Introduction: Advanced Field Epidemiology Training Programmes depend on prolonged, mentored public health service. Sierra Leone operates Frontline and Intermediate training, while its 2023 Joint External Evaluation recommended expansion to advanced training. A prospective pilot is needed to determine whether a complete national Advanced programme can operate with sufficient fidelity, field exposure, research support, equitable opportunity, safety and cost control. Methods: We will conduct a prospective, single-cohort, longitudinal mixed-methods implementation pilot with a three-month pre-implementation period, a 24-month programme and six-month follow-up. The complete first cohort comprises 15 residents at eight accredited national or subnational field sites. The intervention includes 17 modules, 102 terminal outcomes, 70 facilitated sessions, 36 exercises, at least 68 supervised field-practice weeks, named mentorship and eight assessed field-product categories. Each resident receives two authentic outbreak or urgent field-investigation opportunities and leads at least one analytic response. Research planning ends by Month 12; implementation, analysis, thesis or dissertation writing, examination and correction occupy most of Year 2. Graduation evidence includes two accepted or published internal or national-channel articles from distinct field products, one independently certified lead-author manuscript submitted to a legitimate peer-reviewed journal, one policy brief and one scientific presentation. An Independent Research and Evaluation Team, separate from programme delivery and assessment, controls consent, source-evidence inventory, fidelity scoring, data locking, analysis and scientific reporting. Overall implementation fidelity at Month 24 is the primary outcome. The team scores 20 unweighted components from verified source records; critical components are non-compensatory, and the component census receives no sampling confidence interval. Key secondary outcomes are field-practice attainment, retention, acceptability, appropriateness, perceived feasibility and primary-data completeness. The Framework Method, mixed-methods joint displays and time-driven activity-based costing support qualitative, integrated and economic analysis. Results: The pilot will estimate implementation fidelity, feasibility, stakeholder experience, educational and service outcomes, recommendation uptake, equity, cost and sustainability readiness. Prespecified green, amber and red decision rules will support an auditable scale-up decision. Conclusion: This protocol tests whether Sierra Leone can deliver a complete competency-based Advanced FETP safely and consistently before wider implementation. It does not estimate causal effectiveness.
Introduction: In Guinea, between 2011 and 2017, there were 95 clinical canine rabies cases, 10,153 cases of bites recorded in the health facilities, and 50 clinical human rabies cases recorded in the veterinary post. The profile of the disease is not well known. This study describes the epidemiological profile of rabies to guide the decision-making of the Ministries of Health and Livestock. Methods: A descriptive incidence study was carried out using January 2018–August 2019 bite and rabies databases of the Ministries of Health and Livestock. We calculated median age, frequency, and district bite incidence per 100,000 population. Results: Overall, 1,953 bite cases were recorded, with an incidence of 10 per 100,000 population and a median age of 14 years. Of those bitten, 75% (1458/1953) benefited from post-exposure vaccination (PEV); none of the 10 rabid humans sought vaccination, and all died. Of the 1,662 biting dogs followed up, 937 (56%) were observed, of which 159 (17%) developed rabies symptoms and were euthanised, and 27 (17%) were sampled, 20 (74%) of which were confirmed for rabies by PCR test. N’Zérékoré and Fria had an incidence of >50 bites per 100,000 inhabitants; 40% of canine rabies cases were from Faranah. Fifteen thousand dogs were vaccinated in districts with high incidence and percentage of confirmed rabies cases. Conclusion: People under 15 years old were most affected. We suggest improving dog bite and rabies surveillance in the district with low incidence, building laboratory sampling capacity, testing suspected canine cases, and conducting an exhaustive census among the dog population.
