This abstract has been accepted at the 2024 DHIS2 Annual Conference
Outbreak response monitoring and evaluation through DHIS2 using the 7-1-7 target in Sierra Leone
Background: Responding to public health threats is critical to ensuring global health security by quickly and effectively addressing outbreaks at their source. Sierra Leone implemented an electronic-based surveillance system through the DHIS2 platform in 2018. Typically used as an early warning system, data from DHIS2 have recently been used to evaluate the effectiveness and timeliness of recent outbreak responses utilizing the 7-1-7 targets, where every suspected outbreak is detected within seven days, reported to public health authorities within one day, with an effective response mounted within seven days. Methods: The Sierra Leone Event-Based Surveillance Unit, with technical implementing partners JHPIEGO and US CDC, retrospectively analyzed surveillance data using the DHIS2 timeline and laboratory functions to identify and evaluate outbreaks that occurred during December 12, 2020, through March 30, 2023. The variables used for analysis included dates of detection, notification to the national team, laboratory confirmation, and other critical activities for effective outbreak response. Timeline of required measures to mount an effective response were analyzed including response initiation, epidemiological investigation, laboratory confirmation, and medical treatment. Additionally, countermeasures, communications, community engagement, and response coordination were analyzed where applicable. Results: Events included in this analysis represented outbreaks of anthrax, Zika, Chikungunya, Lassa fever, and chemical food poisoning. Among 16 events identified, 11/16 (69%) were detected within seven days, 14/16 (88%) had national teams notified within one day, and 10/16 (63%) mounted an effective response within seven days of notification. The average time to detection was 7 days, and the average time to national notification was 0.3 days. Among the required effective response measures, 15/16 (94%) initiated an investigation, 16/16 (100%) underwent epidemiological investigation, 6/16 (38%) were laboratory confirmed, and 3/16 (19%) documented effective medical treatment. Only two of the events also required medical countermeasures, community engagement, and response coordination, and both met all three of these effective response measures. The average time to effective response was 64 days. Conclusion: Data elements from DHIS2 were effectively used to evaluate performance of outbreak detection, notification, and response in Sierra Leone using the 7-1-7 associated metrics. While outbreaks are being detected and reported promptly, gaps were identified in mounting an effective response, particularly delays in laboratory confirmation. Through routine assessment of performance against the 7-1-7 targets, using outbreak data captured by DHIS2, countries can identify bottlenecks and prioritize immediate actions to improve future outbreak detection, notification, and response.
Primary Author: Swaray Lengor
Keywords:
outbreak response, public health threat, monitoring and evaluation, 7-1-7 targets
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