Skip to content

2. Syndromic Approach

To Countries

  • Recommendation: Adopt the syndromic approach to surveillance in countries with indigenous populations to heighten sensitivity in detection and speed up case management, such as STD and febrile icteric syndrome. Select sentinel sites on the basis of risk assessments and optimize posts so that diseases with similar risk factors or transmission routes can be monitored simultaneously.
    Compliance: The syndromic approach to surveillance is employed to some extent in all the Amazon countries. The results of its use were published in the Rev. Patol Trop. 34 (Sup1.): Jan–Jul, 2005, as well as in the report of the IIIrd Joint Meeting of the Regional EID Surveillance Networks, OPS/DPC/CD/319/04.
  • Recommendation: Jointly review and prepare manuals and guidelines for syndromic surveillance in the subregión, and continue improving surveillance of leptospirosis, FBD, deaths from unknown causes, dengue, and yellow fever.
    Compliance: While surveillance of leptospirosis and FBD has improved, there is no evidence that countries have conducted a joint review of the manuals and guidelines for syndromic surveillance.


  • Recommendation: Provide a platform for information exchange to reach a consensus on protocols in the subregión.
    Compliance:There were no formal activities in this regard.

3. Evaluation of Laboratory Performance

To Countries

  • Recommendation: Participate in the performance evaluation conducted by CENETROP for serodiagnosis of EID. In addition, begin or continue conducting national evaluations to establish how quality assurance is carried out in public health laboratories.
    Compliance: Ten countries participated in the III annual evaluation of performance in the serodiagnosis of EID conducted by CENETROP, Bolivia, identifying a panel of serum samples with an unknown diagnosis, accompanied by a brief clinical history. However, there is no evidence that this activity was replicated in national laboratories of each country.


  • Recommendation: Make the necessary arrangements for resuming the performance evaluation in the serodiagnosis of infectious diseases and present a report on the results at the next meeting.
    Compliance: The performance evaluation was reinitiated in 2004, but the results were analyzed in 2005. A report on the results obtained from the third panel was presented at this meeting of the Amazon countries.

4. Influenza

To Countries

  • Recommendation: Continue preparing and implementing the contingency plans for an eventual pandemic and at the next meeting, describe the progress made in Brazil and some other country.
    Compliance: With the partial exception of Brazil and, to a lesser extent, Colombia and Venezuela, the rest of the countries should continue improving their national plans for an influenza pandemic.
  • Recommendation: Set support to expand the epidemiológical surveillance network (including virological surveillance), and have the national influenza reference centers report their findings regularly to FLUNET.
    Compliance: The Spanish-speaking countries are expanding their sentinel surveillance network and attempting to increase the information periodically sent to FLUNET.

5. Antimicrobial Resistance

To countries

In 2005, they must report on

  • Recommendation:The results of the surveillance of antimicrobial resistance in community and hospital isolates collected in 2004.
    Compliance: Brazil, Colombia, Ecuador, Peru, and Venezuela annually report the surveillance results for community and hospital species.
  • Recommendation: Detail the operations of the quality assurance system, including the performance evaluation in the area of antimicrobial resistance surveillance.
    Compliance: 14 countries have this information and disseminate it.
  • Recommendation: Network countries should produce and disseminate information, mainly from hospitals, and on local resistance patterns.
    Compliance:There is still a need to improve local dissemination of information in hospitals on the prevalence of the species isolated and the resistance profiles of bacteria responsible for hospital infections in the services at greater risk.
  • Recommendation: Begin EIC (Education, Information, and Communication) for the general public on the rational use of antibiotics, getting both health workers and the community involved.
    Compliance: Activities were launched in Brazil, Bolivia, Chile, Colombia, Ecuador, and Peru.

6. RAVREDA (Amazon Surveillance Network on Resistance to Antimalarials)

To countries

  • Recommendation: Discuss the conclusions and recommendations of this network at the next meeting of RAVREDA in Suriname on 17 March 2004. Distribute the report from this meeting to the countries of the EID network of the Amazon region.
    Compliance: The report was distributed.

Recommendations of the Amazon Meeting, 2005

I. General Activities of the Network


  • Guarantee access to and the transfer of documents and information among the technical personnel.
  • To continue supporting network activities

To countries:
Tasks (in each country) prior to each future meeting of the network

  • Guarantee access to and the transfer of documents and information among the technical personnel of the participating countries of the network.
  • Update and disseminate background documents (reports, projects, guides, protocols, etc.).
  • Identify potential solutions for each problem detected in the countries that is hindering compliance with the agreements in each area.
  • Those countries with more expertise in specific areas should have the leadership to promote and support the progress of activities in those areas. For example: Brazil, ACT organization projects; Bolivia, performance evaluation of laboratory diagnosis; Ecuador, dengue; Peru, bartonellosis, and febrile illnesses in border areas; Suriname, dengue; and Venezuela, syndromic surveillance.


  • Develop instruments and methodologies to evaluate basic skills for the detection, diagnosis, and control of EIE, and prepare a matrix to determine compliance with the commitments of the annual meetings.
  • PAHO should send the reports from these network meetings to the Ministries of Health, as well as ACT organization, pursuant to the existing Framework Agreement between PAHO and ACT.

Last Updated on Friday, 25 April 2014 11:03

Regional Office for the Americas of the World Health Organization
525 Twenty-third Street, N.W., Washington, D.C. 20037, United States of America
Tel.: +1 (202) 974-3000 Fax: +1 (202) 974-3663

© Pan American Health Organization. All rights reserved.