Early-warning health and process indicators for sentinel surveillance in Madagascar 2007-2011

Authors

  • Soatiana Rajatonirina Institut Pasteur de Madagascar
  • Fanjasoa Rakatomanana Institut Pasteur de Madagascar
  • Laurence Randrianasolo Institut Pasteur de Madagascar
  • Norosoa Harline Razanajatovo Institut Pasteur de Madagascar
  • Soa Fy Andriamandimby Institut Pasteur de Madagascar
  • Lisette Ravolomanana Minister of health ,Antananarivo, Madagascar
  • Armand Eugène Randrianarivo-Solofoniaina Minister of healthAntananarivo, Madagascar
  • Jean-Marc Reynes Institut Pasteur de Madagascar
  • Patrice Piola Institut Pasteur de Madagascar
  • Alyssa Finlay-Vickers Malaria Branch, Division of Parasitic Diseases US Centers for Disease Control and Prevention, President's Malaria Initiative, Madagascar
  • Jean-Michel Heraud Institut Pasteur de Madagascar
  • Vincent Richard Pasteur Institute from Dakar

DOI:

https://doi.org/10.5210/ojphi.v6i3.5400

Abstract

Background: Epidemics pose major threats in resource-poor countries, and surveillance tools for their early detection and response are often inadequate. In 2007, a sentinel surveillance system was established in Madagascar, with the aim of rapidly identifying potential epidemics of febrile or diarrhoeal syndromes and issuing alerts. We present the health and process indicators for the five years during which this system was constructed, showing the spatiotemporal trends, early-warning sign detection capability and process evaluation through timely analyses of high-quality data.

Methods: The Malagasy sentinel surveillance network is currently based on data for fever and diarrhoeal syndromes collected from 34 primary health centres and reported daily via the transmission of short messages from mobile telephones. Data are analysed daily at the Institut Pasteur de Madagascar to make it possible to issue alerts more rapidly, and integrated process indicators (timeliness, data quality) are used to monitor the system.

Results: From 2007 to 2011, 917,798 visits were reported. Febrile syndromes accounted for about 11% of visits annually, but the trends observed differed between years and sentinel sites. From 2007 to 2011, 21 epidemic alerts were confirmed. However, delays in data transmission were observed (88% transmitted within 24 hours in 2008; 67% in 2011) and the percentage of forms transmitted each week for validity control decreased from 99.9% in 2007 to 63.5% in 2011.

Conclusion: A sentinel surveillance scheme should take into account both epidemiological and process indicators. It must also be governed by the main purpose of the surveillance and by local factors, such as the motivation of healthcare workers and telecommunication infrastructure. Permanent evaluation indicators are required for regular improvement of the system. 

Author Biographies

Soatiana Rajatonirina, Institut Pasteur de Madagascar

Epidemiology unit

Fanjasoa Rakatomanana, Institut Pasteur de Madagascar

Epidemiology Unit

Laurence Randrianasolo, Institut Pasteur de Madagascar

epidemiology unit

Norosoa Harline Razanajatovo, Institut Pasteur de Madagascar

Virology unit

Soa Fy Andriamandimby, Institut Pasteur de Madagascar

Virology unit

Lisette Ravolomanana, Minister of health ,Antananarivo, Madagascar

Directions des Urgences et de la Lutte contre les Maladies Négligées (DULMN),

Armand Eugène Randrianarivo-Solofoniaina, Minister of healthAntananarivo, Madagascar

4Direction de la Veille Sanitaire et de la Surveillance Epidémiologique (DVSSE), Ministère de la Santé Publique, Antananarivo, Madagascar

Jean-Marc Reynes, Institut Pasteur de Madagascar

Virology unit

Patrice Piola, Institut Pasteur de Madagascar

Epidemiology unit

Jean-Michel Heraud, Institut Pasteur de Madagascar

Virology unit

Vincent Richard, Pasteur Institute from Dakar

Epidemiology unit

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Published

2014-12-15

How to Cite

Rajatonirina, S., Rakatomanana, F., Randrianasolo, L., Razanajatovo, N. H., Andriamandimby, S. F., Ravolomanana, L., … Richard, V. (2014). Early-warning health and process indicators for sentinel surveillance in Madagascar 2007-2011. Online Journal of Public Health Informatics, 6(3). https://doi.org/10.5210/ojphi.v6i3.5400

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Section

Original Articles