Introduction: Lassa fever (LF) is endemic in West Africa, representing a significant public health security threat. While Nigeria bears the highest burden, detailed state-level epidemiological data, particularly in North-Eastern states like Taraba, remain scarce. This study provided a comprehensive descriptive epidemiological pattern of Lassa fever in Taraba State from epidemiological weeks 1 – 7, 2025, addressing a critical evidence gap and informing targeted public health interventions. Methods: We conducted a descriptive epidemiological study analysing Taraba State surveillance and contact tracing data during the outbreak response from epidemiological week 1 – 7, 2025. A suspected case was defined as any person with malaise, fever, headache, sore throat, cough, nausea, vomiting, diarrhoea, myalgia, chest pain, hearing loss and a history of contact with rodent excreta or with a case of Lassa fever, while a confirmed case was defined as a suspected case that is laboratory-confirmed with Reverse-Transcription Polymerase Chain Reaction. We reviewed response logs, risk communication, and medical supply distribution. Descriptive statistics, including frequencies, proportions, positivity rate, and case fatality rate (CFR), were calculated, and the temporal distribution was analysed. Results: A total of 165 suspected cases were reported, of which 70 (42.6%) were laboratory-confirmed cases. Three suspected cases (1.8%; 3/165) occurred among healthcare workers. Thirty-seven confirmed cases died, giving a case fatality rate of 52.9%. The 15- 24-year age group accounted for 40.6% (67/165) of suspected cases, and 52.7% (87/165) were male. Bali LGA recorded the highest positivity rate (67.7%; 23/35), accounted for the highest proportion of confirmed cases (32.9%; 23/70) and high CFRs were noted in Ibbi and Wukari LGA (100%), Gassol (75%), Ardo-Kola (53.3%) and Bali (52.2%). The outbreak peaked during epidemiological week 4 (late January 2025). Conclusion: The Lassa fever outbreak in Taraba State was characterised by a high CFR, concentration of cases among young adult males and the epidemiological week 4 peak necessitated immediate and targeted public health interventions, including strengthening surveillance, implementing intensive community awareness campaigns for high-risk groups, and ensuring prompt access to life-saving treatment in high-burden LGAs.
Introduction: Guinea adopted the University of Oslo’s DHIS2 COVID-19 Surveillance Package in March 2020 to capture all COVID-19 data, marking the first large-scale deployment of DHIS2 in Guinea for a public health emergency response. This paper describes the implementation of the COVID-19 package, including the role of DHIS2 in public health decision-making, in Guinea from March 2020 to December 2022. Methods: Implementation was organized around four interconnected components: data collection during the response, training and equipment, data quality and innovations, and data use and public health decision-making. A multidisciplinary committee guided package configuration and customization to fit the Guinean epidemiological context. Results: In total, 648 data agents were trained across 43 week-long sessions, and 500 devices were provided to support data collection at testing sites, laboratories, treatment centres, and vaccination sites. Two country-specific innovations were developed: automated SMS notification of negative test results to patients and automated COVID-19 travel certificates for authorized travelers. From March 2020 to December 2022, data on 557,886 persons tested for COVID-19 were entered in DHIS2; 406,088 records were classified, of which 40,961 were confirmed cases, representing 10% of classified records. Data completeness was 56% for confirmed case outcomes and 60% for symptom severity variables, highlighting ongoing data quality challenges during large, rapidly scaled operations. A total of 4,045 situation reports were produced, and 155 national-level meetings were held, with dashboards and situation reports supporting real-time decision-making at district, regional, and national levels. DHIS2 data directly informed a targeted vaccination campaign that reached over 500,000 high-risk individuals between July and September 2022. Conclusion: Guinea’s experience demonstrates that DHIS2 can be adapted and deployed for large-scale epidemic response when supported by early preparedness, strong multi-partner collaboration, continuous data quality monitoring, and sustained institutional investment.
Introduction: The impacts of night shift work and lengthened working days on physical, psychosocial and occupational outcomes have been described in some populations; however, evidence from underserved and high demand healthcare in sub-Saharan Africa is limited. Methods: Data were obtained via a hospital-based cross-sectional survey at two Khartoum, Sudan, tertiary hospitals from August 15, 2021 through January 31, 2022. A total of 530 health care workers completed the structured, self-reporting questionnaires (response rate 100%). Chi-square tests, one-way ANOVA and independent t-tests were performed to evaluate the associations between type of shift and working hours and different health outcomes. Results: Of the 530 participants, the majority were female (60.6%), aged 20-30 years (85.3%), and single (75.3%). Gastrointestinal symptoms (37.5%) and cardiovascular symptoms (23.6%) were the most commonly reported systemic symptoms. About 80.9% of the participants reported poor sleep quality, 83.0% reported adverse effects on social life, and 80.2% reported adverse effects on family life. Workers performing both day and night shifts had consistently higher rates across all outcome domains than day-shift-only workers (P<0.05). Extended 16–24 h shifts were correlated with large effects for family (P< 0.001) and social life (P< 0.001), and small effects on sleep quality (P< 0.001). Conclusion: Night shift work and long working hours exert small to moderate physical health effects and moderate to large psychosocial burdens for Sudanese healthcare workers. Workload management, mandatory rest days, and peer social services are viable and clinically necessary interventions, particularly under resource constraints.
