Ameh Celestine A, Sufiyan Muawiyyah B, Jacob Matthew, Waziri Ndadilnasiya E, Olayinka Adebola T
Nigerian Field Epidemiology and Laboratory Training Program, Abuja, Nigeria.
Ahmadu Bello University Zaria, Nigeria.
Online J Public Health Inform. 2016 Nov 28;8(3):e206. doi: 10.5210/ojphi.v8i3.7089. eCollection 2016.
To evaluate the case-based measles surveillance system in Kaduna State of Nigeria and identify gaps in its operation.
In Africa, approximately 13 million cases, 650,000 deaths due to measles occur annually, with sub-Saharan Africa having the highest morbidity and mortality. Measles infection is endemic in Nigeria and has been documented to occur all year round, despite high measles routine and supplemental immunization coverage. The frequent outbreaks of measles in Kaduna State prompted the need for the evaluation of the measles case-based surveillance system.
We interviewed stakeholders and conducted a retrospective record review of the measles case-based surveillance data from 2010 - 2012 and adapted the 2001 CDC guidelines on surveillance evaluation and the Framework for Evaluating Public Health Surveillance Systems for Early Detection of Outbreaks, to assess the systems usefulness, representativeness, timeliness, stability, acceptability and data quality. We calculated the annualized detection rate of measles and non-measles febrile rash, proportion of available results, proportion of LGAs (Districts) that investigated at least one case with blood, proportion of cases that were IgM positive and the incidence of measles. We compared the results with WHO(2004) recommended performance indicators to determine the quality and effectiveness of measles surveillance system.
According to the Stakeholders, the case-based surveillance system was useful and acceptable. Median interval between specimen collection and release of result was 7days (1 - 25 days) in 2010, 38 days (Range: 16 - 109 days) in 2011 and 11 days (Range: 1 - 105 days) in 2012. The annualized detection rate of measles rash in 2010 was 2.1 (target: 2), 1.0 (target: 2) in 2011 and 1.4 (target: 2) in 2012. The annualized detection rate of non-measles febrile rash in 2010 was 2.1 (target: 2), 0.6 (target: 2) in 2011 and 0.8 (target: 2) in 2012. Case definitions are simple and understood by all the operators.
This evaluation showed that the surveillance system was still useful. Also, the efficiency and effectiveness of the laboratory component as captured by the "median interval between specimen collection and the release of results improved in 2010 and 2012 compared to 2011. However, there was a progressive decline in the timeliness and completeness of weekly reports in the years under review.
评估尼日利亚卡杜纳州基于病例的麻疹监测系统，并找出其运行中的差距。
在非洲，每年约有1300万例麻疹病例，65万人死于麻疹，撒哈拉以南非洲的发病率和死亡率最高。麻疹感染在尼日利亚呈地方性流行，尽管麻疹常规免疫和补充免疫覆盖率很高，但全年都有麻疹病例报告。卡杜纳州频繁爆发麻疹，因此需要对基于病例的麻疹监测系统进行评估。
我们采访了相关利益者，并对2010 - 2012年基于病例的麻疹监测数据进行了回顾性记录审查，并采用了2001年美国疾病控制与预防中心（CDC）的监测评估指南以及《用于早期发现疫情的公共卫生监测系统评估框架》，以评估该系统的有用性、代表性、及时性、稳定性、可接受性和数据质量。我们计算了麻疹和非麻疹发热性皮疹的年化检出率、可用结果的比例、至少调查了一例血样的地方政府辖区（行政区）的比例、IgM阳性病例的比例以及麻疹发病率。我们将结果与世界卫生组织（2004年）推荐的绩效指标进行比较，以确定麻疹监测系统的质量和有效性。
据相关利益者称，基于病例的监测系统是有用且可接受的。2010年，样本采集与结果发布之间的中位间隔为7天（1 - 25天），2011年为38天（范围：16 - 109天），2012年为11天（范围：1 - 105天）。2010年麻疹皮疹的年化检出率为2.1（目标：2），2011年为1.0（目标：2），2012年为1.4（目标：2）。2010年非麻疹发热性皮疹的年化检出率为2.1（目标：2），2011年为0.6（目标：2），2012年为0.8（目标：2）。病例定义简单，所有操作人员都能理解。
本次评估表明该监测系统仍然有用。此外，与2011年相比，2010年和2012年“样本采集与结果发布之间的中位间隔”所反映的实验室环节的效率和有效性有所提高。然而，在审查的年份中，每周报告的及时性和完整性呈逐步下降趋势。
