Arboviral disease surveillance staff perceptions

Surveillance staff perceptions of factors contributing to success or barriers/challenges in human arboviral disease surveillance (ref Q14)

Country	Successes	Barriers
Bangladesh	Infectious Disease Control Act 2018	Collecting data from private sector
Bhutan	Integrated Primary Health Care management system where all health workers were trained on public health and health promotion; the arboviral diseases are notifiable disease list; periodic vector surveillance and risk mapping	Limited public knowledge on the disease. Rare/very seasonal disease and health workers forget for ruling out the disease; limited stakeholders participation and community ownership especially on mosquito breeding source reduction and community behavior on preventive and control measures
India
Indonesia
Maldives	Close collaboration between national and peripheral surveillance focal points. Daily reporting of communicable diseases including arboviruses.	Lacks of proper integrated surveillance mechanism, old system (SIDAS; SEARO integrated Disease Surveillance System). Lack of use of advanced surveillance tools at national and subnational levels.
Myanmar	Development of dengue web-based surveillance system(transition from paper to electronic system). Technical support from WHO including EWARS and risk mapping Availability of guidelines and plans The dedicated dengue control program.	Late and incomplete report. Prediction of the outbreak is late due to late reporting. Limited resources of VBDC staffs. Not enough RDT and program support materials.
Nepal	Dengue notification through EWARS which covers all public hospitals at district level and above and few big private hospitals. The national guidelines for dengue has a specific section on disease surveillance and has categorized dengue disease as suspected, probable and confirmed for notification purposes. 118 EWARS sentinel sites are reporting dengue cases through this platform.	Dengue cases are categorized into suspected (clinically), probable (based on RDT both antigen and antibody detection) and confirmed cases (PCR OR Viral Culture, OR IgM seroconversion in paired sera OR IgG seroconversion in paired sera OR four fold IgG titer increase in paired sera). Mostly diagnosis are made clinically or based on RDT. Due to availability of various kind of RDTs in the country and health workers not using the right kind of RDT at the right point of time during illness, there are many false positive or false negative cases. Since there is no WHO-PQ RDT for the national program to procure, RDTs from various companies are used at the peripheral level. This has impacted in disease surveillance. Also, during large outbreak, the health staff responsible for notifying diseases are overburden to report huge number of cases with detailed information
Sri Lanka
Thailand	Effective National Arboviral disease surveillance system.
Timor-Leste