title: Influenza sentinel surveillance in Rwanda, 2008-2010.
abstract: BACKGROUND
  In 2008, Rwanda established an influenza sentinel surveillance (ISS) system to describe the epidemiology of influenza and monitor for the emergence of novel influenza A viruses. We report surveillance results from August 2008 to July 2010.
  
  
  METHODS
  We conducted ISS by monitoring patients with influenza-like illness (ILI) and severe acute respiratory infection (SARI) at 6 hospitals. For each case, demographic and clinical data, 1 nasopharyngeal specimen, and 1 oropharyngeal specimen were collected. Specimens were tested by real-time reverse-transcription polymerase chain reaction for influenza A and B viruses at the National Reference Laboratory in Rwanda.
  
  
  RESULTS
  A total of 1916 cases (945 ILI and 971 SARI) were identified. Of these, 29.2% (n = 276) of ILI and 10.4% (n = 101) of SARI cases tested positive for influenza. Of the total influenza-positive cases (n = 377), 71.8% (n = 271) were A(H1N1) pdm09, 5.6% (n = 21) influenza A(H1), 7.7% (n = 29) influenza A(H3), 1.6% (n = 6) influenza A (unsubtyped), and 13.3% (n = 50) influenza B. The percentage of positivity for influenza viruses was highest in October-November and February-March, during peaks in rainfall.
  
  
  CONCLUSIONS
  The implementation of ISS enabled characterization of the epidemiology and seasonality of influenza in Rwanda for the first time. Future efforts should determine the population-based influenza burden to inform interventions such as targeted vaccination.
authors.affiliation: Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda.
authors.forename: Thierry
authors.initials: T
authors.lastname: Nyatanyi
authors.forename: Richard
authors.initials: R
authors.lastname: Nkunda
authors.forename: Joseph
authors.initials: J
authors.lastname: Rukelibuga
authors.forename: Rakhee
authors.initials: R
authors.lastname: Palekar
authors.forename: Marie Aimée
authors.initials: MA
authors.lastname: Muhimpundu
authors.forename: Adeline
authors.initials: A
authors.lastname: Kabeja
authors.forename: Alice
authors.initials: A
authors.lastname: Kabanda
authors.forename: David
authors.initials: D
authors.lastname: Lowrance
authors.forename: Stefano
authors.initials: S
authors.lastname: Tempia
authors.forename: Jean Baptiste
authors.initials: JB
authors.lastname: Koama
authors.forename: David
authors.initials: D
authors.lastname: McAlister
authors.forename: Odette
authors.initials: O
authors.lastname: Mukabayire
authors.forename: Justin
authors.initials: J
authors.lastname: Wane
authors.forename: Pratima
authors.initials: P
authors.lastname: Raghunathan
authors.forename: Mark
authors.initials: M
authors.lastname: Katz
authors.forename: Corine
authors.initials: C
authors.lastname: Karema
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D009980:Influenza A virus / Q000145:classification* / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000821:virology; D009960:Oropharynx / Q000821:virology; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012432:Rwanda / Q000453:epidemiology; D018571:Sentinel Surveillance; D055815:Young Adult