Healthcare personnel acceptance and recommendations for influenza vaccine in twelve low- and middle-income countries: A pooled analysis from 2018 to 2020.

Background: Although healthcare personnel (HCP) are targeted for influenza vaccination they typically underutilize vaccines especially in low- and middle-income countries. We explored knowledge, attitudes, and practices of HCP about seasonal influenza vaccines (SIV) to identify factors associated with and modifiable barriers to SIV uptake.

Methods: We pooled individual-level data from cross-sectional surveys about SIV conducted among health workers in 12 low- and middle- income countries during 2018-2020 (i.

Do Pregnant Persons Want Influenza Vaccines? Knowledge, Attitudes, Perceptions, and Practices Toward Influenza Vaccines in 8 Low- and Middle-Income Countries.

Background: Vaccination is the most effective way to prevent influenza infection and adverse outcomes; despite global recommendations to vaccinate pregnant persons, access to influenza vaccines remains low. We explored knowledge, attitudes, and practices of pregnant persons to inform actions to improve vaccine uptake.

Methods: We pooled data from cross-sectional surveys assessing pregnant persons' attitudes toward influenza vaccines in 8 low- and middle-income countries.

Costs of in- and outpatient respiratory disease and the seasonal influenza vaccination program in Armenia - 2020-2021.

Background: Despite the substantial global impact of influenza, there are limited economic data to guide influenza vaccination programs investments in middle-income countries. We measured the costs of influenza and the costs of an influenza vaccination program in Armenia, using a societal perspective.

Methods: During December 2022 through March 2023, retrospective cost data were collected from case-patients and healthcare providers through structured questionnaires at 15 healthcare facilities selected through stratified sampling.

Strengthening influenza surveillance capacity in the Eastern Mediterranean Region: Nearly two decades of direct support from the United States Centers for Disease Control and Prevention.

Since 2004, the US Centers for Disease Control and Prevention (CDC) Influenza Division (ID) has supported seven countries in the Eastern Mediterranean region and the World Health Organization Regional Office for the Eastern Mediterranean to establish and strengthen influenza surveillance. The substantial growth of influenza surveillance capacities in the region demonstrates a commitment by governments to strengthen national programs and contribute to global surveillance. The full value of surveillance data is in its use to guide local public health decisions.

Leveraging International Influenza Surveillance Systems and Programs during the COVID-19 Pandemic.

A network of global respiratory disease surveillance systems and partnerships has been built over decades as a direct response to the persistent threat of seasonal, zoonotic, and pandemic influenza. These efforts have been spearheaded by the World Health Organization, country ministries of health, the US Centers for Disease Control and Prevention, nongovernmental organizations, academic groups, and others. During the COVID-19 pandemic, the US Centers for Disease Control and Prevention worked closely with ministries of health in partner countries and the World Health Organization to leverage influenza surveillance systems and programs to respond to SARS-CoV-2 transmission.

CDC's COVID-19 International Vaccine Implementation and Evaluation Program and Lessons from Earlier Vaccine Introductions.

The US Centers for Disease Control and Prevention (CDC) supports international partners in introducing vaccines, including those against SARS-CoV-2 virus. CDC contributes to the development of global technical tools, guidance, and policy for COVID-19 vaccination and has established its COVID-19 International Vaccine Implementation and Evaluation (CIVIE) program. CIVIE supports ministries of health and their partner organizations in developing or strengthening their national capacities for the planning, implementation, and evaluation of COVID-19 vaccination programs.

Development of a road map to scale up the uptake and utilization of influenza vaccine in 22 countries of Eastern Mediterranean Region.

Background: The aim of this project was to develop a road map to support countries in Eastern Mediterranean Region in developing and implementing evidence-based seasonal influenza vaccination policy, strengthen influenza vaccination delivery program and address vaccine misperceptions and hesitancy.

Methods: The road map was developed through consultative meetings with countries' focal points, review of relevant literature and policy documents and analysis of WHO/UNICEF Joint Reporting Form on immunization ((JRF 2015-2020) data. Countries were categorised into three groups, based on the existence of influenza vaccination policy and national regulatory authority, availability of influenza vaccine in the country and number of influenza vaccine doses distributed/ 1000 population.

An Update on Posterior Tarsal Tunnel Syndrome.

