Evaluation of measles surveillance system, Western North Region, 2025

Abstract

Introduction: Global reported measles cases is on the increase. Western North Region confirmed four cases in 2023 in the midst of decreasing measles vaccination coverage in the region. Evaluating the measles surveillance system in the region would ensure reduction in morbidity and mortality of measles. The evaluation was conducted to determine whether the system was meeting its objectives, assess its performance, its attributes, and determine its usefulness. Methods: Descriptive cross-sectional study using CDC updated guideline for evaluating surveillance systems was used. Measles surveillance data from 2020 to 2024 was reviewed whilst stakeholders were interviewed using semi-structured questionnaire. Quantitative data was analyzed and presented as tables, graphs and charts while thematic analysis was done for qualitative data. Results: The system reported 394 measles cases from 2020 to 2024 with 14 laboratories confirmed. Knowledge on appropriate channel of reporting and flow of information was 97.1% (33/34). Ability to identify the appropriate reporting forms was 47.1% (16/34). Completion of measles case investigation forms was 100%. No reliable funds for measles surveillance activities in all nine health facilities visited. Measles case definition was flexible and helped to identify other disease. Investigation on all reported cases were initiated within 24 hours. Positive Predictive Value was 4.7% (14/394). Reporting rate for weekly IDSR reports was 99% (299/302). Suspected measles cases entered in SORMAS was 320 cases but 394 cases in source document. There was no decision made as a result of the surveillance data. Conclusion: The measles surveillance system met its objectives of suspecting and confirming measles cases. The system was sensitive, acceptable, and flexible, but had poor data quality. The system was partially simple, stable and useful. Deputy Director of Public Health for the region should solicit for support to fund Measles Surveillance activities. The Regional Surveillance Officer should regularly validate Measles Surveillance data to avoid data inconsistencies.