JMIR Publications

ABSTRACT

Background:

Egypt National Disease Surveillance (NEDSS) is a routine system established in 2002. The system is electronically reporting 41 infectious diseases including COVID-19. Reporting sites include all Egyptian governorates, districts, governmental infectious diseases hospitals, and primary health units. Surveillance is essential during pandemics to early detect cases, describe the epidemiology of health problems, guide priority-setting and planning, and evaluation of public health policy and strategies.

Objective:

Evaluation of surveillance during the pandemic is necessary to assess its effectiveness in achieving these objectives, find and fill the gaps.

Methods:

The evaluation was performed using CDC guidelines. A structured questionnaire was used to evaluate the qualitative attributes including simplicity, flexibility, and acceptability through interviewing surveillance teams at the central level, health directorate, and Sahel district. while quantitative attributes including completeness, timeliness, and predictive positive value were performed using COVID-19 surveillance data of Sahel district March-December 2020. Data were assessed for completeness and accuracy. The usefulness of surveillance was assessed in terms of achieving its objectives and utilization of data.

Results:

Out of 33 respondents, 90% think that system is simple, 77% acceptable, work overload reduced acceptability rate. The system is funded by MoHP and operational 53% of the time due to connectivity problems. The system was flexible when adapting to include COVID-19 in a short time with minimal cost. It is quite representative as it covers 60% of the population. Completeness was 82%, positive value predictive 78% and data validity 86%. The median duration between patient admissions and reporting was 2.7 days.

Conclusions:

Evaluation of Egypt COVID-19 surveillance system indicated that system partly achieved its objectives, in the area of simplicity, flexible with adequate data quality. There is a need to improve acceptability and timeliness through increasing manpower and enhancing stability through effective connectivity. Expansion of the system to cover all of Egypt's population is recommended to improve representativeness.