Public enrolled in Ghana disease fight

Members of the public trained on how to collect health information in Ghana are enabling early detection and reporting of vaccine-preventable diseases such as measles, a study says.

The system, called community-based surveillance, allows disease outbreaks to be picked up by eagle-eyed members of the public.

"The community members, who may be professionals or otherwise, are engaged and trained to collect health information from their communities and report it for public health surveillance purposes," the study adds.

"Community-based surveillance detected 26 percent of all suspected vaccine-preventable disease cases that were reported," says the study, adding that within 48 hours of detection, 87 percent of the health issues detected were responded to. This demonstrates that community-based surveillance is effective in capturing disease cases that may have been otherwise missed by the routine disease surveillance system," says Sharifa Merali, the study's lead author and an epidemiologist at the Division of Viral Diseases at the US-based Centers for Disease Control and Prevention. It also demonstrates that the diseases detected through the surveillance were responded to rapidly, which reduces the potential for spread and more severe outcomes for those affected."

Routine surveillance, often limited to healthcare facilities, is inadequate for patients who come to seek treatment. Community-based surveillance can capture disease outbreaks in hard-to-reach populations, Merali adds.

Ghana implemented a modified community-based surveillance program, and the evaluation data showed improved detection of vaccine-preventable diseases, according to the study published in PLOS One last month (11 August).

"Community-based surveillance functions well as an early warning system that complements the existing routine surveillance system in Ghana," Merali tells SciDev.Net.

"We found it pertinent to study how to build and improve surveillance capacity at the community level in Ghana … to provide evidence for other countries to enhance these capacities."

According to the study, community-based surveillance detected 317 cases that might otherwise have been missed by the routine surveillance system.

Merali explains that the study occurred in two phases. Phase I took place in two districts between June 2017 and March 2018 and the second phase was implemented in 30 districts between June 2018 and March 2019.

She tells SciDev.Net: "The WHO conducts joint external evaluations to assess country capacities to prevent, detect and rapidly respond to public health risks. Gaps revealed in Ghana's most recent evaluation are similar to those in most countries across Sub-Saharan Africa. Recent public health happenings, including the 2014-2016 Ebola outbreak in West Africa as well as the current COVID-19 pandemic, have exposed the urgent need for countries to bolster their surveillance to include early warning and response mechanisms."

Pauline Bakibinga, associate research scientist at Kenya-based African Population Health Research Center, says: "This is an important study as it focuses on community-based surveillance, an initiative that enables effective communication of unusual events or changes in the health status of community members to authorities for further action, there are lessons that can be used even in the current [COVID-19] pandemic crisis."

Bakibinga calls for more concerted efforts in improving users' understanding of the value of reporting as well as accommodating them in the design of the study to aid better uptake of the innovation.