Sept 22 - 14:00 - Building resilient eIDSR systems in Sierra Leone Q&A

In this discussion thread, feel free to ask questions related to the Building resilient eIDSR systems in Sierra Leone session of the 2020 DHIS2 Digital Annual Conference. You can post your questions ahead of, during, or after the session. The panellists will check this thread for questions, and select some for responding to in the session, or follow up after the session has ended. Feel free to respond to other questions or add to them if you have something to follow up with.

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Bridget, do you know what is behind the lab staff’s resistance to record the data in the system? Skills? Connectivity? Time-consuming? Other?

Thanks for the presentation. You describe the functionality. Could you give us an estimate of the number of cases you have til data covered?

It sounds like you are getting both aggregate (weekly) reports and case-based reports for the same diseases and from the same reporting units. This is useful of course to assess data quality, but doesn’t this duplication in reporting pose challenges, and are there any plans to drop aggregate and only report cases through the tracker?


  1. General resistance to change
  2. Preference for solutions that result in additional resources
  3. Poor design of mobile device capturing interfaces, especially if you consider that lab work is commonly done while dressed up in full PPE
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  1. For the main NMC tracker program, we totally have just under 7,000 cases (just over 2,000 confirmed covid cases)
  2. For the contact tracing Tracker Program, we have just under 12,000 cases
  3. For the port locator Event program, a few thousand cases (more recent air traveller data is supposed to be imported from another app, but this has not happened up to now).

So basically it is a small database - which makes it even more absurd to set up silofied systems on a per disease or per outbreak basis.


Correct, SL is collecting weekly aggregated data for around 26-30 diseases, including a few (malaria, typhoid) with very large numbers per annum. The case based surveillance in eCBDS covers just over 20 diseases - none of them would normally have more than 10,000 cases per annum. So far, it seems Acute Respiratory Infections (aka suspected/confirmed Covid-19 cases) for 2020 will come in just under 10,000.
The Directorate for Health Security and Emergency (DHSE) is not likely to consider completely replacing eIDSR data with eCBDS aggregated data before the numbers have become stable and near-identical.
During their weekly multi-partner meetings, eIDSR weekly data and eCBDS case data are typically presented in the same session, and discussions around developments thus tend to be integrated. For instance, “suspicious” numbers seen in the weekly data get a more practical focus by also using eCBDS data: people will, for instance, drill-down into eCBDS data to focus on case investigations, or delays in getting lab results, and other practical aspects that the stakeholders can ACTUALLY take action on.
My guesstimate is that over the next 3-5 years, we will see at least uncommon diseases be based only on eCBDS - overall reducing the workload for both District Surveillance Officers and facility managers/staff.

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Does the Relationships app in Tracker show the time component of transmission chains? Does Go.Data show the time component of person-place-time? The commonly used starburst pattern shows relationships among cases and suspects but the time component is not visible.


  1. The weekly aggregate reports suspected cases while case based reports all suspected, probable and confirmed cases with the linkage to lab results.
  2. Weekly reporting comprises of other disease conditions that cannot be reported case by case and may not need lab confirmation like Malaria, Dysentery. These diseases also have so many cases, which capacity doesn’t exist in country.
  3. During the review and adoption of the IDSR technical guidelines 3rd Edition, the ministry of Health agreed on what conditions to report weekly and immediately/case based. So disease conditions apply for both while others don’t based on public health reasons.
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Thanks a lot @Calle_Hedberg and @bridget the instructive responses, good to know. Here in Laos, where caseloads for our 19 notifiable diseases are generally much lower, we’re considering moving to event reports only - a key difference with SL is that we’re not using Tracker and the new disease surveillance module does not only include lab-confirmed cases.

We’re early on in the roll-out but hopefully at the next annual conference we can share some of our experience here.