scholarly journals Assessment of the core and support functions of the integrated disease surveillance and response system in Zanzibar, Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatma Saleh ◽  
Jovin Kitau ◽  
Flemming Konradsen ◽  
Leonard E. G. Mboera ◽  
Karin L. Schiøler
Keyword(s):  
Infectious Disease ◽  
Early Detection ◽  
Disease Surveillance ◽  
Health Facilities ◽  
Outbreak Detection ◽  
World Health ◽  
Support Functions ◽  
The Core ◽  
Surveillance And Response ◽  
Facility Level

Abstract Background Disease surveillance is a cornerstone of outbreak detection and control. Evaluation of a disease surveillance system is important to ensure its performance over time. The aim of this study was to assess the performance of the core and support functions of the Zanzibar integrated disease surveillance and response (IDSR) system to determine its capacity for early detection of and response to infectious disease outbreaks. Methods This cross-sectional descriptive study involved 10 districts of Zanzibar and 45 public and private health facilities. A mixed-methods approach was used to collect data. This included document review, observations and interviews with surveillance personnel using a modified World Health Organization generic questionnaire for assessing national disease surveillance systems. Results The performance of the IDSR system in Zanzibar was suboptimal particularly with respect to early detection of epidemics. Weak laboratory capacity at all levels greatly hampered detection and confirmation of cases and outbreaks. None of the health facilities or laboratories could confirm all priority infectious diseases outlined in the Zanzibar IDSR guidelines. Data reporting was weakest at facility level, while data analysis was inadequate at all levels (facility, district and national). The performance of epidemic preparedness and response was generally unsatisfactory despite availability of rapid response teams and budget lines for epidemics in each district. The support functions (supervision, training, laboratory, communication and coordination, human resources, logistic support) were inadequate particularly at the facility level. Conclusions The IDSR system in Zanzibar is weak and inadequate for early detection and response to infectious disease epidemics. The performance of both core and support functions are hampered by several factors including inadequate human and material resources as well as lack of motivation for IDSR implementation within the healthcare delivery system. In the face of emerging epidemics, strengthening of the IDSR system, including allocation of adequate resources, should be a priority in order to safeguard human health and economic stability across the archipelago of Zanzibar.

scholarly journals Twenty Years of Integrated Disease Surveillance and Response in Sub-Saharan Africa: Challenges and Opportunities for Effective Management of Infectious Disease Epidemics

2020 ◽  
Author(s):  
Irene Mremi ◽  
Janeth George ◽  
Susan F. Rumisha ◽  
Calvin Sindato ◽  
Leonard E.G. Mboera ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Information ◽  
Disease Surveillance ◽  
Sub Saharan Africa ◽  
Health Management Information System ◽  
Support Functions ◽  
Surveillance And Response ◽  
Sub Saharan ◽  
Disease Epidemics

Abstract Background: Public health surveillance requires valid, timely and complete health information for early detection of outbreaks. Countries in Sub-Saharan Africa (SSA) adopted Integrated Disease Surveillance and Response (IDSR) strategy in 1998 in response to an increased frequency of emerging and re-emerging diseases in the region. This systematic review aimed to analyse how IDSR implementation has embraced advancement in information technology, big data analytics techniques and wealth of data sources to strengthen detection and management of infectious disease epidemics in SSA. Methods: A search for eligible articles was done through HINARI, PubMed, and advanced Google Scholar databases. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. Using the key search descriptors, 1,809 articles were identified and screened at two stages and 45 studies met the inclusion criteria for detailed review.Results: Of the 45 studies, 35 were country-specific, seven studies covered the region and three studies covered 3-4 countries. A total of 24 studies assessed the IDSR core functions while 42 studies assessed the support functions. Twenty-three studies addressed both the core and support functions. Most of the studies involved Tanzania (9), Ghana (6) and Uganda (5). The implementation of the IDSR strategy has shown improvements mainly in the support functions. The Health Management Information System (HMIS) has remained the main source of IDSR data. However, the HMIS system is characterised by inadequate data completeness, timeliness, quality, analysis and utilisation as well as lack of integration of data from sources other than health care facilities. Conclusion: In most SSA, HMIS is the main source of IDSR data, characterised by incompleteness, inconsistency and inaccuracy. This data is considered to be biased and reflects only the population seeking care from healthcare facilities. Community-based event-based surveillance is weak and non-existence in the majority of the countries. Data from other systems are not effectively utilized and integrated for surveillance. It is recommended that SSA countries consider and adopt multi-sectoral, multi-disease and multi-indicator platforms that integrate the existing surveillance systems with other sources of health information to provide support to effective detection and prompt response to public health threats.

