Leveraging the influenza sentinel surveillance platform for SARS-CoV-2 monitoring in Bangladesh (2020-2024): a prospective sentinel surveillance study.
prospective_cohort · Level II
Where this comes from
- Record sourced from PubMed, PMID 40896357.
- Also identified by DOI 10.1016/j.lansea.2025.100657 and PMC identifier 12398867.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
There is limited global evidence on whether influenza sentinel surveillance platforms can be effectively adapted for long-term SARS-CoV-2 monitoring in low-resource contexts. We explored the utility of the hospital-based influenza sentinel surveillance (HBIS) platform for monitoring SARS-CoV-2 in Bangladesh by comparing SARS-CoV-2 detection in HBIS platform with national COVID-19 platform and assessing how its integration into influenza surveillance aligns with national trends. From March 2020 to December 2024, we analysed data from patients with severe acute respiratory infection (SARI) and influenza-like illness (ILI) enrolled in HBIS. Socio-demographic and clinical data were recorded, and nasopharyngeal and oropharyngeal swabs were tested for influenza and SARS-CoV-2 using rRT-PCR. Whole-genome sequencing was performed on a subset of SARS-CoV-2-positive samples. Data from national COVID-19 platform were obtained from the Directorate General of Health Services, Bangladesh, and were compared with HBIS platform data using epidemic curves and Pearson correlation analysis. Among 25,366 (SARI: 20,226; ILI: 5140) patients, 13.0% (3310) tested positive for influenza, 6.6% (1680) for SARS-CoV-2, and 0.2% (43) were co-infected. SARS-CoV-2 positivity in HBIS (6.8%), including 0.2% co-infections, was lower than the national average (13.1%), but showed a strong correlation with national trends (Pearson <i>r</i> = 0.86, P < 0.001). Sequencing of 234 SARS-CoV-2 strains detected the beta and delta variants in April and May 2021, respectively, and omicron subvariants circulating from 2022 to 2024, aligning with the national COVID-19 platform. SARS-CoV-2 positivity trends in HBIS platform closely aligned with the national COVID-19 platform, demonstrating its potential as a sustainable platform for COVID-19 monitoring. Our findings underscore the feasibility of influenza sentinel surveillance as an early warning system for future COVID-19 outbreaks or other respiratory viruses of pandemic concern in Bangladesh and similar settings. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA (U01GH002259).