Expanding severe acute respiratory infection (SARI) surveillance beyond influenza: The process and data from 1 year of implementation in Vietnam

Alroy, Karen A.; Do, Trang Thuy; Tran, Phu Dac; Dang, Tan Quang; Vu, Long Ngoc; Le, Nga Thi Hang; Dang, Anh Duc; Ngu, Nghia Duy; Ngo, Tu Huy; Hoang, Phuong Vu Mai; Phan, Lan Trong; Nguyen, Thuong Vu; Nguyen, Long Thanh; Nguyen, Thinh Viet; Vien, Mai Quang; Le, Huy Xuan; Dao, Anh The; Nguyen, Trieu Bao; Pham, Duoc Tho; Nguyen, Van Thi Tuyet; Pham, Thanh Ngoc; Phan, Binh Hai; Whitaker, Brett; Do, Thuy Thi Thu; Dao, Phuong Anh; Balajee, S. Arunmozhi; Mounts, Anthony W.

After the harmonization workshop, the SARI Surveillance Table 3 for results by sentinel site 20 Studies of Vietnamese pediatric patients with acute respiratory infections identified 23.8% and 23% as positive for RSV. 27, 28 As RSV is believed to be the most common pathogen causing acute lower respiratory infections in children, 29 it is predictable and consistent with our findings that the proportion of RSV in pediatric- given the sensitivity of the rRT-PCR platform and the unclear role of non-influenza viruses in virulence, this conclusion warrants further research. [31] [32] [33] [34] The 7 non-influenza respiratory viruses used in this study were selected based on historical data demonstrating their potential involvement in respiratory infections, as well as their potential for future vaccine development. [11] [12] [13] [14] [15] [16] [35] [36] [37] [38] [39] Of the 7 viruses, significant progress has been made toward RSV vaccine development; however, despite several potential candidates, some of which advanced to clinical trials, no vaccine so far is both safe and effective. 40 Establishing baseline data for these viruses in people with SARI helps to provide evidence to GDPM to guide public health decision-making. ters. 41 In addition, healthcare utilization is reported to be 3-4 times higher in urban areas than in the mountainous regions in the north or central regions of the country. 42 In spite of these limitations, the existence of a SARI surveillance network in Vietnam provided a platform for collecting data on important non-influenza respiratory viruses, and the process of expanding the system offered an opportunity to revisit the data collection and analysis practices that were routine for SARI surveillance. As a multistep process, the expansion and strengthening of SARI surveillance continued to develop throughout 2016 and 2017, and will likely continue to improve with further attention and refinement to the system. The future integration of the expanded SARI surveillance data into the GDPM data warehouse offers additional potential benefit of reduced delays due to data sharing, reduced need for manual data curation, as well as provision of data to the public health emergency operation center for routine data analysis. 17 The process of expanding SARI surveillance to test for noninfluenza respiratory viruses has engaged numerous organizations in Vietnam ranging from sentinel hospitals, RIs to GDPM and international donor organizations. Additionally, in the era of GHSA the study demonstrates an ability to enhance and expand surveillance by building and extending upon existing in-country capacities.