Event-based surveillance in north-western Ethiopia: experience and lessons learnt in the field

Abstract

This study piloted an event-based surveillance system at the health centre (HC) level in Ethiopia. The system collects rumours in the community and registers them in rumour logbooks to record events of disease outbreaks and public health emergencies. Descriptive analysis was conducted on the events captured at the 59 study HCs in the Amhara Region in north-western Ethiopia between October 2013 and November 2014. A total of 126 rumours were registered at two thirds of the HCs during the study period. The average event reporting time was 3.8 days; response time of the HCs was 0.6 days, resulting in a total response time of 4.4 days. The most commonly reported rumours were measles-related (n = 90, 71%). These rumours followed a similar pattern of measles cases reported in the routine surveillance system. The largest proportion of rumours were reported by community members (n = 38, 36%) followed by health post workers (n = 36, 29%) who were normally informed by the community members about the rumours. This surveillance system was established along with an existing indicator-based surveillance system and was simple to implement. The implementation cost was minimal, requiring only printing and distribution of rumour logbooks to the HCs and brief orientations to focal persons. In countries where routine surveillance is still weak, an event-based surveillance system similar to this should be considered as a supplementary tool for disease monitoring.

Community-Based Surveillance in Côte d'Ivoire

“…This finding is similar to other recent studies demonstrating the value of community-based surveillance as an early warning system. [3][4][5]9,10 The study has limitations. The first limitation was heavy reliance on the electronic IDSR database for data analyses.…”

“…C ommunity-based surveillance is the systematic detection and reporting of events of public health significance in a community by community members. [1][2][3][4][5] Community health workers play an important role in early warning of emerging events by engaging with their communities to detect potential public health events and connecting individuals to health services. [6][7][8][9][10][11] Community health workers are particularly valuable in areas of the world with limited access to health care.…”

Red Cross volunteers’ experience with a mobile community event- based surveillance (CEBS) system in Sierra Leone during-and after the Ebola outbreak- A qualitative study

“…As a CBS should predominantly report on suspected diseases that occur infrequently, refresher trainings are likely necessary for both maintaining the knowledge and following up and motivating the volunteers by coming together, learning and giving feedback. The need for sufficient training is supported by a study conducted in Ghana [29] were the CHWs receive minimum refresher training and thus were unable to report according to case definitions.…”

Strengthening timely detection and reporting of unusual respiratory events from health facilities in Yaoundé, Cameroon

“…This finding is consistent with EBS systems where triage and verification take place at healthcare facilities, such as in Ethiopia where 64% of EBS reports from health centers were verified and found to be true events. 13 Another challenge experienced in EBS implementation was one of physical infrastructure. Telephone landlines are not commonplace in Cameroon, therefore the health facility staff lacked a reliable and free mechanism for reporting.…”

“…7 While much of the EBS literature focuses on web or media EBS, [8][9][10] and community EBS, 8,[11][12][13][14] few reports describe the implementation of EBS in healthcare facilities. 13,14 The EBS program in Yaoundé was a collaboration among DLMEP, CPC, Cameroon's National Public Health Laboratory (Laboratoire National de Santé Publique de Cameroun, LNSP), and CDC. This report describes the implementation process, signal detection data, and the strengths and challenges of the program.…”