Evaluation of Australia's Enhanced Invasive Pneumococcal Disease (IPD) Surveillance Program

Australia's Enhanced Invasive Pneumococcal Disease Surveillance Program is part of the National Notifiable Diseases Surveillance System, and is coordinated by the Enhanced Invasive Pneumococcal Disease Surveillance Working Group (EIPDSWG). This first evaluation of the surveillance program aimed to evaluate its performance against a number of attributes, identify ways in which surveillance may be improved, and make recommendations to the EIPDSWG. We conducted literature and document reviews; key informant interviews; an online stakeholder survey; and descriptive analyses of a subset of surveillance data. The program is complex, but has proved useful for detecting serotype replacement in response to the national infant vaccination program-informing a change to the recommended vaccine in 2011. The program is less useful for monitoring targeted programs in other high-risk groups, because complete data for cases aged between five and 50 years are not routinely collected in the largest jurisdictions and data collection is hampered by the absence of accessible electronic health records. Lack of support for reference laboratories for antimicrobial susceptibility testing, and data entry and transmission problems in some jurisdictions, have reduced the utility of the program for surveillance of antimicrobial resistance (AMR). Priority recommendations to the EIPDSWG focus on collecting complete data for all cases, to allow matching of serotypes to vaccines and surveillance of vaccine failures, while ensuring stakeholders can easily access useful surveillance data at the level of detail they require. Efforts should also be made to improve AMR data completeness, and to explore the feasibility of whole-genome sequencing methods for monitoring resistance.