Abstract
BackgroundThe correct knowledge of standard case definition is necessary for frontline health workers to diagnose suspected diseases across Africa. However, surveillance evaluations commonly assume this prerequisite. This study assessed the knowledge of case definitions for health workers and their supervisors for disease surveillance activities in rural Kenya.MethodsA cross-sectional survey including 131 health workers and their 11 supervisors was undertaken in two counties in Kenya. Descriptive analysis was conducted to classify the correctness of knowledge into four categories for three tracer diseases (dysentery, measles, and dengue). We conducted a univariate and multivariable logistic regression analyses to explore factors influencing knowledge of the case definition for dysentery.ResultsAmong supervisors, 81.8% knew the correct definition for dysentery, 27.3% for measles, and no correct responses were provided for dengue. Correct knowledge was observed for 50.4% of the health workers for dysentery, only 12.2% for measles, and none for dengue. Of 10 examined factors, the following were significantly associated with health workers’ correct knowledge of the case definition for dysentery: health workers’ cadre (aOR 2.71; 95% CI 1.20–6.12; p = 0.017), and display of case definition poster (aOR 2.24; 95% CI 1.01–4.98; p = 0.048). Health workers’ exposure to the surveillance refresher training, supportive supervision and guidelines were not significantly associated with the knowledge.ConclusionThe correct knowledge of standard case definitions was sub-optimal among health workers and their supervisors, which is likely to impact the reliability of routine surveillance reports generated from health facilities.
Highlights
The correct knowledge of standard case definition is necessary for frontline health workers to diagnose suspected diseases across Africa
We conducted a cross-sectional study among frontline health workers and their disease surveillance supervisors in rural Kenya to assess their knowledge of Integrated Disease Surveillance and Response (IDSR) standard case definitions
To explore factors influencing the knowledge of IDSR standard case definition, we focused on dysentery because the variability of correct responses was observed only for this tracer disease
Summary
The correct knowledge of standard case definition is necessary for frontline health workers to diagnose suspected diseases across Africa. This study assessed the knowledge of case definitions for health workers and their supervisors for disease surveillance activities in rural Kenya. The first step in disease surveillance for frontline health workers is to diagnose and identify cases at health facilities. The knowledge of IDSR standard case definitions by health workers and their supervisors have been assumed and no study has examined the awareness and knowledge of case definitions as stipulated in the guidelines [18, 19]. We conducted a cross-sectional study among frontline health workers and their disease surveillance supervisors in rural Kenya to assess their knowledge of IDSR standard case definitions
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