org/indicator/SP.DYN.LE00.IN?locations=NP 4https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locations=NP https://data.unicef.org/country/npl/ Infl uenza Like Illness (ILI) Surveillance Type of ILI surveillance Sentinel Sites involved in ILI surveillance Hospitals (outpatients) Clinical case defi nition used for ILI case ascertainment WHO 2011 Is laboratory confi rmation sought in ILI cases? Yes, testing all ILI cases Number of ILI surveillance sites 13 Number of states/districts covered by the surveillance system 5 % of the population covered by the surveillance system - Denominator used for ILI surveillance No denominator Reporting frequency to the national level Weekly How are the data reported? Aggregated Form of the reporting tool Electronic Severe Acute Respiratory Infection (SARI) Surveillance Type of SARI surveillance Sentinel Sites involved in SARI surveillance Hospitals (inpatients) Clinical case defi nition used for SARI case ascertainment WHO 2011 Is laboratory confi rmation sought in SARI cases? Yes, testing all SARI cases Number of SARI surveillance sites 9 Number of states/districts covered by the surveillance system 5 % of the population covered by the surveillance system - Denominator used for SARI surveillance No denominator Reporting frequency to the national level Weekly How are the data reported? Aggregated Form of the reporting tool Electronic Influenza Surveillance – Landscape Analysis 2019 Nepal Epidemiological data (FluID) – Influenza Like Illness (ILI) surveillance 0 2 4 6 8 10 12 14 16 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 2019 Nu mb er of ca se s Data for ILI/outpatient rate unavailable. Plotted in R (ggplot2). Data source: FluMART, available at http://apps.who.int/flumart/ Epidemiological data (FluID) – Severe Acute Respiratory infections (SARI) surveillance 0 0.2 0.4 0.6 0.8 1 1.2 0 50 100 150 200 250 300 350 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 2019 Pr op or tio n Nu mb er of ca se s Data for SARI/inpatient rate unavailable. Plotted in R (ggplot2). Data source: FluMART, available at http://apps.who.int/flumart/ Intensive Care Unit (ICU) surveillance Does the country have surveillance for influenza in the ICU? No Is laboratory confirmation sought in ICU cases? Not Applicable Is case-based information collected? Not Applicable 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 National and sentinel – If sentinel, number of sites involved 16 Nepal Influenza Surveillance – Landscape Analysis 2019 Is epidemiological case information collected? Yes – If yes, are the laboratory results linked with epidemiological data? No Average number of virological samples processed per week 62 Are samples processed from ILI or SARI surveillance systems? Yes, from both systems Does the country have virus isolation capacity? Yes Does the country have RT-PCR capacity? Yes – laboratories that perform RT-PCR - – RT-PCR laboratories that report to NIC - Does the country use rapid diagnostic testing for influenza surveillance? Yes Does the country have sequencing capacity? No Does the country test for other respiratory viruses? No Location of Influenza sentinel surveillance sites Virological data (FluNet) 0 20 40 60 80 100 0 50 100 150 200 250 300 350 400 450 500 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 % Po sit ive 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/ Influenza Surveillance – Landscape Analysis 2019 Nepal National Influenza Centre Does the country have a National Influenza Centre (NIC) or national laboratory? Yes, (NIC was established in 2010) Assays routinely performed at the NIC or national laboratory Rapid influenza test, RT-PCR, Immunofluorescence assay (IFA), virus isolation Does the NIC have – Virus isolation capability – Antigenic characterisation capability – Antiviral susceptibility testing capability – Sequencing capability Yes No No No Does the NIC test for other respiratory viruses? No Does the country have a quality control plan? Yes 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, The National Institute of Infectious Diseases (NIID)Tokyo-Japan, China National Influenza Centre, Beijing, China – How often? 1-2 Reporting Frequency of national reports Annually (+ weekly bulletin by IHR NFP) Are epidemiological and virological data integrated? No Reported via a website? Yes – http://www.nphl.gov.np/ http://edcd.gov.np/ Does the country report to FluID? – Year of beginning of reporting – Frequency of reporting Yes 2019 Weekly Does the country report to FluNet? – Year of beginning of reporting – Frequency of reporting Yes 2012 Weekly Are there fixed outbreak thresholds? No 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 2019 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 No Not applicable Not applicable Not applicable Not applicable Not applicable Is seasonal influenza offered in the private sector? – Only offered to particular risk groups? – Vaccination period – Northern/Southern hemisphere vaccine ? – Vaccine type Yes No Available all year Northern Quadrivalent Is vaccine offered to Hajj and Umrah pilgrims? Yes, via the national programme Vaccine production capacity No Nepal Influenza Surveillance – Landscape Analysis 2019 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 2007 2014 Has the country performed simulation exercises? Yes – table top, functional and drills Are there laboratory testing strategies in place for different phases of an influenza pandemic? No Are there surge capacity plans? No, but Nepal intends to develop Does the pandemic preparedness plan include a detailed National Pandemic Vaccine Deployment Plan? – Are there priority groups? No