Introduction: Since its inception, field epidemiology training programs (FETPs) have been strengthening the ability to prevent, detect, and respond to public health threats through workforce development across the world, hence strengthening global health security. The South African FETP (SAFETP) has enrolled a cohort of residents every year since 2007. This evaluation assessed the impact of SAFETP on increasing field epidemiology capacity in South Africa. Methods: We employed a mixed-methods approach and analysed both quantitative and qualitative data from multiple sources, including a descriptive analysis of SAFETP resident tracking data, a literature review of resident publications, key informant interviews with program stakeholders, and an online survey of graduates. Results: A total of 104 residents were enrolled in the past 11 SAFETP cohorts. There is a clear geographic clustering of activities and graduates in a few provinces, particularly Gauteng. The literature search revealed 149 articles with 49 residents as authors. Among the published papers directly related to training, 73% involved a resident as the first author, and 15% described an intervention that likely prevented illness. Informant interviews revealed themes related to the program’s impact on increased evidence-based decision-making and national epidemiological capacity and highlighted the need for a defined career path in epidemiology and increased visibility of the program. Conclusions: Noted impacts include providing trained graduates to the public health system, strengthening data-based decision-making, and disseminating results in scientific journals. The results confirm that FETPs can be effective at building epidemiologic capacity, but in-country institutional factors can limit their potential impact.
Introduction: Antimicrobial Resistance (AMR) poses a growing global threat to human, animal, and environmental health. In Ghana, the animal health sector contributes vital data to national AMR surveillance; however, systematic evaluation of its performance remains limited. This study assessed the functionality of the Antimicrobial Resistance Surveillance System (AMRSS) in Ghana’s animal health sector, focusing on data quality, usefulness, and timeliness within the One Health framework. Methods: A descriptive cross-sectional study was conducted across three sentinel veterinary laboratories in Kumasi, Pong-Tamale, and Accra from 2023 to 2024. Evaluation followed World Health Organization (WHO) and Food and Agriculture Organization (FAO) AMR surveillance assessment frameworks. Data were collected through document reviews, WHONET database analyses, and a semi-structured checklist with laboratory and surveillance personnel. System attributes were rated as poor (<40%), moderate (40–70%), or good (>70%) based on predefined criteria. Results: All three laboratories actively contributed to national AMR data reporting. Overall data quality was rated good (72–84%), though inconsistencies in antimicrobial susceptibility testing (AST) methods and incomplete metadata were observed. Timeliness ranged from moderate to good (64–94%), with delays primarily due to manual data entry, reagent shortages, and lack of timestamp tracking. Usefulness was high (71–84%), as AMRSS outputs supported national antimicrobial stewardship policies and informed decision-making on veterinary drug use. Major challenges included inconsistent AST standardization, reagent stock-outs, limited feedback mechanisms, and underdeveloped digital infrastructure. Conclusion: Ghana’s AMR surveillance system in the animal health sector demonstrates strong potential in supporting national and global AMR monitoring. While data quality and usefulness are commendable, timeliness and system standardization require improvement. Enhancing laboratory capacity, harmonizing AST protocols, and transitioning to digital, real-time reporting platforms will strengthen evidence-based responses to emerging resistance threats. Continued investment and integration under the One Health approach are essential for sustaining an effective AMR surveillance system.
Introduction: Tuberculosis remains a major public health challenge in Ghana, with accurate diagnosis relying on the quality of sputum specimens. Despite existing national guidelines, adherence to sputum specimen management protocols is inconsistent, especially in peripheral health facilities. This study assessed the preparedness and compliance of referring facilities in Mfantseman Municipality with the National Tuberculosis Control Programme’s (NTP) sputum management standards. Methods: A cross-sectional descriptive study was conducted between January and June 2025 in five facilities with the highest sputum submissions. Approximately 20 healthcare workers directly involved in sputum management participated and were interviewed using structured questionnaires. Facility practices were evaluated using an observational checklist adapted from the NTP and the Africa Society of Laboratory Medicine guidelines. Data were analyzed in STATA 17 using descriptive statistics. Results: There were 20 healthcare workers with equal male to female ratio. Staff knowledge was generally high (median score: 80%) but misconceptions about storage and transport conditions existed in all facilities. Only one facility had a functional refrigerator with none having standard operating procedures (SOP) for cold chain management. Three facilities (60%) adhered to correct specimen handling, while key biosafety measures were lacking in all facilities. Conclusion: The study revealed major deficiencies in logistics, biosafety, and adherence. Strengthening infrastructure, SOP implementation, and staff training is critical to enhance tuberculosis diagnostic reliability in Ghana.
