Project work Report
Maima D. Kiatamba
District Surveillance Officer,
Bushrod District, Monrovia, Liberia
November 2, 2015
Introduction
• Background to Bushrod District
– total population of 287493
– 48 health facilities
• FETP Project work
– Weekly surveillance reporting
– Expanded surveillance report (Weeks 31-42)
– Problem analysis
Expanded Surveillance Report, Epi
Weeks 31 to 42, 2015, Bushrod
District
Summary
• Immediately reportable diseases;
– 22 suspected EVD, 10 suspected Measles and 9
suspected cholera
– None confirmed
– No deaths
• 3 silent facilities
Reporting quality
Completeness & Timeliness of weekly zonal reporting in
Bushrod District for Epi Weeks 31-42 2015
EPI
Wk31
EPI
Wk32
100
T
200
EPI
Wk38
EPI
Wk39
EPI
Wk40
EPI
Wk41
EPI
Wk42
%
Cumulative
Timeliness
Wk31-35
T
T
T
T
T
T
83%
100%
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
92%
75%
100%
100%
83%
100%
L
T
T
T
T
T
T
T
75%
83%
L
T
T
T
T
T
T
T
58%
83%
EPI
Wk33
EPI
Wk34
EPI
Wk35
T
L
L
400
T
NR
T
T
NR
T
T
T
T
600
NR
NR
1600
NR
NR
Zones
300
EPI
Wk36
EPI
Wk37
T
T
L
L
T
T
T
T
T
T
L
L
Legend
This week
On
time
T
Late
L
No report
received
NR
%
Cumulative
>=80%
on
time
>=5079.9%
on
time
<50%
on
time
%
cumulati
ve
Complete
ness
% cumulative
Completenes
s
Wk31-35
•
Most of the late reports / NR were in wks 31-35
• Logistics issues
• Poor attitude
• Hard to reach areas (zone 1600)
• Public Health Action
• Regular sensitization of OICs on surveillance
Summary of Key Notifiable diseases Epi week
31-42, Bushrod District 2015
Disease
Cumulative: Week __31__to___42___
Cases
Deaths
Case Fatality
Rate
Acute Flaccid Paralysis (AFP)
0
0
0%
Measles (Suspected)
NNT
EVD (Suspected)
Suspected Cholera (AWD)
Dysentery
Lassa Fever
Maternal death
Yellow fever, suspected or confirmed
Meningococcal meningitis
10
0
22
9
0
0
0
0
0
0
0
0
0
0
0
0%
0%
0%
0%
0%
0%
0
0
0%
0%
Comments/actions taken
• No samples were taken to the lab
• All were treated and discharged (no death)
Comments/Actions taken
• At the beginning, figures were low until during
supervision we observed that the cases were being
under-reported
• No positive EVD result was received
• Follow-up on pending results
• No deaths of live suspected cases reported
PROBLEM ANALYSIS
Surveillance quality problem:
Inadequate Laboratory Support for Surveillance
Activities in Bushrod District
Method
1.
2.
3.
4.
Team formation:
Team field/assessment visit:
Brainsorming/working sessions:
Final report/presentation development:
Problem Analysis Team Members
•
•
•
•
•
•
•
•
Maima D. Kiatamba-District Surveillance Officer
William S. Sawyer-District Health Officer
HF-Doressa Bestman-Zonal Surveillance Officer
Winifred Y. Hallowwanger-Lab Supervisor
Redemption Hospital
Mohammed A Bah-Lab Assistant Supervisor
Slipway Clinic
Samuel B. Browne
Emmanuel Lansannah-OIC Redemption OPD
Tamba Borbor SFP Redemption Hospital
Fishbone analysis diagram
Lab Environment
staffing
Lack of Timely
suppy of reagents
(P)
Work
overload (P)
Inadequate workspace (T)
Inadequate
knowledge on
surveillance (P)
Non-adhereance to
established protocols (P)
Inadequate coordination, mentorship
and supportive
supervision of lab
services
Poor storage of
Specimen (T)
Poor labeling of
specimen (T)
Sample Handling
Lack of logistics
movement plan (T)
Lack of adequate
communication
gadgets (P)
Inadequate reagents
(P)
Logistics
Lack of feedback
mechanisms (T) flow of
feedback
Poor co-ordination,
monitoring
&Supervision (T)
Lack of staff
performance
(T)
Administration
Inadequate
laboratory support
for surveillance in
Bushrod District
Recommendations for Improvement
•
DHT
•
•
•
•
•
•
provide mentorship to staff on established surveillance
protocols
provide regular supportive supervision to address rising
constraints
work with county health team and partners to provide
adequate storage and organize workspace for lab staff.
work with CHT, partners for timely delivery of supplies and
reagents
conduct regular training for facility staff on areas where
knowledge is inadequate.
Health facilities OICs
•
provide staff feedback and positive motivations on
performance
Acknowledgement
The District team that is a part of this rewarding training
program is very grateful for this opportunity that has
allowed them to enhance their skills in epidemiology
specifically with surveillance activities. Special thanks go to
1. FETP organizers, sponsors and facilitators
2. Ministry of Health
3. Montserrado County Health Team
4. Local partners
For all of the support in making this happen, a big thank you
to ALL.