JMIR Publications

ABSTRACT

Background:

Tuberculosis remains a public problem that is considered one of the top causes of morbidity and mortality worldwide. The National Tuberculosis Control Program in Yemen was established in 1970 and included in the national health policy, under the leadership of the Ministry of Public Health and Population to monitor the TB control. The tuberculosis surveillance system has not been evaluated before and it is not clear if the system can monitor the TB problem in Yemen efficiently and effectively.

Objective:

This study aimed to assess the usefulness and the performance of the tuberculosis surveillance system and identify the strength and weaknesses of the system.

Methods:

A quantitative and qualitative evaluation of the National Tuberculosis surveillance system was conducted using the Centers for Disease Control and Prevention updated guidelines. The study was carried out in ten districts in Sana’a City. 28 Public health facilities providing TB services for the whole population in their assigned catchment areas were purposively selected. All key stakeholders were interviewed based on their involvement with key aspects of TB surveillance activities.

Results:

TB surveillance system found average performance in the usefulness (71%), flexibility (75%), acceptability (66%), data quality (67%), and the positive predictive value (73%), while poor performance in simplicity (59%) and stability (15%). Also, a good performance in sensitivity (96%).

Conclusions:

The TB surveillance system was found useful. Flexibility, PVP, and data quality were average. Stability and simplicity were poor. The sensitivity was good. The main weaknesses in the TB surveillance system include lack of governmental financial support, a paper-based system, and lack of regular staff training. Developing an electronic system, securing governmental finances, and training the staff on TB surveillance are strongly recommended to improve the system performance.