Introduction: Veterinary laboratories play a vital role in safeguarding animal health, conducting disease surveillance, and ensuring effective disease control. However, these facilities frequently handle infectious biological agents and hazardous chemicals, posing significant risks to laboratory personnel, animals, the public, and the environment. The absence of a comprehensive biosafety management program exacerbates these risks, leading to potential exposure to infectious agents, environmental contamination, and compromised diagnostic accuracy. This project aimed to establish and implement a biosafety and risk management program in the veterinary laboratory, Donkorkrom in the Kwahu Afram Plains North District of Eastern Region of Ghana. Methods: A quality improvement approach was employed to develop and implement a biosafety management framework for the Veterinary Laboratory in Donkorkrom. Key activities included: review of national and international biosafety and biosecurity guidelines, development of a comprehensive biosafety manual and standard operating procedures (SOPs), conducting risk assessments and laboratory safety audits to identify hazards and implement corrective measures; and establishment of a monitoring and evaluation plan to ensure continuous compliance and improvement. Results: A biosafety manual was developed and implemented. A total of 14 SOPs were finalized. Essential safety was structure such as emergency eye wash, shower station, first aid kits, and fire safety equipment were installed and operationalized. Hands-on training in biosafety, health emergency response and incident management was conducted for staff. Safety drills, biosafety audit and risk assessment were conducted as part of the program. Conclusion: The implementation of this project improved staff awareness of biosafety measures and significantly strengthened safety practices within the Donkorkrom Veterinary Laboratory. The initiative provides a practical and scalable model for other veterinary laboratories in Ghana seeking to establish or improve their biosafety management systems.
Introduction: Globally, medical laboratories contribute about 70% of medical decisions. While a strong laboratory capacity is crucial to these decisions, its maintenance could be more challenging in resource-constraint settings. In 2019, the Savannah Region was created to serve the health needs of the people, however, critical laboratory infrastructures are still lacking. We aimed to determine the laboratory capacity gaps that exist in the Savannah Region of Ghana to help identify system strengthening activities. Methods: A descriptive cross-sectional study was conducted between January and April, 2025. We used the WHO laboratory assessment tool to collect data from 10 laboratories. Data was collected through structured interviews. Responses were scored and estimated using averages and percentages. Capacity was defined based on a 100-point scale and interpreted as weak score (<50%), a moderate score (50-80%), and a strong score (>80%). Results were presented in tables and charts. Results: Overall, the laboratories received a weak average score, 49.8% (95% CI [44.9-54.7]). The highest average score was in testing performance, 74.3% (95% CI [66.8-81.8]) and the lowest score was in biorisk management, 25.4% (95% CI [10.8-40.0]). Point-of-care test (POCT) (40.2%) was the most used test discipline, while advanced disciplines such as bacteriological culture, cytology and water testing were limited. Major gaps identified included human resources, equipment, laboratory safety and public health functions. Conclusion: Laboratory capacity was found to be weak and limited as per the WHO laboratory assessment. The greatest gaps were human resources, quality assurance, equipment adequacy, laboratory safety and public health functions. These gaps have direct implications for public health surveillance and response. Addressing these challenges will require targeted capacity-building programs and stronger coordination among health stakeholders at both the regional and national levels.
