Timor-Leste has leveraged its influenza sentinel surveillance sites to develop an integrated surveillance system to simultaneously detect and monitor SARS-CoV-2 and influenza.
During the COVID-19 pandemic, influenza surveillance in Timor-Leste was severely interrupted as its limited resources were diverted to deal with the pandemic. As the pandemic evolved, surveillance for SARS CoV-2 also dropped and the minimal samples available from health care facilities made it increasingly difficult to identify and interpret epidemiological patterns and changes.
To overcome this twin challenge, Timor-Leste adopted an integrated approach to sustain SARS CoV-2 testing while maintaining the country’s influenza sentinel surveillance. In line with WHO integration guidelines, and with the support of the Pandemic Influenza Preparedness (PIP) Partnership Contribution, several activities were carried out, including:
- national consultations to develop a strategy for integrated surveillance;
- a national workshop to inform stakeholders and development partners, including municipal health directors and executive directors from national and referral hospitals and from the national health laboratory; and
- training workshops to build the capacity of health workers and laboratory technicians to operationalize the strategy.
High priority was given to achieving consensus on the integrated surveillance strategy using rounds of advocacy to high-level ministry officials. These policy-makers well understood the importance of integrated surveillance for sustainability and cost-effectiveness as well as the challenges to implementation.
The standard operating procedures for integrated surveillance were finalized based on lessons learnt during the COVID-19 pandemic and the recommendations of the consultation workshop. Activities to enhance staff capacities at sentinel surveillance sites were then carried out.
The new strategy for integrated surveillance in Timor-Leste, and its successful implementation, has ensured the country can effectively detect and monitor SARS-Cov-2 while mitigating disruptions to influenza surveillance caused by COVID-19. In the near future, Timor-Leste will begin reporting the integrated surveillance data to FluMART.