Weak surveillance the cause of epidemics - Adibo.

Accra (Greater Accra) 8 March '99

Weak surveillance system is responsible for the continued presence of epidemics in the sub-region, Dr Moses Adibo, a Deputy Minister of Health said on Monday. Dr Adibo, opening a week's meeting in Accra on disease surveillance in West Africa, said surveillance and data collection on diseases is difficult because the exercise is limited to big health institutions, which do not represent the real situation on the ground. This is unlike the rural areas where a large number of the population live and early detection of diseases is lacking. The situation was unacceptable on the eve of the 21st century, he said pointing out that poor surveillance is a problem in disease control. Eighty participants from Algeria, Burkina Faso, Benin, Cape Verde, Ghana and Nigeria are attending the meeting organised by the World Health Organisation (WHO) Regional Office for Africa to strengthen the partnership among health workers in integrated disease surveillance. The participants include Expanded Programme on Immunisation (EPI) managers, data managers and epidemiologists. Dr Adibo urged health workers to go to the rural areas and involve the people in disease surveillance because they stand in a very good position to give out accurate information on the type of diseases prevalent in their community. Dr Martin Mandara, WHO representative in Ghana, said recent outbreaks of cerebro-spinal meningitis, yellow fever and cholera have shown that most national surveillance systems are not effective enough to detect outbreaks "let alone to predict them. " The same goes for the laboratory support for surveillance which is on the whole rudimentary ". A recent assessment of disease surveillance activities at different levels of the systems in a few selected countries in the African region detected weaknesses at the most crucial levels of the health system, which includes the health facility at the sub-district and the district levels. Dr Mandara said it is in this direction that the Regional Office decided to carry out surveillance in an integrated manner for the whole of the African region, adding that several potential epidemics have been selected for inclusion in the integrated diseases surveillance programme. "These include yellow fever, lassa fever, ebola haemorrhagic fever and cholera." At each level of the health system, four different activities are expected to be carried out, in a sequential manner, to ensure appropriate action. These are, data collection, analysis interpretation and action. " All these activities are expected to be carried out in an integrated manner for all diseases which are considered major causes of mortality, morbidity and disability in any one country with cross border sharing of information." An effective disease surveillance system requires that all players work by constantly exchanging data and information, Dr Mandara said.