Communicable diseases: preparedness, surveillance and response

Situation analysis

Communicable diseases still represent the major public health problems leading to high morbidity and mortality rates among the population, particularly among children under 5 years old. Natural disasters often faced by the country turn the population vulnerable to water borne and drought related disease outbreaks such as cholera, dysentery, and meningococcal meningitis. Sporadic outbreaks of plague have occurred in the country.

The major causes of morbidity and mortality are AIDS, malaria, tuberculosis, respiratory infections, diarrhoea, and meningitis.

Challenges & achievements

Challenges

• Weak epidemiological surveillance system lacking infrastructure and appropriate intra and inter-sectoral coordination;
• Poor health care services, the impact of HIV, and economic migration weakening the health systems;
• Shortage of human resources to implement activities at all levels;
• Lack of radio-communication to liaise remote districts.

Achievements

• Establishment of an epidemiological surveillance system with a list of diseases to be reported by all health facilities;
• Revision of the system with the establishment of two sub-systems known as Weekly Epidemiologic Bulletin (BES) and Monthly Epidemiologic Bulletin-Sentinel Post (BEM-PS).
• Finalization of the national technical guidelines on epidemiological surveillance adapted to the national context.

Next steps

• Revitalization/establishment of the epidemic management committees at central, provincial and district levels;
• Establishment and training of Rapid Response Teams on preparedness and response at all levels;
• Adaptation and introduction of the case based and monthly reporting forms in the country health surveillance system;
• Revision and update the technical guidelines and the training manuals for district health workers;
• Training for health personnel on disease surveillance, reporting, data management, preparedness and response;
• Sensitization of clinicians at hospitals on disease surveillance with emphasis on cases detection and reporting on priority diseases;
• Development of a comprehensive national laboratory policy;
• Training at provincial labs in meningitis surveillance and provide adequate supplies.