Strengthening public health surveillance at points of entry: A Tanzanian case study of FETP-Frontline adaptation

Abstract

Introduction: In an increasingly interconnected world with rising global health risks, the competence of Point of Entry (PoE) staff in epidemiology is essential for timely detection and response to public health threats. This study describes the adaptation of the Field Epidemiology Training Program (FETP)-Frontline curriculum for PoE staff in Tanzania and assesses the performance of the first cohort that completed the training. Methods: We conducted a workshop to review and adapt FETP-Frontline training materials for relevance to port health functions. A total of 30 PoE staff were recruited and trained from April to August 2023. Participants underwent knowledge assessments before and after the first two workshops. We used paired sample t-tests to compare changes in mean knowledge scores. Self-assessed skill levels were also collected after each workshop to evaluate perceived improvements in competencies. Results: The adapted curriculum retained the standard three-workshop FETP-Frontline structure, with contextualised enhancements for PoE operations. Workshop 1 included a session on Population Connectivity Across Borders (PoPCAB). Workshop 2 incorporated International Health Regulations Core Capacities assessments at PoEs, Risk Assessments, and Contingency Planning. Workshop 3 included training on geographic information system (QGIS) mapping. Of the 30 trained PoE staff from 25 different PoEs across Tanzania, 76.7% (n=23) were male, with a median age of 30 years (interquartile range: 28-32). There were significant increases in the mean knowledge scores after both Workshops 1 and 2. Mean knowledge scores increased by 17.4 (95% confidence interval (CI): 12.72 – 22.08) and 15.25 (95%CI: 11.03 – 19.47) points after Workshops 1 and 2, respectively. There were significant increases in all trainee self-assessed skills after all three workshops. Conclusion: The adapted FETP-Frontline curriculum was associated with improved knowledge and self-reported skills among PoE surveillance officers in Tanzania. This context-specific adaptation demonstrates the feasibility of strengthening surveillance capacity at Points of Entry. Scaling up the training to include all PoE personnel may further enhance national preparedness for cross-border public health threats.