Uganda DHIS2 Case Based Surveillance System: Would Have Detected the 2016 Yellow Fever Outbreak in Uganda

Abstract

Majority of developing countries have relayed on aggregate weekly epidemiological data to detect, investigate and respond to outbreak, however as revealed by the West Africa Ebola Outbreak in 2015, these systems were not able to detect the outbreak in time. This has driven countries to building effective case based surveillance systems aimed to link cases to laboratories. Uganda's journey to a web-based electronic case-based surveillance started in 2013 with the United States Government (USG) Uganda Global Health Security (GHS) demo project. On 24th March 2016, an alert of a suspected Viral Haemorrhagic Fever (VHF) outbreak was received by the Ministry of Health through the Public Health Emergency Operations Centre (PHEOC) and the case was confirmed on 8 April 2016 for Yellow Fever. A total of 60 suspected YF cases were reported between April and June, with 7 cases testing positive. Building on the successful GHS Specimen Tracking System, we embarked on rebuilding the DHIS2 tracker expanding the scope and coverage to the now eIDSR. Different disease specific Case notification forms were reviewed and common key notification elements harmonized into a general minimum data case DHIS2 tracker registry for immediate reporting. The system underwent vigorous testing and fine tuning using the yellow fever outbreak cases. The systems demonstrated that it's possible to build an effective case notification and lab confirmation system using DHIS2 tracker with automated SMS and email notification. With the success above it recommended to countrywide rollout and adoption.