RTI International, Research Triangle Park, North Carolina, United States of America.
RTI International, Conakry, Guinea.
PLoS One. 2020 Jun 25;15(6):e0234796. doi: 10.1371/journal.pone.0234796. eCollection 2020.
The 2014-2016 Ebola virus disease outbreak revealed the fragility of the Guinean public health infrastructure. As a result, the Guinean Ministry of Health is collaborating with international partners to improve compliance with the International Health Regulations and work toward the Global Health Security Agenda goals, including enhanced case- and community-based disease surveillance. We assessed the case-based disease surveillance system during October 1, 2015-March 31, 2016, in the Boffa prefecture of Guinea. We conducted onsite interviews with public health staff at the peripheral (health center), middle (prefectural), and central (Ministry of Health) levels of the public health system to document leadership structure; methods for maintaining case registers and submitting weekly case reports; disease surveillance feedback; data analysis; and baseline surveillance information on four epidemic-prone diseases (cholera, meningococcal meningitis, measles, and yellow fever). The surveillance system was simple and paper-based at health centers and computer spreadsheet-based at the prefectural and central levels. Surveillance feedback to stakeholders at all levels was infrequent. Data analysis activities were minimal at the peripheral levels and progressively more robust at the prefectural and central levels. Reviewing the surveillance reports from Boffa during the study period, we observed zero reported cases of the four epidemic-prone diseases in the weekly reporting from the peripheral to the central level. Similarly, the national District Health Information System 2 had no reported cases of the four diseases in Boffa but did indicate reported cases among all four neighboring prefectures. Based on the assessment findings, which suggest low sensitivity of the case-based disease surveillance system in Boffa, we recommend additional training and support to improve surveillance data quality and enhance Guinean public health workforce capacity to use these data.
2014-2016 年埃博拉病毒病疫情揭示了几内亚公共卫生基础设施的脆弱性。因此，几内亚卫生部正在与国际伙伴合作，提高对《国际卫生条例》的遵守程度，并努力实现全球卫生安全议程的目标，包括加强以病例和社区为基础的疾病监测。我们评估了 2015 年 10 月 1 日至 2016 年 3 月 31 日期间几内亚博法省的基于病例的疾病监测系统。我们对公共卫生系统的基层（卫生中心）、中层（省）和中央（卫生部）各级的公共卫生工作人员进行了现场访谈，记录领导结构；维护病例登记册和提交每周病例报告的方法；疾病监测反馈；数据分析；以及四种流行疾病（霍乱、脑膜炎球菌性脑膜炎、麻疹和黄热病）的基线监测信息。该监测系统在卫生中心是简单的纸质系统，在省和中央一级是基于计算机电子表格的系统。各级利益攸关方的监测反馈都很不频繁。在基层一级，数据分析活动很少，而在省和中央一级则逐渐增多。在研究期间审查博法的监测报告时，我们观察到从基层向中央每周报告中，这四种流行疾病均无报告病例。同样，国家区卫生信息系统 2 也没有博法报告的这四种疾病病例，但确实表明在所有四个邻近省份都有报告病例。基于评估结果，即博法基于病例的疾病监测系统敏感性较低，我们建议提供更多培训和支持，以提高监测数据质量，并增强几内亚公共卫生工作人员使用这些数据的能力。
