What Do the 2023 GERMS-SA Findings Reveal About Disease Trends?
For over two decades, GERMS-SA has led national laboratory surveillance in South Africa, tracking bacterial and fungal infections of public health importance. The programme enhances disease monitoring through laboratory reporting and sentinel site data collection. This includes antimicrobial resistance testing, serotyping, and whole genome sequencing to provide a comprehensive understanding of infectious disease trends.
GERMS-SA monitors vaccine-preventable diseases, epidemic-prone infections, healthcare-associated bloodstream infections, and AIDS-related opportunistic infections. Last year alone, the programme analyzed 14,138 cases, offering critical insights that shape patient management strategies and public health interventions.
By estimating disease burden and evaluating vaccine impact, GERMS-SA provides strategic data that informs health policy and strengthens disease prevention efforts. For a detailed analysis, access the full 2023 report here.
The following report presents the key findings from the GERMS-SA 2023 Annual Surveillance Review.
Materials and Methods
In 2023, approximately 222 South African clinical microbiology laboratories participated in the surveillance programme. Laboratories reported case patients to the NICD using laboratory case report forms (CRFs), according to standard case definitions. If available, isolates from case-patients were submitted on Dorset transport media to the NICD for further phenotypic and genotypic characterisation.
Diseases under surveillance included opportunistic infections associated with HIV, e.g., cryptococcosis, and nontyphoidal Salmonella infections; vaccine-preventable diseases caused by Haemophilus influenzae type b, Streptococcus pneumoniae, and Streptococcus agalactiae; epidemic-prone diseases caused by Neisseria meningitidis, Salmonella enterica serotype Typhi, Salmonella enterica serotype Paratyphi A, B, and C, Shigella species, Vibrio cholerae, Campylobacter species, Listeria species, and Streptococcus pyogenes; and healthcare-associated bloodstream infections/modified ESKAPE infections caused by Escherichia coli.
Results
A total of 14 138 surveillance cases were detected by GERMS-SA in 2023. Excluding the cases of cryptococcosis (n=4 278), which are all retrospectively detected by audit, 3 268/9 860 (33%) cases were detected by audit of the NICD SDW, and 6 592/9 860 (67%, target=80%) of episodes had isolates sent by the clinical microbiology laboratories to the NICD for further characterisation. At ESS, 4 408/4 852 (91%) cases had a CRF completed (target=90%). Forty-four percent (1 956/4 408) of CRFs were completed by patient interview, a marginal increase from 2022 (1 251/3 045; 41%) but still missing the target of 70%.
These cases reveal different trends in pathogen incidence and age groups. Respiratory-transmitted pathogens that were affected by COVID-19 nonpharmaceutical practices have gone back to their pre-COVID-19 trends. For many pathogens, the highest burden was found in the Western Cape Province, possibly related to health-seeking behaviour, and better laboratory capacity and hence specimen-taking practices.
For a more in-depth look into this captivating review, download the full article below.
