We have made considerable progress in setting and scaling up surveillance systems to drive evidence-based policy decisions, but the recent epidemics highlight that current systems are not optimally designed. Good surveillance systems should be coordinated, comprehensive, and adaptive. They should generate data in real time for immediate analysis and intervention, whether for endemic diseases or potential epidemics. Such systems are especially needed in low-resource settings where disease burden is the highest, but tracking systems are the weakest here due to competing priorities and constraints on available resources. In this article, using the examples of 3 large, and mostly successful, infectious disease surveillance studies in Bangladesh, we identify 2 core limitations—the pathogen bias and the vaccine bias—in the way current surveillance programs are designed for low-resource settings. We highlight the strengths of the current Global Invasive Bacterial Vaccine Preventable Disease Surveillance Network of the World Health Organization and present case studies from Bangladesh to illustrate how this surveillance platform can be leveraged to overcome its limitations. Finally, we propose a set of criteria for building a comprehensive infectious disease surveillance system with the hope of encouraging current systems to use the limited resources as optimally as possible to generate the maximum amount of knowledge.

中文翻译：

---

侵入性细菌疫苗可预防疾病监测：孟加拉国的成功经验和经验教训是可持续发展的道路

我们在建立和扩大监测系统以推动基于证据的政策决策方面取得了相当大的进展，但最近的流行病凸显了当前系统的设计并非最佳。良好的监测系统应该是协调的、全面的和适应性的。他们应该实时生成数据，以便立即进行分析和干预，无论是针对地方病还是潜在的流行病。在疾病负担最高的资源匮乏地区尤其需要此类系统，但由于优先级竞争和可用资源的限制，这里的跟踪系统最薄弱。在本文中，以孟加拉国 3 项大型且大部分成功的传染病监测研究为例，我们确定了当前监测计划是为资源匮乏地区设计的两个核心限制——病原体偏差和疫苗偏差。我们强调了世界卫生组织当前全球侵入性细菌疫苗可预防疾病监测网络的优势，并介绍了来自孟加拉国的案例研究，以说明如何利用该监测平台来克服其局限性。最后，我们提出了一套建立综合传染病监测系统的标准，希望鼓励当前系统尽可能优化地利用有限的资源来产生最大量的知识。我们强调了世界卫生组织当前全球侵入性细菌疫苗可预防疾病监测网络的优势，并介绍了来自孟加拉国的案例研究，以说明如何利用该监测平台来克服其局限性。最后，我们提出了一套建立综合传染病监测系统的标准，希望鼓励当前系统尽可能优化地利用有限的资源来产生最大量的知识。我们强调了世界卫生组织当前全球侵入性细菌疫苗可预防疾病监测网络的优势，并介绍了来自孟加拉国的案例研究，以说明如何利用该监测平台来克服其局限性。最后，我们提出了一套建立综合传染病监测系统的标准，希望鼓励当前系统尽可能优化地利用有限的资源来产生最大量的知识。