Epidemic-prone Disease Reports Timeliness in Cameroon from 2014 to 2016: Targeting Poorly-performing Districts

  • Public health surveillance
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Introduction: Surveillance data are critical for health decision-making. Cameroon adopted the Integrated Disease Surveillance and Response System in 2000 with epidemic-prone diseases weekly reports (EDWR) transmitted from districts to the national level. Despite improved communication between districts, EDWR timeliness is still low in some areas. We assessed the EDWR timeliness since 2014, to determine possible causes of poor performances.

Methods:
We used the EDWR database to obtain district timeliness from epidemiological week 1 to 45 in the 189 districts of Cameroon from 2014 to 2016. Timeliness was qualified as good (≥80%), medium (50%-80%) or poor (<50%). Poorly-performing districts included EDWR timeliness <50% in 2016 and/or EDWR timeliness <50% over the 3 years and/or a more than 10% decline in timeliness from 2015 to 2016. A telephone survey for poorly-performing districts was conducted.

Results:
Average EDWR timeliness was 76% in 2014, 85% in 2015, and 84% in 2016. Districts with low, medium and good timeliness were respectively 17.5% (33/189), 25.4% (48/189), and 57.1% (108/189) in 2014, 6.4% (12/189), 20.6% (39/189) and 73% (138/89) in 2015, 6.3% (13/189), 21.7% (41/189) and 72% (135/189) in 2016. With regard to poorly-performing district indicators alone, 20.6% (39/189) decreased by more than 10% in their readiness rate from 2015 to 2016, 6.3% (12/189) districts had low timeliness in 2016 and 2.1%(4/189) districts had a low timeliness for 3 years. Districts with the three-combined indicators accounted for 21.7% (41/189). Poor performances were attributed to limited or unskilled human resources in 41.6% (17/41) of cases.

Conclusion:
From 2014 to 2016, the average EDWR timeliness increased overall, though we were able to identify poorly-performing districts. Our results suggest that EDWR data flow need to be improved and factors influencing timeliness must be identified as well as experimenting an alert system for poorly-performing districts.

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