Introduction: The National Public Health and Reference Laboratory (NPHRL) in 2024 reported an increase in measles and yellow fever specimen rejection which threatened timely outbreak detection and response. We conducted this study to systematically review and identify the root causes of these rejections at referring peripheral facilities to inform targeted public health interventions and strengthen the surveillance system. Methods: A mixed-methods study was conducted among six peripheral health facilities with the highest specimen rejection rates. These facilities are in the Upper West and Ashanti regions. A structured questionnaire was used to assess the knowledge and practices of health care workers within the facilities directly involved in measles and yellow fever specimen collection and handling. An independent onsite audit was also conducted using a structured checklist. Data was collected into a Microsoft Excel template, cleaned and analyzed using descriptive statistics and thematic comparison of self-reported practices versus audited realities. Participants comprised 14 laboratory personnel, laboratory managers, nurses, and disease control officers directly involved in measles and yellow fever specimen collection and handling. Results: A total of 15 health care workers were assessed. These consisted of 5 laboratory Scientists/Technicians,2 nurses, and 7 disease surveillance officers. Majority of staff 53.3% (8/15) had no training on specimen collection and handling. Up to 40.0% (6/15) of facilities lack effective sample transportation logistics and 86.7% (13/15) of facilities lacked temperature tracking tools during sample transportation. All facilities lacked specimen referral logs and a formal Corrective and Preventive Action (CAPA) system. Conclusion: High measles and yellow fever specimen rejection was due to lack of trained staff and sample management logistics at the selected facilities. Immediate remedial measure includes the establishment of a dedicated cold-chain logistics network to ensure specimen delivery within 72 hours and institution of a mandatory competency-based training linked to facility performance targets. Prioritizing these will improve specimen integrity and strengthen surveillance system.
Introduction: Tuberculosis (TB) diagnosis relies heavily on the adequacy of sputum samples. Inadequate sputum samples compromise laboratory accuracy, delay treatment and worsen patient outcomes. Over a 6 months period, Paga Port Health Laboratory rejected approximately 40% of sputum samples due to contamination and 30% of sputum samples due to incorrect labelling. We investigated to determine contributing factors to inadequate sputum samples received and developed targeted interventions. Methods: A cross-sectional study using Root Cause Analysis (RCA) was conducted across nine health facilities. Data were collected through brainstorming sessions, questionnaires and training assessments with healthcare workers. Contributing factors were categorized using a fishbone diagram (staff, processes, logistics, environment) and prioritized through a Weighted Scoring Prioritization Matrix (Impact–Effort Matrix). A training intervention was implemented for 30 healthcare workers, with pre- and post-test scores analysed to assess knowledge gain. Data was analysed using Excel and results presented in tables and charts. Results: Twenty-two contributing factors with an assigned degree of control were identified: 18.2% were fully within control, 22.7% were partially within control, and 59.1% were outside our control. The impact effort matrix reveals inadequate staff training as the most significant underlying factor, followed by incorrect storage temperature, inadequate collection procedures, and poor labelling. Training intervention significantly improved participant knowledge, with post-test mean score showing highly significant gains 17.5±1.67, 16.87,18.13, p < 0.001. Conclusion: Inadequate sputum specimens result from a complex interaction of systemic, logistical and human-related factors. However, inadequate training was the most significant critical cause. Structured training proved effective in bridging knowledge gaps and improving staff competencies.
Introduction: Biosafety and biosecurity are essential in laboratories that handle infectious animal diseases, especially those that can spread to humans. These measures protect laboratory workers, animals, and the wider community from accidental exposure or release of dangerous pathogens. This study assessed the level of compliance with biosafety and biosecurity standards at the Accra Veterinary Laboratory (AVL), a national reference facility responsible for diagnosing and monitoring animal diseases in Ghana. Methods: A cross-sectional study which used the Food and Agriculture Organization (FAO) Laboratory Management Tool for Safety (LMT-S) assessment framework was done. The tool covered administration, operational practices, engineering controls, and the use of personal protective equipment (PPE). Data were collected through staff interviews, group discussions, direct observation, and document review. All laboratory staff were included, to ensure a comprehensive assessment. The data were analyzed using the FAO scoring system, and results were summarized in percentages and charts. Results: The findings revealed that the overall biosafety and biosecurity compliance level at AVL was low, with all four areas scoring below 50%. The administrative component scored 35.6% staff health and safety programs (16.7%), and poor enforcement of standard operating procedures. Operational practices (42.1%) showed moderate performance in waste management (66.7%) and sample shipping (66.7%) but were weak in animal facility management (23.8%). Engineering controls (19.8%) scored the lowest because of poor infrastructure, inadequate ventilation, and lack of emergency preparedness. The PPE category (43.6%) performed fairly, though several staff did not consistently use or dispose of protective gear properly. Conclusion: The study concludes that AVL faces major challenges in maintaining biosafety and biosecurity standards, mainly due to limited resources, inadequate training, and ineffective administrative enforcement. Strengthening leadership commitment, improving infrastructure, conducting regular training, and establishing a national monitoring system are essential.