scholarly journals Level and Predicators of quality of Integrated Disease Surveillance and Response for Infectious Disease in Tigray, Northern Ethiopia: Cross-Sectional Study

2020 ◽  
Author(s):  
Kiros Fenta Ajemu ◽  
Abraham Aregay Desta ◽  
Nega Mamo Bezabih ◽  
Alemnesh Abraha Araya ◽  
Essayas Haregot Hilawi
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Service Quality ◽  
Disease Surveillance ◽  
Qualitative Data ◽  
Health Facilities ◽  
Northern Ethiopia ◽  
Cross Sectional ◽  
Surveillance And Response

Abstract Background: The health impacts of recent global infectious disease outbreaks have demonstrated the importance of strengthening public health systems. The aim of the study was to assess the level of quality of integrated disease surveillance and response for infectious disease in public health facilities of Tigray, Northern Ethiopia. Methods: the study was facility based cross-sectional. It was conducted from June- July 2018 in 46 health facilities. It has involved mixed method approach both quantitative and qualitative data collection methods. Donabedian input-process-output quality assessment model was used to evaluate the service. The magnitude of the association was considered at p-value of ≤0.05 in multivariable logistic regression analysis using adjusted odds ratio (AOR) at 95% confidence interval (CI). Concurrently, facility surveillance officers were subjected to an in-depth interview autonomously to explore factors for good and bad service quality. Quantitative data were analyzed using SPSS version 21. Use of manual thematic approach was used for qualitative data analysis. Result: The level of the overall quality of IDSR service provision has rendered as good in 6 out of 46(13%) studied health facilities. Two third of studied health facilities were rated as good for input service quality but 34.7% for process service quality. The output service quality was two times better than the overall service quality. Being enrollment of HIT to rapid response team (AOR=7, 95% CI: 1.092- 37.857) and accessing technical guideline to the health facility (AOR=3, 95% CI: 0.399-22.567) were predictor factors for facilitating overall service quality.

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 Twenty Years of Integrated Disease Surveillance and Response in Sub-Saharan Africa: Challenges and Opportunities for Effective Management of Infectious Disease Epidemics

2020 ◽  
Author(s):  
Irene Mremi ◽  
Janeth George ◽  
Susan F. Rumisha ◽  
Calvin Sindato ◽  
Leonard E.G. Mboera ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health Information ◽  
Disease Surveillance ◽  
Sub Saharan Africa ◽  
Health Management Information System ◽  
Support Functions ◽  
Surveillance And Response ◽  
Sub Saharan ◽  
Disease Epidemics

