Article
Assessment of core and support functions of the communicable disease surveillance system in the Kurdistan Region of Iraq
Registro en:
HAMALAW, Soran Amin et al. Assessment of core and support functions of the communicable disease surveillance system in the Kurdistan Region of Iraq. Journal of Medical Virology, v. 94, p. 469-479, 2021.
1096-9071
10.1002/jmv.27288
Autor
Hamalaw, Soran Amin
Bayati, Ali Hattem
Babakir‐Mina, Muhammed
Benvenuto, Domenico
Fabris, Silvia
Guarino, Michele
Giovanetti, Marta
Ciccozzi, Massimo
Resumen
Early detection and prompt response are crucial measures to prevent and control
outbreaks. Public health agencies, therefore, designed the Communicable Disease
Surveillance System (CDSS) to obtain essential data instantaneously to be used for
appropriate action. However, a periodic evaluation of CDSS is indispensable to
ensure the functionality of the system. For this reason, this study aims to assess the
performance of the core and support functions of the CDSS in the Kurdistan Region
of Iraq. A descriptive cross‐sectional study was used. From a total of 291 health
facilities HFs (Primary health care centers and Hospitals) in the Kurdistan region of
Iraq that have surveillance activities, 74 HFs were selected using a random stratified
sampling approach. The World Health Organization (WHO) generic questionnaire
has been used to interview the surveillance staff, together with direct collection of
the data. Our analysis shows a lack of surveillance guiding manual in the HFs. Even at
the district level, where a surveillance manual existed, case definitions, thresholds,
and control measures were still missing. To note, more than 93% of HFs had organized
and comprehensive patients registers for the collection of their clinical and
secondary data. Also, all HFs had functioning laboratories. The majority of them
(almost 93%) were equipped to collect, process, and store blood, stool, and urine
specimens. About 72% of these laboratories were also able to transport timely the
specimens to more specialized laboratories. At all levels, data reporting to the higher
level exceeded the recommended minimum rate of 80%. The reporting system at the
district level was based on emails, while in the periphery on hand‐delivered in paperbased
formats (50%), telephone (22%), and social media (22%). Furthermore, our
analysis highlights the lack of data analysis: only 3.8% of Primary Health Care
Centers conduct simple data analysis regularly, while hospitals do not do any sort of
analysis. Also, only a few HFs investigated an outbreak, though using system routine
sources to capture these public health events. Our findings show a lack in epidemic preparedness (3%), in feedback (53%), in standard guidelines, training, supervision,
and resource allocations in HFs (0%). Taken together, our data show the importance
of strengthening the CDSS in the Kurdistan region of Iraq, by reinforcing the surveillance
system with continuous feedback, supervision, well‐trained and motivated
staff, technical support, and coordination between researchers and physicians.