Evaluation of diarrheal disease surveillance in the Minawao refugee camp, Cameroon, 2016

Between 2013 and 2015, the Minawao refugee camp in Cameroon received about 51000 refugees fleeing Boko Haram. A rapid increase in population and inadequate sanitary installations increase the risk of diarrheal disease. This study was performed to assess the structure and attributes of the surveillance system in Minawao.

Updated US Centers for Disease Control and Prevention guidelines were used to evaluate the public health surveillance system. Information sources included health registers, surveillance reports, and key informant interviews. Scorecards were used to assess the simplicity, flexibility, data quality, acceptability, sensitivity, timeliness, stability, and usefulness of the system.

Surveillance in Minawao is both passive and active, integrating four diseases reported weekly/immediately. All key informants agreed that surveillance was part of their routine work. Of 138 surveillance reports reviewed, all were complete; 91 (66%) were timely. Overall, 143 (100%) cases of diarrheal disease identified in health registers were reported to the next level. Only two (20%) surveillance personnel could correctly state standardized case definitions (SCD); three (30%) were unable to identify cases of diarrheal disease based on SCD.

In Minawao, diarrheal disease surveillance is acceptable, flexible, sensitive, and useful. To improve timeliness and the use of SCD, we recommend the use of mobile phones to report and display SCD in health facilities.