A rapid assessment of the implementation of integrated disease surveillance and response system in Northeast Nigeria, 2017

Luka Mangveep Ibrahim,Chikwe Ihekweazu,Saliu Oladele,Sadiq Garba,Olubunmi Ojo,Ibrahim Njida Mamadu,Ali Ahmed Yahaya,Wondimagegnehu Alemu,Clement Lugala Peter Lasuba,Peter Nsubuga,Samuel Mutbam Kitgakka,Isha Fatma Njai,Mary Stephen,Ifeanyi Okudo

doi:10.1186/s12889-020-08707-4

Abstract

BackgroundIntegrated disease surveillance and response (IDSR) is the strategy adopted for public health surveillance in Nigeria. IDSR has been operational in Nigeria since 2001 but the functionality varies from state to state. The outbreaks of cerebrospinal meningitis and cholera in 2017 indicated weakness in the functionality of the system. A rapid assessment of the IDSR was conducted in three northeastern states to identify and address gaps to strengthen the system.MethodThe survey was conducted at the state and local government areas using standard IDSR assessment tools which were adapted to the Nigerian context. Checklists were used to extract data from reports and records on resources and tools for implementation of IDSR. Questionnaires were used to interview respondents on their capacities to implement IDSR. Quantitative data were entered into an MS Excel spreadsheet, analysed and presented in proportions. Qualitative data were summarised and reported by thematic area.ResultsA total of 34 respondents participated in the rapid survey from six health facilities and six local government areas (LGAs). Of the 2598 health facilities in the three states, only 606 (23%) were involved in reporting IDSR. The standard case definitions were available in all state and LGA offices and health facilities visited. Only 41 (63%) and 31 (47.7%) of the LGAs in the three states had rapid response teams and epidemic preparedness and response committees respectively. The Disease Surveillance and Notification Officers (DSNOs) and clinicians’ knowledge were limited to only timeliness and completeness among over 10 core indicators for IDSR. Review of the facility registers revealed many missing variables; the commonly missed variables were patients’ age, sex, diagnosis and laboratory results.ConclusionsThe major gaps were poor documentation of patients’ data in the facility registers, inadequate reporting tools, limited participation of health facilities in IDSR and limited capacities of personnel to identify, report IDSR priority diseases, analyze and interpret IDSR data for decision making. Training of surveillance focal persons, provision of IDSR reporting tools and effective supportive supervisions will strengthen the system in the country.

Highlights

Integrated disease surveillance and response (IDSR) is the strategy adopted for public health surveillance in Nigeria
A total of 34 respondents participated in the rapid survey from six health facilities and six local government areas (LGAs)
Training of surveillance focal persons, provision of IDSR reporting tools and effective supportive supervisions will strengthen the system in the country

Summary

Introduction

Integrated disease surveillance and response (IDSR) is the strategy adopted for public health surveillance in Nigeria. Increasing globalization has meant increasing vulnerability for countries and communities to the potential threat of emerging infectious disease outbreaks and pandemics across the globe [1]. To safeguard against these global threats, the International Health Regulations (IHR 2005) provide the platform for early notification of all events that might constitute public health emergency of international concern. These regulations are strengthened by domestic public health surveillance of a country [2, 3]. This information provides the foundational knowledge and scientific information essential for informed decision making and guides appropriate public health planning and interventions including responses to outbreaks of diseases and events [5,6,7,8]

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Conclusion