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Published on: November 7, 2018
Implementing sequencing-based surveillance in developing countries: findings from a pilot rollout for hepatitis A in
Xiaotong Hu1, Wenting Zhou2, Li Zhang3
1The First Affiliated Hospital, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, College of Medicine, Zhejiang University, Hangzhou, China.
Implementing sequencing-based surveillance for infectious diseases like hepatitis A (HepA) is feasible in developing countries. A pilot study in China showed its utility for outbreak detection, though data quality and timeliness require improvement.
Area of Science:
- Public Health
- Infectious Disease Surveillance
- Genomic Epidemiology
Background:
- Emerging SARS-CoV-2 variants necessitate robust sequencing-based surveillance, especially in developing nations.
- Limited data exists on implementing and evaluating such surveillance systems for mutant virus detection.
Purpose of the Study:
- To assess the implementation, feasibility, and performance of sequencing-based surveillance.
- To identify challenges and areas for improvement in a pilot hepatitis A surveillance system.
Main Methods:
- A pilot sequencing-based surveillance for hepatitis A (HepA) was conducted in five Chinese provinces.
- System performance was evaluated using indicators: acceptability, data quality, simplicity, utility, and timeliness (1-3 scale).
Main Results:
- 306 HepA cases reported; 49.79% of samples sequenced.
- Eleven genomic clusters identified; seven potentially linked to a foodborne outbreak.
- Simplicity scored highest (2.63); data quality and timeliness scored lowest (1.75).
Conclusions:
- The system demonstrated satisfactory performance and utility for virological characterization and early outbreak detection.
- Addressing resource constraints and improving physician support and data quality are crucial for scale-up.
- Decentralized networks may enhance timeliness for emerging infections.