Posterior tarsal tunnel syndrome (PTTS) is an entrapment neuropathy due to compression of the tibial nerve or one of its terminal branches within the tarsal tunnel in the medial ankle. The tarsal tunnel is formed by the flexor retinaculum, while the floor is composed of the distal tibia, talus, and calcaneal bones. The tarsal tunnel contains a number of significant structures, including the tendons of 3 muscles as well as the posterior tibial artery, vein, and nerve.

United States Centers for Disease Control and Prevention support for influenza surveillance, 2013-2021.

Objective: To assess the stability of improvements in global respiratory virus surveillance in countries supported by the United States Centers for Disease Control and Prevention (CDC) after reductions in CDC funding and with the stress of the coronavirus disease 2019 (COVID-19) pandemic.

Methods: We assessed whether national influenza surveillance systems of CDC-funded countries: (i) continued to analyse as many specimens between 2013 and 2021; (ii) participated in activities of the World Health Organization's (WHO) Global Influenza Surveillance and Response System; (iii) tested enough specimens to detect rare events or signals of unusual activity; and (iv) demonstrated stability before and during the COVID-19 pandemic. We used CDC budget records and data from the WHO Global Influenza Surveillance and Response System.

Cost-effectiveness of seasonal influenza vaccination in pregnant women, healthcare workers and adults >= 60 years of age in Lao People's Democratic Republic.

Background: Pregnant women, healthcare workers (HW), and adults >= 60 years have shown an increased vulnerability to seasonal influenza virus infections and/or complications. In 2012, the Lao People's Democratic Republic (Lao PDR) initiated a national influenza vaccination program for these target groups. A cost-effectiveness evaluation of this program was undertaken to inform program sustainability.

Barriers and activities to implementing or expanding influenza vaccination programs in low- and middle-income countries: A global survey.

Introduction: Despite considerable global burden of influenza, few low- and middle-income countries (LMICs) have national influenza vaccination programs. This report provides a systematic assessment of barriers to and activities that support initiating or expanding influenza vaccination programs from the perspective of in-country public health officials.

Methods: Public health officials in LMICs were sent a web-based survey to provide information on barriers and activities to initiating, expanding, or maintaining national influenza vaccination programs.

Ancillary benefits of seasonal influenza vaccination in middle-income countries.

While seasonal influenza vaccines (SIV) remain the best method to prevent influenza-associated illnesses, implementing SIV programs may benefit countries beyond disease reduction, strengthening health systems and national immunization programs, or conversely, introduce new challenges. Few studies have examined perceived impacts of SIV introduction beyond disease reduction on health systems; understanding such impacts will be particularly salient in the context of COVID-19 vaccine introduction. We collected qualitative data from key informants-Partnership for Influenza Vaccine Introduction (PIVI) contacts in six middle-income PIVI vaccine recipient countries-to understand perceptions of ancillary benefits and challenges from SIV implementation.

Observations of the global epidemiology of COVID-19 from the prepandemic period using web-based surveillance: a cross-sectional analysis.

Unlabelled: Background Scant data are available about global patterns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread and global epidemiology of early confirmed cases of COVID-19 outside mainland China. We describe the global spread of SARS-CoV-2 and characteristics of COVID-19 cases and clusters before the characterisation of COVID-19 as a pandemic.

Methods: Cases of COVID-19 reported between Dec 31, 2019, and March 10, 2020 (ie, the prepandemic period), were identified daily from official websites, press releases, press conference transcripts, and social media feeds of national ministries of health or other government agencies.

Establishing seasonal and alert influenza thresholds in Morocco.

Background: Several statistical methods of variable complexity have been developed to establish thresholds for influenza activity that may be used to inform public health guidance. We compared the results of two methods and explored how they worked to characterize the 2018 influenza season performance-2018 season.

Methods: Historical data from the 2005/2006 to 2016/2018 influenza season performance seasons were provided by a network of 412 primary health centers in charge of influenza like illness (ILI) sentinel surveillance.

Improved capacity for influenza surveillance in the WHO Eastern Mediterranean Region: Progress in a challenging setting.

Background: The World Health Organization Regional Office for Eastern Mediterranean has partnered with the United States Centers for Disease Control and Prevention (CDC) to strengthen pandemic influenza preparedness and response in the Region since 2006. This partnership focuses on pandemic preparedness planning, establishing and enhancing influenza surveillance systems, improving laboratory capacity for detection of influenza viruses, estimating the influenza disease burden, and providing evidence to support policies for the introduction and increased use of seasonal influenza vaccines.

