scholarly journals Integrated Disease Surveillance and Response (IDSR) in Malawi: Implementation Gaps and Challenges for Timely Alert

2018 ◽  
Author(s):  
Tsung-Shu Joseph Wu ◽  
Matthew Kagoli ◽  
Jens Johan Kaasbøll ◽  
Gunnar Aksel Bjune
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Qualitative Data ◽  
Ebola Virus ◽  
Service Providers ◽  
Virus Disease ◽  
Health Information System ◽  
Early Response ◽  
District Health ◽  
Surveillance And Response

AbstractObjectiveThe emerging and recent 2014 Ebola Virus Disease (EVD) outbreaks rang the bell to call upon efforts from globe to assist resource-constrained countries to strengthen public health surveillance system for early response. Malawi adopted the Integrated Disease Surveillance and Response (IDSR) strategy to develop its national surveillance system since 2002 and revised its guideline to fulfill the International Health Regulation (IHR) requirements in 2014. This study aimed to understand the state of IDSR implementation and differences between guideline and practice for future disease surveillance system strengthening.MethodsThis was a mixed-method observational study. Quantitative data were to analyze completeness and timeliness of surveillance system performance from national District Health Information System 2 (DHIS2). Qualitative data were collected through interviews with 29 frontline health service providers from the selected district and key informants of the IDSR system implementation and administration at district and national levels.FindingsThe current IDSR system showed relatively good completeness (76.4%) but poor timeliness (41.5%) of total expected monthly reports nationwide and zero weekly reports. The challenges of IDSR implementation revealed through qualitative data included lack of supervision, inadequate resources for training and difficulty to implement weekly report due to overwhelming paperwork at frontline health services.ConclusionsThe differences between IDSR technical guideline and actual practice were huge. The developing information technology infrastructure in Malawi and emerging mobile health (mHealth) technology can be opportunities for the country to overcome these challenges and improve surveillance system to have better timeliness for the outbreaks and unusual events detection.

scholarly journals Use of Peripheral Health Units in Low-Transmission Ebola Virus Disease Surveillance

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Alyssa J. Young ◽  
Allison Connolly ◽  
Adam Hoar ◽  
Brooke Mancuso ◽  
John Mark Esplana ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Ebola Virus ◽  
Virus Disease ◽  
Malaria Prevalence ◽  
Ebola Virus Disease ◽  
Alert System ◽  
Community Based

Surveillance strategies for Ebola Virus Disease (EVD) in Sierra Leone use a centralized "live alert" system to refer suspect cases from the community to specialized Ebola treatment centers. As EVD case burden declined in Port Loko District, Sierra Leone so did the number of reported alerts. Because EVD presents similarly to malaria, the number of alerts should remain consistent with malaria prevalence in malaria-endemic areas, irrespective of the reduction in true EVD cases. A community-based EVD surveillance system with improved symptom recording and follow-up of malaria-confirmed patients at PHUs was implemented in order to strengthen the sensitivity of EVD reporting.

scholarly journals Self-reported challenges to border screening of travelers for Ebola by district health workers in northern Ghana: An observational study

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245039
Author(s):  
John Koku Awoonor-Williams ◽  
Cheryl A. Moyer ◽  
Martin Nyaaba Adokiya
Keyword(s):  
Observational Study ◽  
Disease Surveillance ◽  
Qualitative Data ◽  
Virus Disease ◽  
World Health ◽  
Northern Ghana ◽  
Suspected Case ◽  
Support Functions ◽  
Surveillance And Response ◽  
Entry Points

