JMIR Publications

ABSTRACT

Background:

Multi- Drug Resistant Tuberculosis (MDR-TB) is a major challenge to end TB by 2035. In Yemen, the 2011 survey showed a MDR-TB prevalence of 1.4% among new cases and 14.4% among previously treated cases. The National Tuberculosis Control Program (NTCP) established four MDR-TB sentinel surveillance sites in 2013 to monitor MDR-TB situation. : Multi- Drug Resistant Tuberculosis (MDR-TB) is a major challenge to end TB by 2035. In Yemen, the 2011 survey showed a MDR-TB prevalence of 1.4% among new cases and 14.4% among previously treated cases. The National Tuberculosis Control Program (NTCP) established four MDR-TB sentinel surveillance sites in 2013 to monitor MDR-TB situation.

Objective:

This study aimed to assess the performance of MDR-TB Surveillance and determine its strengths and weaknesses

Methods:

We used the updated Center for Diseases Control (CDC) guidelines for evaluating public health surveillance systems. Interviews were conducted with NTCP managers and Regional MDR-TB centers’ staff using semi-structured questionnaire. We used 5-Likert scale to assess the usefulness and other attributes (e.g. simplicity, flexibility). The mean percent was calculated for each attribute and used for final rank of the performance: Poor (<60%), average (60-80%), and good (>80%).

Results:

MDR-TB Surveillance System achieved good performance in usefulness (87%), acceptability (82%) and data quality (91%), achieved average in flexibility (61%) and simplicity (72%), and achieved poor score in stability (55%). The overall performance score was average (74%). Although strong commitment, good monitoring, and well-trained staff are the main strengths, depending on external fund is a major weakness together with unavailability of MDR-TB unit at the governorate level.

Conclusions:

: Although MDR-TB surveillance system has achieved an average overall performance, more efforts are required to improve stability through ensuring constant power supply to enable laboratories to perform necessary diagnostic and follow up tests. Gradual replacement of donor’s funds by the government is recommended. Scaling-up of MDR-TB services and removing access barriers are crucial.