Improving measles syndromic surveillance via dried blood spot testing in Laos 2016-17


The Lao PDR is aiming for measles elimination despite ongoing outbreaks of the disease. Outbreak detection in the country relies on recognising cases meeting a set fever and rash case definition incorporated into the syndromic surveillance system run by the National Center for Laboratory and Epidemiology (NCLE). Suspected cases are passively identified by presentations at health care facilities, with information forwarded to the NCLE's Early Alert and Response Network (EWARN) along with event-based reported data1. World Health Organization (WHO) measles surveillance guidelines require 80% of fever and rash cases be sampled for testing; currently only 20% sampling occurs in Laos2,3. Sampling using DBS has been proposed as an alternative to conventional venepuncture in facilitating suspected measles case detection. In this study, DBS was proposed to improve blood uptake of syndromic cases, by evaluating whether it increased ascertainment compared to conventional venepuncture. It also analysed reasons for poor diagnostic uptake among healthcare personnel involved in syndromic surveillance.

Objective: To evaluate whether dried blood spot (DBS) testing improves diagnostic uptake in Vientiane Capital City province, Lao People's Democratic Republic (PDR) compared to conventional diagnostic techniques (venous blood by venepuncture) during syndromic surveillance from 2016-17. To also explore reasons for low blood sampling uptake via quantitative results and qualitative responses from health care workers; in addition to the perceived acceptance of DBS compared to venepuncture.

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Original Publication Year: 
Event/Publication Date: 
January, 2019

June 18, 2019

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