This community innovation has been accepted at the 2026 DHIS2 Annual Conference as a physical poster.
DHIS2 Early Warning for Hepatitis A in Lebanon
Hepatitis A remains an endemic public health concern in Lebanon. Timely surveillance is essential to ensure time response at national and district levels and improve situational awareness. The Epidemiological Surveillance Program aimed to enhance Hepatitis A monitoring through the development of DHIS2 dashboards. The objective is to develop dashboards for alert monitoring. Five DHIS2 dashboards were designed to monitor multiple reporting streams, including case-based, laboratory-based, medical center-based surveillance, and school-based surveillance. Dashboards provided key indicators such as reporting completeness, cumulative cases, deaths, hospital admissions, age-group distribution, and laboratory positivity rates. Early warning functionality was operationalized through automated district-level alert tables using a standardized ratio approach (cases/threshold) and trend visualizations comparing observed against threshold levels. Thresholds were implemented using historical baseline averages and standard deviation-based alert levels (mean + 2 SD) to distinguish normal variation from unusual increases, thus for case-based, medical center-based and laboratory-based data. Laboratory dashboards included monitoring of testing volume, positivity rate, and geographic distribution through maps. School-based dashboards provided rapid signals in school settings. A complementary retrospective analysis of 25 years of Hepatitis A case data (2000–2024) was conducted externally in R to provide epidemiological context for interpreting current surveillance patterns. The dashboard set enables visualization of alerts and geographic hotspots at district level. Dashboards were presented during two national workshops targeting surveillance officers at central and peripheral levels, supporting capacity-building for operational use. This Lebanon case study demonstrates the feasibility of using DHIS2 to operationalize a multi-stream early warning surveillance framework for endemic Hepatitis A, providing a scalable model for outbreak detection and monitoring of epidemic-prone diseases.
Primary Author: Abass Jouny
Keywords:
DHIS2; Hepatitis A; Early Warning; Threshold Alerts; Lebanon; Surveillance Dashboards
