Evaluation of an Electronic Case-based Disease Surveillance System in Karene District, Sierra Leone
Introduction: In 2018, the Government of Sierra Leone introduced an electronic Case-based Disease Surveillance System (eCBDS) to enhance timely data collection, analysis, and dissemination for outbreak detection. Despite the significant impact of the eCBDS on the healthcare system, there is limited...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
African Field Epidemiology Network
2025-02-01
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| Series: | Journal of Interventional Epidemiology and Public Health |
| Subjects: | |
| Online Access: | https://www.afenet-journal.net/content/series/8/2/2/full/ |
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| Summary: | Introduction: In 2018, the Government of Sierra Leone introduced an electronic Case-based Disease Surveillance System (eCBDS) to enhance timely data collection, analysis, and dissemination for outbreak detection. Despite the significant impact of the eCBDS on the healthcare system, there is limited information on the performance of the eCBDS system. This study evaluates the performance of the eCBDS in Karene district, focusing on its operation and key surveillance attributes to determine if it meets its intended objectives.
Methods: From October to December 2022, we conducted a cross-sectional, mixed-method study involving 15 purposively selected stakeholders, including nurses and community health officers, from 12 health facilities to assess the qualitative attributes. We reviewed health facility registers and the eCBDS database covering January to December 2022. We used the U.S CDC updated guidelines to evaluate the attributes of the eCBDS system. System attributes were assessed using a Likert scale, categorizing simplicity, flexibility, usefulness, sensitivity, predictive value positive, acceptability, representativeness, timeliness, stability, and data quality as poor (<30%), average (30-70%), and good (>70%).
Results: The eCBDS system operates as both an active and passive surveillance system. Flexibility and stability were rated as average, 40% (6/15) of the respondents confirmed that the eCBDS system can be integrated with other systems. The system showed good acceptability (85%) and high sensitivity (100%) and data quality (97%). Representativeness was also rated as good, as cases were representative of the general population, and all (12) selected reporting sites, including government and faith-based health facilities, reported a case in the system. However, the predictive value positive was poor (18.8%). Usefulness was rated as average, with 67% of respondents indicating the system's data was used for outbreak detection.
Conclusion: The eCBDS system in Karene district demonstrates effectiveness in several key areas, such as sensitivity, acceptability, and data quality. However, improvements are needed in stability, flexibility, and particularly predictive value positive. We recommend regular supportive supervision, enhanced feedback mechanisms, and continuous training for health workers to sustain and improve the system's performance. |
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| ISSN: | 2664-2824 |