Home | Supplements | Volume 36 | This supplement | Article number 13

Case study

Evaluation of influenza sentinel surveillance system, Saudi Arabia, 2017-2018: a teaching case-study

Evaluation of influenza sentinel surveillance system, Saudi Arabia, 2017-2018: a teaching case-study

Mohamed Nageeb Abdalla1,&, Muhannad Almalki1, Sami S. Almudarra1


1Saudi Field Epidemiology Training Program, Ministry of Health, Riyadh, Saudi Arabia



&Corresponding author
Mohamed Nageeb Abdalla, Saudi Field Epidemiology Training Program, Ministry of Health, Riyadh, Saudi Arabia




Influenza is a disease of global importance and concern. The World Health Organization (WHO) Global Influenza Strategy for 2019-2030 categorizes influenza as a global threat, where national prevention and control programs play a substantial role in achieving the strategy´s goals. Strengthening Influenza surveillance activities is a core function of control and preparedness for future pandemics. The Kingdom of Saudi Arabia (KSA) is very much concerned with such epidemic-prone diseases, given the annual gathering of Muslims from all over the world for Hajj and Umra. In response, the Saudi Public Health authority established a National Influenza Surveillance System. Initial and periodic evaluation of such programs leads to improvement to their performance and quality. This case-study aims to build capacity of trainees in the processes of public health surveillance evaluation and to develop essential trainee´s competencies in surveillance programs evaluation. It is intended to inform Field Epidemiology Training Program (FETP) residents of the know-hows of being engaged in evaluation tasks, in particular evaluation of surveillance programs. The case study is designed for training novice field epidemiology trainees. The case study can be administered in 3-4 hours. Used as adjunct training material, the case study provides the trainees with competencies in evaluating public health surveillance programs at local or national levels including analysis and interpretation of data. It is also designed to improve their practice of teamwork concepts.



How to use this case study    Down

General instructions: this case study should be used as adjunct training material for novice epidemiology trainees to reinforce the concepts taught in prior lectures. The case study is ideally taught by a facilitator in groups of about 20 participants. Participants are to take turns reading the case study, usually a paragraph per student. The facilitator guides the discussion on possible responses to questions. The facilitator may make use of flip charts to illustrate certain points. Additional instructor´s notes for facilitation are coupled with each question in the instructor´s guide to aid facilitation.

Audience: this case study was developed for novice field epidemiology students. These participants are commonly health care workers working in the country departments of health whose background may be as medical doctors, nurses, environmental health officers or laboratory scientists who work in public health-related fields. Most have a health science or biology background.

Prerequisites: Before using this case study, participants should have received lectures on disease surveillance and evaluation of public health surveillance.

Materials needed: Flash drive, flip charts, markers, computers with MS Excel.

Level of Training and Associated Public Health Activity: Novice - Disease Surveillance and Evaluation of Public Health Surveillance.

Time required: 3-4 hours

Language: English



Case study material Up    Down



Competing interest Up    Down

The authors declare no competing interests.



Acknowledgement Up    Down

We wish to acknowledge the Eastern Mediterranean Public Health Network (EMPHNET) for their support to develop this case study. We appreciate assistance provided by ISSA and are grateful to those who participated in the survey.



Annexes Up    Down

Annex 1: Epidemiological data (modified) of ILI & SARI cases, MS-Excel

Annex 2: Survey data on influenza surveillance attributes, MS-Excel

Annex 3: Influenza surveillance evaluation Survey questionnaire



References Up    Down

  1. General Authority for Statistics, KSA, Last Updated 6 Apr 2020, https://www.stats.gov.sa/en/43. Accessed 31 January 2020.. PubMed | Google Scholar

  2. World Health Organization. Global Epidemiological Surveillance Standards for Influenza. WHO Press.2014. WHO website. Available: www.who.int/influenza/resources/documents/influenza_surveillance_manual/en. Accessed 31 January 2020.. PubMed | Google Scholar

  3. Ministry of Health, Saudi Arabia, Assistant Agency for Preventive Health. Influenza Surveillance in Saudi Arabia, 2017. Saudi MOH website. Available: https://www.moh.gov.sa/CCC/healthp/regulations/Documents/ISSA%20Protocol.pdf. Accessed 31 January 2020.. PubMed | Google Scholar

  4. German RR, Lee LM, Horan JM, Milstein RL, Pertowski CA, Waller MN. Updated guidelines for evaluating public health surveillance systems: recommendations from the Guidelines Working Group. MMWR Recomm Rep. 2001 Jul 27;50(RR-13):1-35; quiz CE1-7. PubMed | Google Scholar

  5. Pan American Health Organization. IHR, Alert and Response, and Epidemic Diseases Project. Operational Guidelines for Intensified National SARI Surveillance. Washington, D. C. January 2011. https://www.paho.org/hq/dmdocuments/2012/SARI-ENG-NOV2011.pdf. Accessed 31 January 2020.. PubMed | Google Scholar