Background The 2013–2016 Ebola Virus Disease (EVD) outbreak remains the largest on record, resulting in the highest mortality and widest geographic spread experienced in Africa. Ghana, like many other African nations, began screening travelers at all entry points into the country to enhance disease surveillance and response. This study aimed to assess the challenges of screening travelers for EVD at border entry in northern Ghana. Design and methods This was an observational study using epidemiological weekly reports (Oct 2014-Mar 2015) of travelers entering Ghana in the Upper East Region (UER) and qualitative interviews with 12 key informants (7 port health officers and 5 district directors of health) in the UER. We recorded the number of travelers screened, their country of origin, and the number of suspected EVD cases from paper-based weekly epidemiological reports at the border entry. We collected qualitative data using an interview guide with a particular focus on the core and support functions (e.g. detection, reporting, feedback, etc.) of the World Health Organization’s Integrated Disease Surveillance and Response system. Quantitative data was analyzed based on travelers screened and disaggregated by the three most affected countries. We used inductive approach to analyze the qualitative data and produced themes on knowledge and challenges of EVD screening. Results A total of 41,633 travelers were screened, and only 1 was detained as a suspected case of EVD. This potential case was eventually ruled out via blood test. All but 52 of the screened travelers were from Ghana and its contiguous neighbors, Burkina Faso and Togo. The remaining 52 were from the four countries most affected by EVD (Guinea, Liberia, Sierra Leone, and Mali). Challenges to effective border screening included: inadequate personal protective equipment and supplies, insufficient space or isolation rooms and delays at the border crossings, and too few trained staff. Respondents also cited lack of capacity to confirm cases locally, lack of cooperation by some travelers, language barriers, and multiple entry points along porous borders. Nonetheless, no potential Ebola case identified through border screening was confirmed in Ghana. Conclusion Screening for Ebola remains sub-optimal at the entry points in northern Ghana due to several systemic and structural factors. Given the likelihood of future infectious disease outbreaks, additional attention and support are required if Ghana is to minimize the risk of travel-related spread of illness.

scholarly journals Revitalization of integrated disease surveillance and response in Sierra Leone post Ebola virus disease outbreak

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Charles Njuguna ◽  
Amara Jambai ◽  
Alexander Chimbaru ◽  
Anders Nordstrom ◽  
Roland Conteh ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Disease Surveillance ◽  
Ebola Virus ◽  
Virus Disease ◽  
Disease Outbreak ◽  
Ebola Virus Disease ◽  
Surveillance And Response

scholarly journals Advancing GHSA: Lessons learned about strengthening HIS and disease surveillance

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Pia D. MacDonald ◽  
Niamh Darcy ◽  
Rita Sembajwe ◽  
Eileen Reynolds ◽  
Henry Chidawanyika ◽  
...  
Keyword(s):  
Information System ◽  
Health Information ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Health Information System ◽  
Lessons Learned ◽  
Surveillance Systems ◽  
Disease Surveillance System ◽  
Surveillance And Response ◽  
Roll Out

ObjectiveThe objective is to discuss two decades of international experiencein health information and disease surveillance systems strengtheningand synthesize lessons learned as applicable to implementation of theGlobal Health Security Agenda (GHSA).IntroductionRTI International has worked on enhancing health informationand disease surveillance systems in many countries, includingThe Democratic Republic of the Congo (DRC), Guinea, Indonesia,Kenya, Nepal, Philippines, Tanzania, Zambia, and Zimbabwe.Strengthening these systems is critical for all three of the Prevent,Detect and Respond domains within the Global Health SecurityAgenda.We have deep experience in this area, ranging from implementingDistrict Health Information Software (DHIS), electronic medicalrecords, health facility registries, eHealth national strategies,electronic Integrated Disease Surveillance and Response system(eIDSR), mobile real-time malaria surveillance and response, nationalweekly disease surveillance, patient referral system, and communitybased surveillance. These experiences and lessons learned can informwork being done to advance the GHSA.We will discuss several examples, including activities in Zimbabweand Tanzania. RTI has been working in Zimbabwe for over six yearsto strengthen the national health information system. This workhas included the configuration and roll-out of DHIS 2, the nationalelectronic health information system. In doing so, RTI examinedand revitalized the weekly disease surveillance system, improvingdisease reporting timeliness and completeness from 40% to 90%.Additionally, RTI has integrated mobile technology to help morerapidly communicate laboratory test results, a laboratory informationmanagement systems to manage and guide test sample processing,and various other patient level systems in support of health servicedelivery at the local level. This work has involved capacity buildingwithin the ministry of health to allow for sustainable support of healthinformation systems practices and technology and improvements todata dissemination and use practices.Similarly, RTI has worked for more than five years to helpstrengthening the National HIS in Tanzania. These activities haveincluded stakeholder coordination, developing national eHealthstrategy and enterprise architecture, harmonizing indicators,redesigning routine reporting instruments, national DHIS 2 roll-out,information technology infrastructure management and user helpdesk support, reducing the number of parallel information systems,data dissemination and use, development of district health profiles,development of the national health facility registry, and supportingroll-out of the electronic integrated disease surveillance system.MethodsWe will profile selected projects and synthesize critical lessonslearned that pertain to implementation of the GHSA in resourceconstrained countries.ResultsWe will summarize our experience and lessons learned withhealth information and disease surveillance systems strengthening.Topics such as those that relate to advancing the GHSA RealTime Surveillance and Reporting Action Package areas will bediscussed, including: indicator and event based surveillance systems;interoperable, interconnected, electronic real-time reporting system;analysis of surveillance data; syndromic surveillance systems;systems for efficient reporting to WHO, FAO and OIE; and reportingnetwork and protocols in country.ConclusionsOur experience working over the past 14 years in 9 countrieson different HIS and disease surveillance system strengtheningprojects has led to a deep understanding of the challenges aroundimplementation of these systems in limited resource settings. Theseexperiences and lessons learned can inform initiatives and programsto advance the GHSA.

