Assessment of core and support functions of the communicable disease surveillance system in the Kurdistan Region of Iraq

Assessing the performance of the integrated disease surveillance and response systems: a systematic review of global evidence

OBJECTIVES

Public health surveillance systems are critical for detecting and responding to health threats. This review aims to analyze international literature on the performance of these systems in terms of core, support, and attributes of surveillance system.

STUDY DESIGN

Systematic review.

METHODS

Following the preregistered protocol (PROSPERO: CRD42022366051), a systematic search was conducted on PubMed/MEDLINE, CINHAL, CABI, Web of Science, and Google Scholar for articles evaluating Public Health Surveillance System performance from inception to July 21, 2023. Various study designs were included, and quality assessment was performed. Thematic analysis categorized findings into key surveillance system functions.

RESULTS

Nine studies from different countries assessed core and supportive functions, as well as surveillance attributes. Performance varied among countries, with some excelling overall and others showing poor performance in specific areas. Many countries' surveillance systems had inadequate performance in key measures in terms of the core and supportive functions, as well as the attributes of the surveillance system.

CONCLUSION

This review shows significant variations in the performance of public health surveillance systems across countries. Further research is needed to understand underperformance reasons and inform global policymaking for strengthening surveillance systems.

Qualitative Analysis of Newborn Hearing Screening Program in Iran

Background

Early diagnosis of hearing loss and timely interventions are important to minimize the consequences of this condition, especially for children. This research was conducted to analyze the newborn hearing loss screening program in Iran.

Methods

This qualitative study was conducted using the content analysis method and based on the CIPP model in 2023. The snowball method was used to recruit a sample with maximum diversity. The criteria for selecting people for interviews included having at least three years of experience in the newborn hearing loss screening program and sufficient knowledge in the field. To ensure the reliability of the results, four criteria proposed by Lincoln and Guba were used. Data analysis was conducted by MAXQDA2022 software.

Results

In the current research, using content analysis in the form of the CIPP model, based on the viewpoints of the interviewees (40 people), the management requirements of the newborn hearing loss screening program were categorized into the four main categories of context (texture), input, process, and output. Eight subcategories were identified in the context dimension, four subcategories in the input dimension, seven subcategories in the process dimension, and four subcategories in the output dimension.

Conclusion

According to the findings of this research, in order to properly implement the newborn hearing loss screening program, there is a need to conduct pilot studies, need assessments, evidence-based programs, and epidemiological studies and to prioritize services and resources. Also, communication between service delivery levels needs to be improved, and attention should be paid to personnel motivation and screening programs.

The lessons of COVID-19 pandemic for communicable diseases surveillance system in Kurdistan Region of Iraq

Objectives

This study aimed to determine the opportunities of and barriers to communicable diseases surveillance system (CDSS) during the COVID-19 pandemic and the extent to which the disease integrated into the CDSS in the Kurdistan region of Iraq.

Study design

A descriptive qualitative approach was applied.

Methods

We conducted seven semi-structured interviews and seven interviewee in a focus group discussion (FGD) with purposefully identified Key Informants (KI) from June to December 2020. All interviews were digitally recorded and transcribed verbatim. We adopted a mixed deductive-inductive approach for thematic data analysis, facilitated by using MAXQDA20 software for data management.

Results

Although the CDSS was considered appropriate and flexible, the COVID-19 was interpreted not to be integrated into the system due to political influence. The main concerns regarding core and support activities were the lack of epidemic preparedness, timeliness, and partial cessation of training and supervision during the pandemic. The existence of reasonable surveillance infrastructure, i.e., trained staff, was identified as an opportunity for improvement. The main challenges include staff deficiency, absence of motivation and financial support for present staff, scarce logistics, managerial and administrative issues, and lack of cooperation, particularly among stakeholders and surveillance staff.

Conclusion

Our findings revealed that the CDSS in the Kurdistan region requires substantial enhancement in epidemic preparedness, strengthening human resources, and logistics. the system can be developed by fostering meaningful intersectoral collaboration. We advocate that the health authorities and policy-makers prioritise the surveillance and effective management of communicable diseases.

Internet search data with spatiotemporal analysis in infectious disease surveillance: Challenges and perspectives

With the rapid development of the internet, the application of internet search data has been seen as a novel data source to offer timely infectious disease surveillance intelligence. Moreover, the advancements in internet search data, which include rich information at both space and time scales, enable investigators to sufficiently consider the spatiotemporal uncertainty, which can benefit researchers to better monitor infectious diseases and epidemics. In the present study, we present the necessary groundwork and critical appraisal of the use of internet search data and spatiotemporal analysis approaches in infectious disease surveillance by updating the current stage of knowledge on them. The study also provides future directions for researchers to investigate the combination of internet search data with the spatiotemporal analysis in infectious disease surveillance. Internet search data demonstrate a promising potential to offer timely epidemic intelligence, which can be seen as the prerequisite for improving infectious disease surveillance.

An Assessment of Timeliness and Quality of Communicable Disease Surveillance System in the Kurdistan Region of Iraq

Background

The quality of the surveillance system can be defined by attributes such as completeness, timeliness, usefulness, simplicity, flexibility, acceptability, and reliability. This study aims to assess these quality features of the communicable disease surveillance system (CDSS) in the Kurdistan Region of Iraq.

Methods

This study was conducted using a retrospective review of records and documents, and the interviews with the surveillance staff (n = 82) of the Kurdistan governorates during 2018, 2019, and 2020. The World Health Organization (WHO) guideline 2006 indicators were used for evaluation and monitoring the quality of the communicable disease surveillance system. The data analyzed and showed as frequencies and percentages using Statistical Package for the Social Sciences (SPSS) version 26 software.

Results

The reporting timeliness declined from 98% in 2019 to 69% in 2020. At the same time, there was an improvement in completeness of reporting from 83% in 2018 to 99% in 2020. The total scores of other surveillance quality attributes, simplicity, usefulness, flexibility, acceptability, and reliability, were 75%, 72%, 67%, 72%, and 69%, respectively.

Conclusion

Current findings demonstrate that the CDSS is still facing significant challenges in timeliness simplicity, usefulness, flexibility, acceptability, and reliability. Further studies to assess the system’s quality, particularly the system’s timeliness of outbreak response, sensitivity, and specificity, are recommended.