Capacities in Laboratory-Based Epidemiological Surveillance in Cameroon's Littoral Region: A Cross-Sectional Study

Laboratories are a critical part of epidemiological surveillance implementation through their participation in cases' detection and investigation. The Integrated Disease Surveillance and Response (IDSR) strategy is implemented in Cameroon since 2003 although weaknesses in terms of low detection, timeliness and reporting rates are reported. The present study was conducted to assess the implication of health facilities' laboratories in epidemiological surveillance by evaluating the activities conducted, the availability of resources and communication pathways.

A cross-sectional descriptive study was conducted in laboratories of health facilities in the Littoral region of Cameroon selected from health districts by stratified random sampling from April to May 2024. Data were collected using a face-to-face structured questionnaire administered to head of each laboratory. Collected data included health facilities' characteristics, epidemiological surveillance activities conducted in the laboratories, availability of supplies and equipment, data reporting and availability of energy supply.

Out of the 302 laboratories reached, 273 (90.4%) consented to participate in the survey. Most (198 [72.53%]) of the laboratories declared being involved in samples' collection while only 61 (22.34%), 18 (6.59%) and 93 (34.07%) declared to be involved in screening of suspected cases during outbreaks, case confirmations during outbreaks and notification of suspected cases respectively. Regarding the availability of transport supplies/equipment, out of the 273 laboratories, 43 (15.8%), 105 (38.5%) and 123 (45.1%) laboratories had Cary Blair medium, isothermal carrying cases and safety bags respectively. It is noted that 26 (9.5%) laboratories reported not communicating their results with surveillance units. A total of 263 (96.3%) laboratories declared to have the national distribution electricity service as their main source of energy and 78 (29.7%) laboratories had an alternative energy source.

The present study revealed gaps in terms of participation of health facilities' laboratories in key epidemiological surveillance such as case confirmation and results' reporting. Weakness in terms of supply chain are also noted. Efforts to strengthen laboratory surveillance capacities must prioritize investments in reliable supply chains and sustainable infrastructure.