Implementing a DHIS2 Ebola virus disease module during the 2021 Guinea Ebola outbreak

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Abstract

In 2017, the national agency for health security (L’Agence Nationale de Sécurité Sanitaire—ANSS) in Guinea implemented the District Health Information Software (DHIS2) as the Ministry of Health national surveillance system to capture and report aggregate disease data. During 2019, the ANSS started using DHIS2 Tracker to collect case-based (individual-level) data for epidemic-prone diseases. In 2020, the capability was expanded, and it was used during the COVID-19 pandemic to capture data relevant to the COVID-19 response. When an Ebola virus disease (EVD) outbreak was announced in February 2021, the Tracker module was updated, and enhanced functionalities were developed to meet the needs for the emerging epidemic. This novel EVD module has components to capture information on cases, contacts, alerts, laboratory and vaccinations and provides a centralised site for all EVD outbreak data. It has since been expanded for use with future viral haemorrhagic fever outbreaks.

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Most cited references 6

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Overview, Control Strategies, and Lessons Learned in the CDC Response to the 2014-2016 Ebola Epidemic.

Beth Bell, Inger K. Damon, Daniel B. Jernigan … (2016)

During 2014-2016, CDC, working with U.S. and international partners, mounted a concerted response to end the unprecedented epidemic of Ebola virus disease (Ebola) in West Africa. CDC's response, which was the largest in the agency's history, was directed simultaneously at controlling the epidemic in West Africa and strengthening preparedness for Ebola in the United States. Although experience in responding to approximately 20 Ebola outbreaks since 1976 had provided CDC and other international responders an understanding of the disease and how to stop its spread, the epidemic in West Africa presented new and formidable challenges. The initial response was slow and complicated for several reasons, including wide geographic spread of cases, poor public health and societal infrastructure, sociodemographic factors, local unfamiliarity with Ebola, and distrust of government and health care workers. In the United States, widespread public alarm erupted after Ebola cases were diagnosed in Dallas, Texas, and New York City, New York. CDC, in collaboration with its U.S. and international counterparts, applied proven public health strategies as well as innovative new approaches to help control the Ebola epidemic in West Africa and strengthen public health readiness in the United States. Lessons learned include the recognition that West African and other countries need effective systems to detect and stop infectious disease threats, the need for stronger international surge capacity for times when countries are overwhelmed by an outbreak, and the importance of improving infection prevention and control in health care settings. The activities summarized in this report would not have been possible without collaboration with many U.S. and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).

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Ebola Surveillance - Guinea, Liberia, and Sierra Leone.

Lucy A McNamara, Ilana Schafer, Leisha D. Nolen … (2016)

Developing a surveillance system during a public health emergency is always challenging but is especially so in countries with limited public health infrastructure. Surveillance for Ebola virus disease (Ebola) in the West African countries heavily affected by Ebola (Guinea, Liberia, and Sierra Leone) faced numerous impediments, including insufficient numbers of trained staff, community reticence to report cases and contacts, limited information technology resources, limited telephone and Internet service, and overwhelming numbers of infected persons. Through the work of CDC and numerous partners, including the countries' ministries of health, the World Health Organization, and other government and nongovernment organizations, functional Ebola surveillance was established and maintained in these countries. CDC staff were heavily involved in implementing case-based surveillance systems, sustaining case surveillance and contact tracing, and interpreting surveillance data. In addition to helping the ministries of health and other partners understand and manage the epidemic, CDC's activities strengthened epidemiologic and data management capacity to improve routine surveillance in the countries affected, even after the Ebola epidemic ended, and enhanced local capacity to respond quickly to future public health emergencies. However, the many obstacles overcome during development of these Ebola surveillance systems highlight the need to have strong public health, surveillance, and information technology infrastructure in place before a public health emergency occurs. Intense, long-term focus on strengthening public health surveillance systems in developing countries, as described in the Global Health Security Agenda, is needed.The activities summarized in this report would not have been possible without collaboration with many U.S and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).

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Framework for evaluating public health surveillance systems for early detection of outbreaks: recommendations from the CDC Working Group.

Marcus Overhage, D Sosin, … (2004)

The threat of terrorism and high-profile disease outbreaks has drawn attention to public health surveillance systems for early detection of outbreaks. State and local health departments are enhancing existing surveillance systems and developing new systems to better detect outbreaks through public health surveillance. However, information is limited about the usefulness of surveillance systems for outbreak detection or the best ways to support this function. This report supplements previous guidelines for evaluating public health surveillance systems. Use of this framework is intended to improve decision-making regarding the implementation of surveillance for outbreak detection. Use of a standardized evaluation methodology, including description of system design and operation, also will enhance the exchange of information regarding methods to improve early detection of outbreaks. The framework directs particular attention to the measurement of timeliness and validity for outbreak detection. The evaluation framework is designed to support assessment and description of all surveillance approaches to early detection, whether through traditional disease reporting, specialized analytic routines for aberration detection, or surveillance using early indicators of disease outbreaks, such as syndromic surveillance.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Glob Health

Journal ID (iso-abbrev): BMJ Glob Health

Journal ID (hwp): bmjgh

Journal ID (publisher-id): bmjgh

Title: BMJ Global Health

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2059-7908

Publication date Collection: 2022

Publication date (Electronic): 18 May 2022

Volume: 7

Issue: 5

Electronic Location Identifier: e009240

Affiliations

[1 ]departmentDivision of Global Health Protection, Center for Global Health , Centers for Disease Control and Prevention , Atlanta, Georgia, USA

[2 ]departmentDivision of Global Health Protection, Center for Global Health , Centers for Disease Control and Prevention , Conakry, Guinea

[3 ]departmentDivision of Parasitic Diseases and Malaria, Center for Global Health , Centers for Disease Control and Prevention , Atlanta, Georgia, USA

[4 ]departmentDivision of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases , Centers for Disease Control and Prevention , Atlanta, Georgia, USA

[5 ]African Field Epidemiology Network , Conakry, Guinea

[6 ]Agence Nationale de Sécurité Sanitaire , Conakry, Guinea

[7 ]Direction Régionale de la Santé , Kindia, Guinea

Author notes

[Correspondence to ] Carrie Eggers; xfy1@ 123456cdc.gov

Article

Publisher ID: bmjgh-2022-009240

DOI: 10.1136/bmjgh-2022-009240

PMC ID: 9121429

PubMed ID: 35589157

SO-VID: cd5c37f4-90b2-4ce1-b830-b38a5a16b1bd

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This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

History

Date received : 31 March 2022

Date accepted : 02 May 2022

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100006090, Center for Global Health;

Award ID: GH20-2131

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Keywords: viral haemorrhagic fevers,public health,infections, diseases, disorders, injuries,epidemiology,health systems

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Keywords: viral haemorrhagic fevers, public health, infections, diseases, disorders, injuries, epidemiology, health systems

Implementing a DHIS2 Ebola virus disease module during the 2021 Guinea Ebola outbreak

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Novel Coronavirus Disease COVID-19

Most cited references 6

Overview, Control Strategies, and Lessons Learned in the CDC Response to the 2014-2016 Ebola Epidemic.

Ebola Surveillance - Guinea, Liberia, and Sierra Leone.

Framework for evaluating public health surveillance systems for early detection of outbreaks: recommendations from the CDC Working Group.

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