title: Capacity of the national influenza surveillance system in Afghanistan, a chronic conflict setting.
abstract: Influenza surveillance is needed to monitor potential public health threats from the emergence of novel influenza viruses. This study assessed the capacity and performance of the national influenza surveillance system in Afghanistan from 2007 to 2014. Data were collected by review of hospital registers and the National Influenza Centre (NIC) database, interviews with influenza focal points at 9 influenza sentinel surveillance sites and the Centre staff, and observation of the sites. Out of 6900 specimens collected, influenza virus was detected in 253 (3.6%), predominantly H1N1 (63%); most of these cases were detected during the 2009 pandemic. The NIC had the capacity for virus isolation and PCR identification and performed reasonably until 2011 when support of the Naval American Medical Research Unit 3 was withdrawn. The limitations identified in the system indicated the need for: more complete data, improved technical competence and trained human resources, updating of the infrastructure/facilities, and the presence of standard operating procedures throughout surveillance.
authors.affiliation: Surveillance Department, Ministry of Public Health, Kabul, Afghanistan.
authors.forename: M H
authors.initials: MH
authors.lastname: Rasooly
authors.affiliation: World Health Organization Country Office, Kabul, Afghanistan.
authors.forename: M N
authors.initials: MN
authors.lastname: Sahak
authors.affiliation: Surveillance Department, Ministry of Public Health, Kabul, Afghanistan.
authors.forename: K I
authors.initials: KI
authors.lastname: Saeed
authors.affiliation: Communicable Disease Surveillance, World Health Organization Country Office, Kabul, Afghanistan.
authors.forename: S K
authors.initials: SK
authors.lastname: Krishnan
authors.affiliation: Pandemic Influenza Preparedness, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt.
authors.forename: W
authors.initials: W
authors.lastname: Khan
authors.affiliation: WHO Collaborating Centre for Public Health Education & Training, Department of Primary Care and Public Health, Imperial College London, London, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Hassounah
mesh_terms: D000293:Adolescent; D000328:Adult; D000346:Afghanistan; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology*; D007407:Interviews as Topic; D008875:Middle Aged; D011634:Public Health; D036301:Qualitative Research; D012042:Registries; D012189:Retrospective Studies; D012621:Seasons; D018571:Sentinel Surveillance; D014857:Warfare; D055815:Young Adult