Methods: Various published and unpublished data from public and WHO sources, programme indicators of the CDC cooperative agreement and Pandemic Influenza Preparedness Framework were reviewed and analysed.

The partnership for influenza vaccine introduction (PIVI): Supporting influenza vaccine program development in low and middle-income countries through public-private partnerships.

Influenza vaccination remains the most effective tool for reducing seasonal influenza disease burden. Few Low and Middle-Income Countries (LMICs) have robust, sustainable annual influenza national vaccination programs. The Partnership for Influenza Vaccine Introduction (PIVI) was developed as a public-private partnership to support LMICs to develop and sustain national vaccination programs through time-limited vaccine donations and technical support.

Evaluation of the influenza-like illness surveillance system in Tunisia, 2012-2015.

Background: This study was initiated to evaluate, for the first time, the performance and quality of the influenza-like illness (ILI) surveillance system in Tunisia.

Methods: The evaluation covered the period of 2012-2015 and used different data sources to measure indicators related to data quality and completeness, representativeness, timeliness, simplicity, acceptability, flexibility, stability and utility.

Results: During the evaluation period, 485.

Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection.

The formulation of accurate clinical case definitions is an integral part of an effective process of public health surveillance. Although such definitions should, ideally, be based on a standardized and fixed collection of defining criteria, they often require revision to reflect new knowledge of the condition involved and improvements in diagnostic testing. Optimal case definitions also need to have a balance of sensitivity and specificity that reflects their intended use.

Influenza-associated mortality in Thailand, 2006-2011.

Background: Influenza-associated mortality in subtropical or tropical regions, particularly in developing countries, remains poorly quantified and often underestimated. We analyzed data in Thailand, a middle-income tropical country with good vital statistics and influenza surveillance data.

Methods: We obtained weekly mortality data for all-cause and three underlying causes of death (circulatory and respiratory diseases, and pneumonia and influenza), and weekly influenza virus data, from 2006 to 2011.

Understanding the poultry trade network in Kenya: Implications for regional disease prevention and control.

Infectious diseases in poultry can spread quickly and lead to huge economic losses. In the past decade, on multiple continents, the accelerated spread of highly pathogenic avian Influenza A (H5N1) virus, often through informal trade networks, has led to the death and culling of hundreds of millions of poultry. Endemic poultry diseases like Newcastle disease and fowl typhoid can also be devastating in many parts of the world.

Mortality in Cambodia: an 18-month prospective community-based surveillance of all-age deaths using verbal autopsies.

To estimate the 2009-2010 death rates, causes, and patterns of mortality in rural Cambodia, we conducted active, population-based death surveillance in 25 rural villages of Cambodia from March 2009 to August 2010. Among the population of 28,053 under surveillance, 280 deaths were reported and explored by physician-certified verbal autopsies, using the International Classification of Diseases 10, yielding an overall mortality rate (MR) of 6.7/1000 persons-year (95% CI 5.

Infectious disease mortality rates, Thailand, 1958-2009.

To better define infectious diseases of concern in Thailand, trends in the mortality rate during 1958-2009 were analyzed by using data from public health statistics reports. From 1958 to the mid-1990s, the rate of infectious disease-associated deaths declined 5-fold (from 163.4 deaths/100,000 population in 1958 to 29.

Knowledge, attitudes, and practices of US travelers to Asia regarding seasonal influenza and H5N1 avian influenza prevention measures.

Background: International travel is a potential risk factor for the spread of influenza. In the United States, approximately 5%-20% of the population develops an influenza-like illness annually. The purpose of this study was to describe the knowledge, attitude, and practices of US travelers to Asia regarding seasonal influenza and H5N1 avian influenza (AI) prevention measures.

Strategy to enhance influenza surveillance worldwide.

The emergence of a novel strain of influenza virus A (H1N1) in April 2009 focused attention on influenza surveillance capabilities worldwide. In consultations before the 2009 outbreak of influenza subtype H1N1, the World Health Organization had concluded that the world was unprepared to respond to an influenza pandemic, due in part to inadequate global surveillance and response capacity. We describe a sentinel surveillance system that could enhance the quality of influenza epidemiologic and laboratory data and strengthen a country's capacity for seasonal, novel, and pandemic influenza detection and prevention.