Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jan 31, 2021
Date Accepted: Aug 15, 2021
Date Submitted to PubMed: Dec 1, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Evaluation of the National Tuberculosis Surveillance System in Sana’a City, Yemen
ABSTRACT
Background:
Tuberculosis (TB) surveillance system in Yemen has not been evaluated before and it is not clear if the system is able to monitor the TB problem in Yemen efficiently and effectively
Objective:
This study aimed to assess the usefulness of the national tuberculosis surveillance system, assess the performance of tuberculosis programs regarding the eight attributes and identify strengths and weakness 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 (CDC) updated guidelines. The study was carried out in ten districts in Sana’a City. Twenty-eight public health facilities providing TB services for whole population in their assigned catchment areas in Sana’a city were purposively selected. All key stakeholders were interviewed based on their involvement with key aspects of TB surveillance activities.
Results:
A total of 54 persons participated in the evaluation. The overall score percent for usefulness was 71%, indicating an average rank. The TB Surveillance System had an average flexibility (score percent = 78%), poor stability (score percent = 15%), poor simplicity (score percent = 59%), and poor acceptability (score percent = 12%). The timeliness was ranked as average. The sensitivity of the TB surveillance system was 96% and the PPV of the TB surveillance system was 73%.
Conclusions:
The usefulness, flexibility, PVP, timeliness, and data quality of the TB surveillance system were rated as an average. The system’s stability, acceptability and simplicity were rated as poor. The main weaknesses in the TB surveillance system include lack of governmental financial support, paper-based system, and lack of regular staff training. Developing an electronic system, involvement of private sector in reporting system, securing governmental financial support, and training the staff on TB surveillance are strongly recommended to improve the performance of the system.
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