Introduction: The Council for Scientific and Industrial Research (CSIR)-Water Research Institute (WRI) Microbiology Laboratory plays a key national role in water quality testing and serves as Ghana’s focal laboratory for environmental antimicrobial resistance (AMR) surveillance. As part of an ongoing quality system strengthening efforts toward ISO 17025 accreditation, an internal assessment of equipment management practices was conducted with the aim of identifying strengths and areas for improvement to support sustainable laboratory excellence and accreditation readiness. Methods: This was a descriptive cross-sectional assessment using a mixed-methods approach. Existing equipment inventories, calibration certificates, and maintenance records were reviewed. In addition, the WHO Strengthening Laboratory Quality Improvement Process Toward Accreditation (SLIPTA) checklist and ISO 17025 Clause 6.4 were applied as benchmarks against current practices at WRI. Results: A total of 108 equipment was documented across the Microbiology (63) and Molecular Biology (42) sections. There were functional systems for equipment inventory and calibration of key instruments. The SLIPTA score for equipment management was 20/38. Areas identified for enhancement included improved documentation of calibration traceability and structured preventive maintenance planning. An ISO-aligned equipment inventory and maintenance templates were developed to strengthen recordkeeping and support standardization. Conclusion: The CSIR-WRI Microbiology Laboratory has a functional quality assurance system that conforms to the requirements of ISO 17025 standard. The development of equipment inventory and maintenance templates will improve documentation consistency, preventive maintenance, and calibration management. Through this initiative, the laboratory will continue to demonstrate leadership and commitment to quality, reliability, and public health excellence in Ghana.
Introduction: Personnel of medical laboratories are at risk of exposure to hazardous pathogens and chemicals. There is a need for robust bio-risk management (BRM) protocols which are regularly assessed for compliance. Emergence and re-emergence of diseases influence regular updates to international BRM protocols. Sekondi Public Health Laboratory (SPHL) responds to infectious public health emergencies in three regions but has not been thoroughly assessed for bio-risk. We assessed bio-risk management protocols at Sekondi Public Health Laboratory. Methods: This cross-sectional study was conducted at SPHL from February to May 2025. We developed a safety and bio-risk management checklist based on four international standards and administered it to staff. We observed safety practices, and scores were awarded according to the requirements of the checklist. A corrective action plan was drawn and implemented for gaps identified from the assessment, after which a final audit was conducted. Results were expressed as proportions and presented in tables and charts. Results: Overall, SPHL scored 64.7% in the baseline audit. Six broad areas were assessed with Audits and Monitoring scoring the highest, 84.4% (27/32), whilst Biosecurity Practices scored the lowest, 16.7% (3/18). Under Risk Assessment, SPHL had not assessed the common pathogens it handles for risks. Though PPEs were available and accessible, contaminated lab coats were sent home for washing. Emergency equipment was available alongside relevant SOPs, but the laboratory had no first aid or spill kits. After the implementation of a corrective action plan, SPHL scored 92.2% in the final audit. Some corrective actions could not be implemented. Conclusion: Biosecurity Practices scored lowest whilst Audits and Monitoring scored highest in the baseline audit. Risk had not been assessed for commonly isolated pathogens. In closing the gaps identified, a risk assessment for pathogens was conducted, and a washing machine was purchased for the laboratory. We recommended that unit supervisors implement pending corrective actions.
