Evaluation of Rotavirus Surveillance System —Kenya, 2010

Summary

Back ground: Rotavirus surveillance in Kenya is part of the WHO/AFRO regional rotavirus surveillance network established in June 2006 to conduct sentinel-hospital based surveillance in the region. Currently there are four sentinel sites reporting to the national office. We evaluated this surveillance system between July and November 2010 to identify its weaknesses and recommend appropriate improvement. Materials: The Centers for Disease Control and Prevention updated guidelines for surveillance system evaluation were used. Qualitative information was collected by conducting key informant interviews, reviewing previous records and data collection instruments, and through direct observations. We collected evidence of the system’s performance and key attributes. Data analysis was done using Epi-info version 3.5.1. Results: Of 3,733 suspected cases of rotavirus gastroenteritis (RVGE) reported between August 2006 and August 2010, 1,545 (41.4%) were laboratory confirmed. Predictive value positive was 98.5%. Staff interviewed considered the system simple. Timeliness of reporting and average completeness were 75% and 88% respectively. Variables on stool samples from newly established sites were largely incomplete (as low as 24%). Only two of the four surveillance sites consistently conducted laboratory quality control. The system has been able to incorporate three new reporting sources. Three out of the four planned surveillance review meetings per year were held in 2010 but no site support supervision was conducted. Conclusions: The system has helped to estimate the burden of RVGE in Kenya and guide decision making on rota virus vaccine introduction. However, data quality in newly established sites is poor. We recommend strengthening of monitoring and evaluation systems, supervision and training of data managers in newly established sites. Quality control should be done in all the surveillance sites. Key words: Rotavirus, Surveillance, Evaluation, Sentinel, Gastroenteritis. Word count: 272