Evaluation of the diarrheal disease surveillance system, Nampula-Mozambique, 2019-2020

Introduction: Diarrhoea is considered the fourth leading cause of mortality in Mozambique, and the northern region has a seasonal occurrence of outbreaks. The study aims to evaluate the surveillance system for diarrheal diseases in the districts of Nampula, Monapo, 2019-2020. Methods: Updated US Centres for Disease Control and Prevention guidelines were used to evaluate the public health surveillance system; specifically, the qualitative attributes of simplicity, acceptability and quality of data and the quantitative attributes: representativeness, stability and timeliness for the period 2019-2020. Diarrhoea/cholera record books and investigation forms were used as data sources. Informal conversations were also held with surveillance technicians to understand how the system works. Results: The surveillance system for diarrheal diseases/cholera is simple, with a logbook containing 12 variables, and the information is sent via the internet to the Health Information System for the Monitoring and Evaluation of Diarrheal Diseases/Cholera of the Ministry of Health of Mozambique. The system was acceptable at 89.4%, representative, with a total of 1,356 diarrhoea cases reported, of which 50.3% (682/1,356) were female, 14.7% (199/1,356) in age groups 1-4. Data quality was 54.5%, timely, with results being received in 3 days on average. 75.0% (3/4) collected the sample within one day. The system was considered stable, as it remained operational throughout the period analysed. Conclusions: The surveillance system for diarrheal diseases achieves the objectives for which it was created. It is simple, acceptable, representative, timely, and stable, but with a poor quality of data, so it is recommended to improve the quality of the data and intensify the investigation of cases.