Performance of COVID-19 case-based surveillance system in FCT, Nigeria, March 2020 –January 2021

Abstract

Introduction The emergence of novel SARS-CoV-2 has caused a pandemic of Coronavirus Disease 19 (COVID-19) which has spread exponentially worldwide. A robust surveillance system is essential for correct estimation of the disease burden and containment of the pandemic. We evaluated the performance of COVID-19 case-based surveillance system in FCT, Nigeria and assessed its key attributes. Methods We used a cross-sectional study design, comprising a survey, key informant interview, record review and secondary data analysis. A self-administered, semi-structured questionnaire was administered to key stakeholders to assess the attributes and process of operation of the surveillance system using CDC’s Updated Guidelines for Evaluation of Public Health Surveillance System 2001. Data collected alongside surveillance data from March 2020 to January 2021 were analyzed and summarized using descriptive statistics. Results Out of 69,338 suspected cases, 12,595 tested positive with RT-PCR with a positive predictive value (PPV) of 18%. Healthcare workers were identified as high-risk group with a prevalence of 23.5%. About 82% respondents perceived the system to be simple, 85.5% posited that the system was flexible and easily accommodates changes, 71.4% reported that the system was acceptable and expressed willingness to continue participation. Representativeness of the system was 93%, stability 40%, data quality 56.2% and timeliness 45.5%, estimated result turnaround time (TAT) was suboptimal. Conclusion The system was found to be useful, simple, flexible, sensitive, acceptable, with good representativeness but the stability, data quality and timeliness was poor. The system meets initial surveillance objectives but rapid expansion of sample collection and testing sites, improvement of TAT, sustainable funding, improvement of electronic database, continuous provision of logistics, supplies and additional trainings are needed to address identified weaknesses, optimize the system performance and meet increasing need of case detection in the wake of rapidly spreading pandemic. More risk-group persons should be tested to improve surveillance effectiveness.

Systems analysis of the effects of the 2014-16 Ebola crisis on WHO-reporting nations’ policy adaptations and 2020-21 COVID-19 response: a systematized review

“…Figure 3 provides case examples of EVD-related countries’ policy learning. Nigeria and Liberia’s COVID-19 national response in 2020 were notably organized and effective at mitigating the first waves often attributed to their EVD-related policy improvements [ 21 , 22 , 55 – 58 ]. One critical factor repeatedly noted is how many of these nations employed a key lesson learnt in the Ebola crisis- the need to identify culturally and contextually appropriate solutions [ 13 , 21 , 49 , 51 , 59 ].…”

“…The World Bank’s International Development Association-supported Regional Disease Surveillance Systems Enhancement (REDISSE) Program was launched in 2016 to support 2014-16 EVD-affected nations and non-affected nations (Benin, Burkina Faso, Cabo Verde, Cote d’Ivoire, The Gambia, Ghana, Guinea-Bissau, Mali, Mauritania, Niger, Nigeria, Senegal, Togo) to incorporate EVD-related policies to better guard against future epidemics. To varying levels of degree, these countries included REDISSE health reforms to combat COVID, including rapid laboratory testing, forming a technical preparedness working group, and activating Incident Action Plans transnationally [ 22 , 66 – 68 ].…”

“…Researchers are only recently beginning to understand the extent of the policy ramifications from the West African epidemic on national health preparedness and response prior to the COVID-19 pandemic [ 15 – 19 ]. A growing number of national case studies indicate that some countries like the governments of Ghana [ 20 ] and Nigeria [ 21 , 22 ], took this recommendation seriously, and that their Ebola-related policy reforms later impacted their national responses to COVID [ 2 , 3 , 6 , 7 , 12 ]. However, there is no identified study to date that specifically measures the extent to which WHO nations incorporated Ebola-related policies in relation their COVID-19 preparedness and response.…”

A cross-sectional survey of COVID-19 testing status among vaccine recipients in Gombe, North-Eastern Nigeria

“…The effectiveness of Nigeria's COVID-19 testing system as well as the acceptance of the COVID-19 vaccines depends on several factors which included the willingness of citizens to be tested, proximity to the testing center, the individual's level of education, preexisting health conditions, knowledge of COVID-19 symptoms, and previous healthcare experience [5,[22][23][24][25]. In addition, risk communication and community engagement strategies have in uenced healthcare seeking behavior of Nigerians, speci cally during the COVID-19 pandemic [26].…”

Reporting COVID-19 Cases through the Integrated Disease Surveillance and Response Network in the Southwestern State of Nigeria: A Health Facility Survey

“…To determine the sample size of the study, Fisher's formula [15] for estimating single proportions and estimation for minimum sample size was applied, and the estimated sample size was 73. Fisher's formula: n=Z 2 P (1−P)/d 2 ; where: n=sample size, Z=standard deviation for a 95% confidence level (Z=1.96), and p=prevalence of the attribute which was obtained from Umeozuru, et al [16] where 5% of health care workers reported at least one suspected COVID-19 case on an e-IDSR platform in FCT, Nigeria; while d = acceptable difference (if 5%, d=0.05); q=1-p.…”