Comprehensive Vaccine-Preventable Disease Surveillance in the Western Pacific Region: A Literature Review on Integration of Surveillance Functions, 2000–2021

Morgane Donadel; Heather M. Scobie; Roberta Pastore; Varja Grabovac; Nyambat Batmunkh; Stephanie O’Connor; Benjamin A. Dahl; Christopher S. Murrill

doi:10.9745/GHSP-D-22-00017

Key Findings

We document factors that influenced integrating surveillance functions for vaccine-preventable diseases (VPDs) and other communicable diseases in the Western Pacific Region (WPR).
Barriers included insufficient coordination within the public and private sectors, inadequate engagement of national Expanded Program on Immunization programs, lack of surveillance and laboratory capacity, inability to link epidemiologic and laboratory data, and suboptimal scope and design of surveillance systems for achieving control and elimination goals.
Best practices and innovations included developing guidelines for integrated VPD surveillance, standardizing processes for laboratory surveillance and testing of multiple VPDs, using multiplex testing for multiple diseases, and conducting joint epidemiology and laboratory surveillance data review meetings.

Key Implications

National WPR stakeholders should consider (1) using the outcomes of this review to inform country implementation plans and (2) developing legal frameworks, guidance documents, and coordination mechanisms for reporting and investigation of cases and clusters of VPDs and other non-VPDs of public health importance.
Public health program managers should consider opportunities for surveillance integration, such as in workforce and laboratory capacity, and information systems and data management.

ABSTRACT

Introduction:

A strategic framework for 2021–2030 developed by the World Health Organization (WHO) Regional Office for the Western Pacific emphasizes the need for high-quality and integrated vaccine-preventable disease (VPD) surveillance. We conducted a literature review to document the barriers, enabling factors, and innovations for integrating surveillance functions for VPDs and other communicable diseases in Western Pacific Region (WPR) countries.

Methods:

We searched published and gray literature on integrated VPD surveillance from 2000 to 2021. Articles in English, Spanish, or French were screened to identify those relating to VPD surveillance in a WPR country and not meeting defined exclusion criteria. We categorized articles using the 8 WHO surveillance support functions and abstracted data on the country; type of surveillance; and reported barriers, enabling factors, and best practices for integration.

Results:

Of the 3,137 references screened, 87 met the eligibility criteria. Of the 8 surveillance support functions, the proportion of references that reported integration related to the laboratory was 56%, followed by workforce capacity (54%), governance (51%), data management and use (47%), field logistics and communication (47%), coordination (15%), program management (13%), and supervision (9%). Several references noted fragmented systems and a lack of coordination between units as barriers to integration, highlighting the importance of engagement across public health units and between the public and private sectors. The literature also indicated a need for interoperable information systems and revealed the use of promising new technologies for data reporting and laboratory testing. In some WPR countries, workforce capacity was strengthened at all administrative levels by the implementation of integrated trainings on data monitoring and use and on laboratory techniques applicable to multiple VPDs.

Conclusion:

This literature review supports integrating VPDs into broader communicable disease surveillance systems in WPR countries while ensuring that the minimal WHO-recommended standards for VPD surveillance are met.

Received: January 19, 2022.
Accepted: October 4, 2022.
Published: October 31, 2022.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-22-00017

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