Emerging Infectious Diseases (Nov 2022)

Incorporating COVID-19 into Acute Febrile Illness Surveillance Systems, Belize, Kenya, Ethiopia, Peru, and Liberia, 2020–2021

  • David C. Shih,
  • Rachel Silver,
  • Olga L. Henao,
  • Aynalem Alemu,
  • Allan Audi,
  • Godfrey Bigogo,
  • Josh M. Colston,
  • Elijah P. Edu-Quansah,
  • Timothy A. Erickson,
  • Andargachew Gashu,
  • G. Burgess Gbelee,
  • Sarah M. Gunter,
  • Margaret N. Kosek,
  • Gorbee G. Logan,
  • Joy M. Mackey,
  • Adrianna Maliga,
  • Russell Manzanero,
  • Gerhaldine Morazan,
  • Francis Morey,
  • Flor M. Munoz,
  • Kristy O. Murray,
  • Thelma V. Nelson,
  • Maribel Paredes Olortegui,
  • Pablo Penataro Yori,
  • Shannon E. Ronca,
  • Francesca Schiaffino,
  • Adamu Tayachew,
  • Musse Tedasse,
  • Mesfin Wossen,
  • Denise R. Allen,
  • Pawan Angra,
  • Amanda Balish,
  • Madeline Farron,
  • Marta Guerra,
  • Amy Herman-Roloff,
  • Victoria J. Hicks,
  • Elizabeth Hunsperger,
  • Lilit Kazazian,
  • Matt Mikoleit,
  • Peninah Munyua,
  • Patrick K. Munywoki,
  • Angella Sandra Namwase,
  • Clayton O. Onyango,
  • Michael Park,
  • Leonard F. Peruski,
  • David E. Sugerman,
  • Emily Zielinski Gutierrez,
  • Adam L. Cohen

DOI
https://doi.org/10.3201/eid2813.220898
Journal volume & issue
Vol. 28, no. 13
pp. 34 – 41

Abstract

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Existing acute febrile illness (AFI) surveillance systems can be leveraged to identify and characterize emerging pathogens, such as SARS-CoV-2, which causes COVID-19. The US Centers for Disease Control and Prevention collaborated with ministries of health and implementing partners in Belize, Ethiopia, Kenya, Liberia, and Peru to adapt AFI surveillance systems to generate COVID-19 response information. Staff at sentinel sites collected epidemiologic data from persons meeting AFI criteria and specimens for SARS-CoV-2 testing. A total of 5,501 patients with AFI were enrolled during March 2020–October 2021; >69% underwent SARS-CoV-2 testing. Percentage positivity for SARS-CoV-2 ranged from 4% (87/2,151, Kenya) to 19% (22/115, Ethiopia). We show SARS-CoV-2 testing was successfully integrated into AFI surveillance in 5 low- to middle-income countries to detect COVID-19 within AFI care-seeking populations. AFI surveillance systems can be used to build capacity to detect and respond to both emerging and endemic infectious disease threats.

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