Table 1.

Progress in capacity strengthening for influenza surveillance in the 22 countries of the WHO Eastern Mediterranean Region between 2011 and 2018.

Indicator	2011	2018	Difference	P value
AInfluenza epidemiological surveillance
No. of countries with a functioning influenza surveillance systema	10/22(50%)	19/22 (86.3%)	36.3%	0.0008
No. of countries with more than 1 sentinel site for ILI/SARI	8	19	57.9%	0.0001
No of countries reporting influenza epidemiological data to FluID for <90% of the weeks a year	5/10 (50%)	9/19 (47.38%)	2.62%	0.89
BInfluenza virological surveillance
No. of NICs	13	16	15.79%	0.25
No. of countries reporting influenza virological surveillance data to FluNET for 90% of the weeks a year	9	16	36.84%	0.01
No. of NICs and influenza laboratories with RT-PCR capacity	9/13 (69.2%)	19/19 (100%)b	30.8%	0.01
No. of NICs and influenza laboratories with capacity for influenza virus isolation	9/13 (69.2%)	12/16 (75%)	5.8%	0.73
No. of NICs and other influenza laboratories with sequencing capacity (including testing for antiviral susceptibility)	3/13 (23%)	7/16 (43.7)	20.7%	0.25
No. of NICs and other influenza laboratories participating in WHO EQAP	9/13 (69.2%)	19/19 (100%)b	30.8%	0.01
No. of NICs and other influenza laboratories achieving a 90% efficiency score on WHO EQAP	11/14 (78.5%)c	19/19 (100%)b	21.5%	0.03
CBurden estimation
No. of countries with influenza surveillance system estimating influenza disease burden using surveillance datad	0/10 (0%)	6/19 (31.57%)	31.57	0.04
DUse of seasonal influenza vaccines
No. of countries using seasonal influenza vaccines	12/22 (55%)	17/22 (77%)	22%	0.11

SARI: severe acute respiratory illness, NIC: national influenza centre, RT-PCR: real-time polymerase chain reaction,EQAP: external quality assessment programme).

^ameasured against all 21 countries and occupied Palestinian territory of the WHO Eastern Mediterranean Region.

^bincludes three influenza laboratories which are not designated as NIC as of 2018.

^cincludes one influenza laboratory which was not designated as NIC in 2011.

^dout of the countries with influenza surveillance system in 2011 (10) and 2018 (19).