Abstract Background: Public health surveillance requires valid, timely and complete health information for early detection of outbreaks. Countries in Sub-Saharan Africa (SSA) adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 1998 in response to an increased frequency of emerging and re-emerging diseases in the region. This systematic review aimed to analyse how IDSR implementation has embraced advancement in information technology, big data analytics techniques and wealth of data sources to strengthen detection and management of infectious disease epidemics in SSA. Methods: Three databases were searched for eligible articles: HINARI, PubMed, and advanced Google Scholar databases. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist. A total of 1,809 articles were identified using key descriptors and screened at two stages, and 45 studies met the inclusion criteria for detailed review.Results: Of the 45 studies, 35 were country-specific, seven studies covered the region, and three studies covered 3-4 countries. A total of 24 studies assessed the IDSR core functions, while 42 studies evaluated the support functions. Twenty-three studies addressed both the core and support functions. Most of the studies involved Tanzania (9), Ghana (6) and Uganda (5). The implementation of the IDSR strategy has shown improvements, mainly in the support functions. The Health Management Information System (HMIS) has remained the main source of IDSR data. However, the HMIS system is characterised by inadequate data completeness, timeliness, quality, analysis and utilisation as well as lack of integration of data from sources other than health care facilities. Conclusion: In most SSA, HMIS is the main source of IDSR data, characterised by incompleteness, inconsistency and inaccuracy. This data is considered to be biased and reflects only the population seeking care from healthcare facilities. Community-based event-based surveillance is weak and non-existence in the majority of the countries. Data from other systems are not effectively utilised and integrated for surveillance. It is recommended that SSA countries consider and adopt multi-sectoral, multi-disease and multi-indicator platforms that integrate the existing surveillance systems with other sources of health information to provide support to effective detection and prompt response to public health threats.

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.

scholarly journals Assessment of the core and support functions of the Integrated Disease Surveillance system in Maharashtra, India

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Revati K Phalkey ◽  
Sharvari Shukla ◽  
Savita Shardul ◽  
Nutan Ashtekar ◽  
Sapna Valsa ◽  
...  
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Support Functions ◽  
The Core ◽  
Disease Surveillance System

scholarly journals Electronic Reporting of Integrated Disease Surveillance and Response: Lessons Learned from Northeast, Nigeria, 2019.

2020 ◽  
Author(s):  
Luka Mangveep Ibrahim ◽  
Ifeanyi Okudo ◽  
Mary Stephen ◽  
Opeayo Ogundiran ◽  
Jerry Shitta Pantuvo ◽  
...  
Keyword(s):  
Public Health ◽  
Disease Surveillance ◽  
Public Health Surveillance ◽  
Health Surveillance ◽  
Lessons Learned ◽  
Health Facilities ◽  
Supportive Supervision ◽  
Electronic Reporting ◽  
Surveillance And Response ◽  
Word Clouds

Abstract Background: Electronic reporting of integrated disease surveillance and response (eIDSR) was implemented in two states in North-East Nigeria as an innovative strategy to improve disease reporting. Its objectives were to improve the timeliness and completeness of IDSR reporting by health facilities, prompt identification of public health events, timely information sharing, and public health action. We evaluated the project to determine whether it met its set objectives.Method: We conducted a cross-sectional study to assess and document the lessons learned from the project. We reviewed the performance of the Local Government Areas (LGAs) on rumors identification and reporting of IDSR data on the eIDSR and the traditional system using a checklist. Respondents were interviewed online on the relevance; efficiency; sustainability; project progress and effectiveness; effectiveness of management; and potential impact and scalability of the strategy using structured questionnaires. Quantitative data were analyzed and presented as proportions using an MS Excel spreadsheet. Qualitative data was cleaned, converted into an MS Excel database, and analyzed using Epi Info version 7.2 to obtain frequencies. Responses were also presented as direct quotes or word clouds.Results: The number of health facilities reporting IDSR increased from 103 to 228 (117%) before and after implementation of the eIDSR respectively. The completeness of IDSR reports in the last six months before the evaluation was ≥ 85%. Of the 201 rumors identified and verified, 161 (80%) were from the eIDSR pilot sites. The majority of the stakeholders interviewed believed that eIDSR met its predetermined objectives for public health surveillance. The benefits of eIDSR included timely reporting and response to alerts and disease outbreaks, improved completeness, and timeliness of reporting, and supportive supervision to the operational levels. The strategy helped the stakeholders to appreciate their roles in public health surveillance.Conclusion: The eIDSR increased the number of health facilities reporting IDSR, enabled early identification, reporting, and verification of alerts, improved completeness of reports, and supportive supervision on staff at the operational levels. It was well accepted by the stakeholder as a system that made reporting easy with the potential to improve the public health surveillance system in Nigeria.

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