scholarly journals The implementation of integrated disease surveillance and response in Liberia after Ebola virus disease outbreak 2015-2017

2019 ◽  
Vol 33 ◽  
Author(s):  
Thomas Nagbe ◽  
Jeremias Domingos Naiene ◽  
Julius Monday Rude ◽  
Nuha Mahmoud ◽  
Mohammed Kromah ◽  
...  
Keyword(s):  
Disease Surveillance ◽  
Ebola Virus ◽  
Virus Disease ◽  
Disease Outbreak ◽  
Ebola Virus Disease ◽  
Surveillance And Response

scholarly journals Evaluation of Ebola virus disease surveillance system in Tonkolili District, Sierra Leone

2019 ◽  
Vol 32 ◽  
Author(s):  
Olayinka Stephen Ilesanmi ◽  
Olufunmilayo Fawole ◽  
Patrick Nguku ◽  
Abisola Oladimeji ◽  
Okoro Nwenyi
Keyword(s):  
Sierra Leone ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Ebola Virus ◽  
Virus Disease ◽  
Ebola Virus Disease ◽  
Disease Surveillance System

scholarly journals Assessment of surveillance core and support functions regarding neglected tropical diseases in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arthur K. S. Ng’etich ◽  
Kuku Voyi ◽  
Clifford M. Mutero
Keyword(s):  
Data Analysis ◽  
Surveillance System ◽  
Qualitative Data ◽  
Neglected Tropical Diseases ◽  
National Level ◽  
World Health ◽  
Tropical Diseases ◽  
Support Functions ◽  
Specimen Handling ◽  
Surveillance And Response

Abstract Background Effective surveillance and response systems are vital to achievement of disease control and elimination goals. Kenya adopted the revised guidelines of the integrated disease surveillance and response system in 2012. Previous assessments of surveillance system core and support functions in Africa are limited to notifiable diseases with minimal attention given to neglected tropical diseases amenable to preventive chemotherapy (PC-NTDs). The study aimed to assess surveillance system core and support functions relating to PC-NTDs in Kenya. Methods A mixed method cross-sectional survey was adapted involving 192 health facility workers, 50 community-level health workers and 44 sub-national level health personnel. Data was collected using modified World Health Organization generic questionnaires, observation checklists and interview schedules. Descriptive summaries, tests of associations using Pearson’s Chi-square or Fisher’s exact tests and mixed effects regression models were used to analyse quantitative data. Qualitative data derived from interviews with study participants were coded and analysed thematically. Results Surveillance core and support functions in relation to PC-NTDs were assessed in comparison to an indicator performance target of 80%. Optimal performance reported on specimen handling (84%; 100%), reports submission (100%; 100%) and data analysis (84%; 80%) at the sub-county and county levels respectively. Facilities achieved the threshold on reports submission (84%), reporting deadlines (88%) and feedback (80%). However, low performance reported on case definitions availability (60%), case registers (19%), functional laboratories (52%) and data analysis (58%). Having well-equipped laboratories (3.07, 95% CI: 1.36, 6.94), PC-NTDs provision in reporting forms (3.20, 95% CI: 1.44, 7.10) and surveillance training (4.15, 95% CI: 2.30, 7.48) were associated with higher odds of functional surveillance systems. Challenges facing surveillance activities implementation revealed through qualitative data were in relation to surveillance guidelines and reporting tools, data analysis, feedback, supervisory activities, training and resource provision. Conclusion There was evidence of low-performing surveillance functions regarding PC-NTDs especially at the peripheral surveillance levels. Case detection, registration and confirmation, reporting, data analysis and feedback performed sub-optimally at the facility and community levels. Additionally, support functions including standards and guidelines, supervision, training and resources were particularly weak at the sub-national level. Improved PC-NTDs surveillance performance sub-nationally requires strengthened capacities.

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