Introduction: Following the COVID-19 pandemic, Ghana expanded the Respiratory Pathogen Sentinel Surveillance (RPSS) system and incorporated SARS-CoV-2 testing into the existing influenza surveillance platform. However, the performance of the newly established sentinel site in Jasikan Municipality had not been formally evaluated. We assessed whether the system met its objectives, was useful, and its attributes to provide targeted recommendations. Methods: We conducted a descriptive evaluation using the updated CDC guidelines for public health surveillance systems. Influenza-like illness (ILI) and severe acute respiratory infection (SARI) records from April 2022 to December 2024 were extracted from Surveillance Outbreak Response Management and Analysis System (SORMAS) and validated against case investigation forms and other records. Data collection included stakeholder interviews using semi-structured questionnaires, direct observation, and document review. Quantitative data were analysed descriptively, while qualitative data underwent deductive thematic analysis. Surveillance attributes were assessed using indicators scored from 1 to 3, with mean scores classified as weak (1.0–<1.8), moderate (1.8–<2.4), or good (≥2.4–3.0). Results: A total of 555 suspected respiratory pathogen cases were reported, including 83 laboratory-confirmed influenza cases (15.0%) and 16 SARS-CoV-2 cases (2.9%). Three outbreak signals were detected during the period. Core variables were >95% complete, although completeness was lower for traceable address 389/555 (70.1%) and reporting time 362/555 (65.2%). Weekly reporting was timely on 154/156 (98.7%) of expected reporting weeks, and 93.7% of laboratory results were returned within 7 days. Samples were transported in 71.8% of expected weeks, while the weekly ILI sampling target was achieved in 80.0% of expected sampling weeks. Attribute scores were good for acceptability (3.0), flexibility (3.0), representativeness (2.7), simplicity (2.7), sensitivity (2.7) and stability (2.6), but moderate for data quality (2.3). The system supported three outbreak investigations and 12 public health actions. Conclusion: The RPSS system in Jasikan Municipality met its objectives and is useful, with good performance in acceptability, flexibility, representativeness, simplicity, timeliness, sensitivity, and stability. However, moderate data quality, incomplete sample transportation coverage, and suboptimal achievement of sampling targets indicate areas requiring improvement to strengthen surveillance performance and ensure consistent case detection and laboratory confirmation.
Introduction: Malaria in pregnant women is a major public health issue. Despite the adoption of sulfadoxine-pyrimethamine (SP) as chemoprevention for malaria during pregnancy in Guinea, its use remains insufficient. The objective of this study was to evaluate the factors associated with suboptimal IPTp-SP uptake in Kissidougou. Methods: A cross-sectional analytical study was conducted in the Kissidougou health district from November 2024 to March 2025 among 532 women who had given birth in the previous 12 months. The analysis was performed using SPSS version 25 software. In order to identify factors associated with inadequate intermittent preventive treatment of sulfadoxine pyrimethamine (IPTp-SP) dosage, binary logistic regression was performed with a significance threshold set at 5% and a confidence interval of 95%. Results: Among the 532 participants surveyed in our study, the average age was 25.9 (± 6.3) years, and most of them (72.0%) lived in rural areas. Almost all of our participants (97.6%) were married, and 61.8% had no formal education. Overall, 54.9% of women had inadequate uptake of the recommended minimum of three IPTp-SP doses during pregnancy. Factors associated with suboptimal IPTp-SP uptake included fewer than three antenatal care visits (aOR=13.05, 95% CI: 4.86-35.03), poor knowledge of the interval between SP doses (aOR = 45.24, 95% CI: 23.99-85.34), poor knowledge of the dangers of malaria during pregnancy (aOR = 0.36, 95% CI: 0.19 – 0.65), and means of transportation (aOR = 0.26, 95% CI: 0.15-0.47). Conclusion: Achieving optimal coverage of IPTp-SP in Kissidougou requires going beyond an approach focused solely on drug availability. An effective strategy must systematically address the economic (cost of consultations) and geographical (transport) determinants that limit access to antenatal care, while filling critical knowledge gaps.
In May 2026, the World Health Organization (WHO) and the Africa Centres for Disease Control and Prevention (Africa CDC) declared the ongoing Ebola virus outbreak caused by the Bundibugyo species in the Democratic Republic of the Congo and Uganda a public health emergency of international concern and a public health emergency of continental security, respectively [1, 2]. These declarations are intended to mobilise global attention, trigger international support and funding, encourage timely recommendations for trade and travel, and strengthen surveillance and response measures. During such periods, the public frequently seeks clarification and opinions from experts. In my experience as an infectious disease epidemiologist, the name “Bundibugyo”, which is actually a district in Uganda where the virus species was first identified, generated fear and panic during the first days of the outbreak, with many people questioning whether Bundibugyo District is affected and should be avoided, or whether travel to Uganda should be restricted altogether [3]. Such perceptions may adversely affect tourism, travel, trade, and local economies, and contribute to the social exclusion of some communities, as observed in previous outbreaks [4]. Bundibugyo is a major tourist destination, and with the summer months approaching, this could pose a danger to tourism in Uganda following travel notices released by, for example, the United States government. Consequently, these implications may further complicate outbreak preparedness and response due to the sensitivity they create. Historically, ebolavirus species were named after geographical locations where they were first identified, a convention that reflected prevailing virological naming practices at the time [5]. However, advances in understanding the social consequences of disease naming have led to greater emphasis on nomenclature that preserves scientific precision [6]. A previous article by Olupot-Olupot and colleagues called for a stigma-free and scientifically precise Ebola virus nomenclature, highlighting the need to minimise the potential harm associated with disease names [7]. They argued that the nomenclature of several ebolavirus species, including Zaire ebolavirus, Sudan ebolavirus, and Bundibugyo ebolavirus, may unintentionally create negative perceptions because these names are directly linked to geographic locations. This call needs to be reignited to establish proper nomenclature for these viruses, or at the very least to ensure alignment during outbreaks. WHO’s best practices for naming infectious diseases discourage the use of geographic references and terminology that may promote discrimination or segregation [6]. Similar principles informed the transition from Mpox during the global outbreak in 2022 [8]. In light of these considerations, scientists, alongside affected communities, public health institutions such as WHO and Africa CDC, and international taxonomy bodies such as the International Committee on Taxonomy of Viruses, should initiate and/or be involved in renewed dialogue and evidence-based consultations to help align Ebola virus nomenclature with contemporary principles of equity and non-stigmatising communication. While any future changes would require consideration of implications for surveillance systems, laboratory reporting, and international classification frameworks, these challenges should not discourage evidence-informed discussion of whether current nomenclature remains fit for purpose.
