Assessing the performance of vaccine-preventable disease surveillance using a multilevel evaluation framework
1
1. Sydani Initiative for International Development, FCT Abuja, Nigeria 2. Sydani Institute for Research and Innovation, FCT Abuja, Nigeria, FCT Abuja, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):A3156
ABSTRACT
INTRODUCTION:
Vaccine-preventable Diseases (VPDs) remain a major public health challenge in Nigeria. Although surveillance performance evaluation is done for priority VPDs within the integrated Disease Surveillance and Response (IDSR) framework, there is limited evidence on state-level surveillance and its determinants.
METHODS:
A cross-sectional analytic evaluation of surveillance systems for four priority vaccine-preventable diseases – measles, diphtheria, Acute Flaccid Paralysis (AFP), and Cerebrospinal Meningitis (CSM) – was conducted in Niger State, Nigeria. Data was collected from 415 clinicians, community resource persons, and surveillance focal persons across 12 purposively selected Local Government Areas (LGAs), using tools adapted from the 2001 CDC Updated Guidelines for Evaluating Public Health Surveillance Systems. Surveillance performance was assessed across three core domains: sensitivity, data quality, and stability. Data analysis included descriptive statistics, bivariate tests, and multilevel logistic regression with random intercepts at the LGA level.
RESULTS:
Key findings from our assessment showed that surveillance sensitivity varies across diseases, with AFP and measles showing high performance, while diphtheria and CSM showed lower sensitivity. Although effect size and direction varied across diseases, operational factors, especially transport availability, showed a consistent association with case detection and confirmation. Equally, there exists a positive association between financial support and measles surveillance sensitivity. Data quality was generally suboptimal, with a small proportion of respondents meeting completeness and accuracy thresholds of ≥80%, and individual-level predictors demonstrating non-consistent associations. Stability assessments revealed substantial system fragility, including recurrent transportation delays, frequent commodity stockouts, infrastructure disruptions, and staff reassignments, all of which contributed to surveillance instability.
CONCLUSIONS:
The surveillance performance for measles, diphtheria, AFP, and CSM in Niger State demonstrates strength disparity and chronic weaknesses, especially in data quality and system stability. To improve surveillance effectiveness and preparedness for priority VPDs, our study recommends addressing operational challenges around transportation, financing, and infrastructure, especially in low-resource settings.
Vaccine-preventable Diseases (VPDs) remain a major public health challenge in Nigeria. Although surveillance performance evaluation is done for priority VPDs within the integrated Disease Surveillance and Response (IDSR) framework, there is limited evidence on state-level surveillance and its determinants.
METHODS:
A cross-sectional analytic evaluation of surveillance systems for four priority vaccine-preventable diseases – measles, diphtheria, Acute Flaccid Paralysis (AFP), and Cerebrospinal Meningitis (CSM) – was conducted in Niger State, Nigeria. Data was collected from 415 clinicians, community resource persons, and surveillance focal persons across 12 purposively selected Local Government Areas (LGAs), using tools adapted from the 2001 CDC Updated Guidelines for Evaluating Public Health Surveillance Systems. Surveillance performance was assessed across three core domains: sensitivity, data quality, and stability. Data analysis included descriptive statistics, bivariate tests, and multilevel logistic regression with random intercepts at the LGA level.
RESULTS:
Key findings from our assessment showed that surveillance sensitivity varies across diseases, with AFP and measles showing high performance, while diphtheria and CSM showed lower sensitivity. Although effect size and direction varied across diseases, operational factors, especially transport availability, showed a consistent association with case detection and confirmation. Equally, there exists a positive association between financial support and measles surveillance sensitivity. Data quality was generally suboptimal, with a small proportion of respondents meeting completeness and accuracy thresholds of ≥80%, and individual-level predictors demonstrating non-consistent associations. Stability assessments revealed substantial system fragility, including recurrent transportation delays, frequent commodity stockouts, infrastructure disruptions, and staff reassignments, all of which contributed to surveillance instability.
CONCLUSIONS:
The surveillance performance for measles, diphtheria, AFP, and CSM in Niger State demonstrates strength disparity and chronic weaknesses, especially in data quality and system stability. To improve surveillance effectiveness and preparedness for priority VPDs, our study recommends addressing operational challenges around transportation, financing, and infrastructure, especially in low-resource settings.
| eISSN: | 2654-1459 |
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