Epidemiological surveillance of land borders in North and South America: a case study

Bruniera-Oliveira, Robson; Horta, Marco Aurélio Pereira; Varan, Aiden; Montiel, Sonia; Carmo, Eduardo Hage; Waterman, Stephen H; Verani, José Fernando de Souza

In Brazil, the Border Laboratories Network can be considered innovative as it seeks to reduce the differences in laboratory capacity between countries. However, despite what has been developed so far, significant obstacles were identified, such as a lack of support from federal laboratories and no standardization of techniques among countries. This hindered comparisons and the planning of binational actions. A study about the occurrence of public health emergencies in Brazil proved that, in the border areas, laboratory confirmation remains low for suspected cases 21 . This lack of diagnosis can be attributed to the high testing demand that these laboratories have, which requires additional investment for its expansion and an increase of capacity to become a robust border network. Although one of the response pillars to the Ebola outbreak in West Africa has been the laboratory support, the lack of capacity during the early stages of the epidemic was undoubtedly a factor that contributed to Ebola's rapid expansion, reinforcing the idea of consolidating a prepared network to respond to any type of threat 32, 33 . Such difficulties in the BES development, including laboratory services, may have contributed to a weak capacity to detect and respond in a timely manner to public health events, as observed for the Brazilian international border municipalities 34 . The analysis of their capacity to report infectious diseases with a potential to generate an epidemic demonstrated a very low proportion (16,6%) of cases of these diseases being reported in a timely manner (< 24 hours -as established nationally).