2015-11-20-世界卫生组织-WHO-coordinated_Global_IB-VPD_and_RV_Surveillance_Network_Meetings_Report_2015_38页_537kb

WHO IB-VPD and Rotavirus Sentinel Global Surveillance Network Meeting Summary

Date: November 16–21, 2015
Location: Geneva, Switzerland

Overview

• IB-VPD Network: Covers surveillance of meningitis, pneumonia, and sepsis across six WHO regions, with a focus on pneumococcal and Hib disease vaccine impact.
• Rotavirus Network: Monitors rotavirus epidemiology and vaccine impact, while expanding capacity for multiplex pathogen detection.
• Key Topics: Laboratory improvements, data quality, funding sustainability, and coordination with other surveillance systems.

IB-VPD Surveillance Progress

• Data Linkage & Quality:
  • 68% of clinical-laboratory data linked globally; some regions (EUR, SEAR) achieved >90%.
  • Action items: Revise core variables (e.g., add "vaccine history") and improve missing data resolution.
• Laboratory Advancements:
  • PCR detected additional cases missed by culture; validated for meningococcal and Hib serotyping.
  • Direct PCR and robotic extraction increase efficiency but require standardization.
• Challenges:
  • India and other large countries not fully integrated despite high data potential.
  • Lab capacity varies; funding sustainability and country ownership are concerns.

Rotavirus Surveillance Progress

• Network Expansion:
  • Includes sites from ~50 countries; detects rotavirus and other enteric pathogens using TaqMan Array Cards.
  • 31% of tested stool samples positive for rotavirus (2014–2015).
• Vaccine Impact:
  • Demonstrated significant reductions in disease post-vaccine introduction in EUR countries.
  • Global rotavirus mortality remains high in Sub-Saharan Africa and Asia, with India and Nigeria as top contributors.
• Technological Innovations:
  • TAC assays enable simultaneous detection of multiple pathogens (e.g., rotavirus, Shigella, norovirus).
  • Genotype tracking supports vaccine strain selection and strain evolution monitoring.

Laboratory & Data Management

• QA/QC Systems:
  • EQA scores >90% for RRLs, >75% for NLs.
  • Regional QC exercises harmonize methods and identify technical discrepancies.
• Data Presentation:
  • Adaptable templates for stakeholder-friendly reporting; emphasize clarity and consistency.
  • Use case-based data for severity analysis (e.g., IV fluid use in rotavirus cases).

Future Directions

• Integration: Synergize with CHAMPS Network for child mortality surveillance.
• Funding Sustainability: Explore Gavi, BMGF, and US GHS as alternative funding sources.
• Technical Development: Validate direct PCR and refine primers for improved genotyping accuracy.
• Network Expansion: Include high-burden countries (e.g., India) and enhance regional capacity building.