Introduction: Neonatal mortality remains a major global health challenge, with an estimated 6,500 neonatal deaths occurring daily worldwide. Due to inadequate healthcare infrastructure and weak surveillance systems, neonatal mortality is significant. The neonatal death surveillance system in Lower River Region has never been evaluated; therefore, this study aims to assess the usefulness, attributes, and performance of the neonatal mortality surveillance system in Lower River Region. Methods: A descriptive cross-sectional study was conducted to evaluate the performance of the neonatal mortality surveillance system in the Lower River Region using semi-structured questionnaires and a checklist. Surveillance data from 2020 to 2024 were reviewed, following the CDC Guidelines for Evaluating Public Health Surveillance Systems (2001). Purposive sampling was used to select respondents from the district hospital and health centres, while random sampling was applied to three community clinics, one private facility, one NGO clinic, and one service clinic. Results: A total of 34 participants were interviewed across all districts in the Lower River Region. The system recorded 89 neonatal deaths between 2020 and 2024, but none were investigated or used for public health action. The overall performance of the surveillance system was 50.1%. Usefulness (25.9%), simplicity (39.4%), acceptability (33.8%), and timeliness (21.3%) were all low. Flexibility (86.0%) was strong, and data quality (64.1%) and stability was moderate (60.1%). The system showed moderate representativeness (66.7%) across districts, sex, and years, but had major gaps in reporting, investigating, feedback, and community engagement. Conclusion: The neonatal mortality surveillance system in the Lower River Region provides useful data but performs moderately due to weak timeliness, incomplete investigations, inconsistent reporting tools, and limited training and feedback. Strengthening supervision, resources, and data management is essential for improving its effectiveness and supporting timely interventions to reduce preventable neonatal deaths.
Introduction: Rabies remains a public health problem in Senegal, particularly in the Kédougou region, where one rabies-related death was reported in 2019. The objective of this study was to analyse the knowledge, attitudes and practices (KAP) of communities regarding rabies prevention. Methods: This cross-sectional study was conducted in the Kédougou district using multistage cluster sampling (n = 845) recommended by WHO. A structured questionnaire was used to collect data on sociodemographic characteristics as well as rabies-related KAP, with a score cut-off of 80%. Frequencies and proportions were presented in tabular form, while odds ratios (ORs), p-values and 95% confidence intervals (CIs) were reported for bivariate analysis. Variables with a p-value less than 0.20 were included in a logistic regression. Results: Among the 845 participants, 552 (65.3%) were male, with a median age of 40 years [18 to 67 years]. About 25.7% had good knowledge, 19.6% had positive attitudes, and 15.0% reported positive practices towards rabies. Community members who were rabies-aware (aOR = 5.57, CI: 2.46 – 15.1, p = 0.001) and males in the community (aOR = 2.54, CI: 1.27-5.65, p = 0.007) had better rabies preventive practices compared to those who were not rabies aware and their female counterparts. Conclusion: This study highlighted significant shortcomings in the KAPs in terms of rabies prevention. In order to reduce these gaps, awareness campaigns have been organised, focusing on the communication of the risks associated with this disease. It is therefore essential to design and implement a targeted communication plan geared towards the prevention and effective management of rabies.
