American Journal of Biomedical Research
ISSN (Print): 2328-3947 ISSN (Online): 2328-3955 Website: Editor-in-chief: Hari K. Koul
Open Access
Journal Browser
American Journal of Biomedical Research. 2020, 8(2), 30-39
DOI: 10.12691/ajbr-8-2-2
Open AccessArticle

Original Article: Timeliness of Reporting in the Community-based Disease Surveillance and Notification System in Anambra State, Nigeria

Chijioke A Ezenyeaku1, Chinomnso C Nnebue1, 2, , Simeon A Nwabueze1, 2, Nkiru N Ezeama1, 2, Cyril C Ezenyeaku3 and Amobi L Ilika1, 2

1Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria

2Department of Community Medicine, Nnamdi Azikiwe University, Awka, Nigeria

3Department of Obstetrics and Gynaecology Chukwuemeka Odumegwu Ojukwu University/University Teaching Hospital, Awka., Nigeria

Pub. Date: April 22, 2020

Cite this paper:
Chijioke A Ezenyeaku, Chinomnso C Nnebue, Simeon A Nwabueze, Nkiru N Ezeama, Cyril C Ezenyeaku and Amobi L Ilika. Original Article: Timeliness of Reporting in the Community-based Disease Surveillance and Notification System in Anambra State, Nigeria. American Journal of Biomedical Research. 2020; 8(2):30-39. doi: 10.12691/ajbr-8-2-2


Background: Community-based disease surveillance systems (CBSS) help the passive health facility-based systems in providing timely information on the health situations in communities. Objective: To determine the timeliness of reporting in the CBSS in Anambra State, Nigeria. Materials and methods: A cross sectional descriptive mix method study of the CBSS in Anambra State was done. Quantitative data were obtained using questionnaires, interviewer- administered on 360 community focal points, selected by multistage sampling technique and were analysed with SPSS version 20. Associations were tested using Chi square, Fisher’s exact and t tests as appropriate at p<0.05. Key informant interviews (KII) were conducted among some officers involved in Disease Surveillance and Notification (DSN), selected using convenience sampling technique and data were transcribed verbatim, thematic content analysis done with key quotes noted. Results: The timeliness of reporting was 82.9%. There were associations between timeliness of reporting and person the detected disease was notified to, means through which the detected disease was notified and availability of supervisors for focal points (p ≤ 0.05). Notification of diseases through means other than phone calls / SMS were 2.5 times more likely to be more timely, while focal points who had supervisors were 4 times more likely to notify diseases more timely. The KII findings, showed that the commonest reason for sub-optimal functioning of the CBSS was lack of funds. Conclusions: This study revealed high level of timeliness of reporting of notifiable diseases, and sub-optimal functioning of the CBSS. There is need for improvement in the means of case notification, training cum supervision of the focal points and funding m the CBSS in the State.

community-based surveillance timeliness community focal points Nigeria

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Dictionary C. General Principles of Surveillance. Available from: [Accessed February 15, 2016].
[2]  World Health Organisation. Communicable Disease Surveillance and Response Systems: Guide to monitoring and evaluating. 2006. Available from: . [Accessed March 11, 2016]
[3]  Integrated Disease Surveillance and Response in the African Region: A guide for establishing community based surveillance. 2014. Available from: https://www.afro [Accessed February 12, 2016].
[4]  World Health Organization. Avian influenza A (H5N1) in humans and poultry in Vietnam. Available from [Accessed March 16, 2016].
[5]  Hyman P. 'Peace technologies' enable eyewitness reporting when disasters strike. Communications of the ACM 2014;57(1):27-29.
[6]  Kumpel E, Sridharan A, Kote T, Olmos A, Parikh TS. NextDrop: Using human observations to track water distribution. 2012. Available from: [Accessed March 16, 2016].
[7]  World Health Organisation, Centre for Disease Control. Technical guidelines for integrated disease surveillance and response in the African region. 2nd edition. Brazzaville, Republic of Congo and Atlanta, USA. 2010: 1-398.
[8]  Jajosky R, Groseclose S. Evaluation of reporting timeliness of public health surveillance systems for infectious diseases. BMC Public Health. 2004; 4(1): 29-38.
[9]  Nnebue CC, CN, CC, POU. Effectiveness of data collection and information transmission process for disease notification in Anambra State, Nigeria. Niger J Clin Pract. 2013; 16(4): 483-489.
[10]  Reijn E, Swaan CM, Kretzschmar MEE, van Steenbergen JE. Analysis of timeliness of infectious disease reporting in the Netherlands.BMC Public Health. 2011;11:409.
[11]  Allport R, Mosha R, Bahari M, Swai E, Catley A. The use of community-based animal health workers to strengthen disease surveillance systems in Tanzania. Rev. sci. tech. Off. int. Epiz. 2005; 24(3): 921-932
[12]  Adokiya MN, JK, C, O. Evaluation of the reporting completeness and timeliness of the integrated disease surveillance and response system in northern Ghana. . 2016; 50(1): 3-8.
[13]  Kiberu VM, Matovu JK, Makumbi F, Kyozira C, Mukooyo E, Wanyenze RK. Strengthening district-based health reporting through the district health management information software system: The Ugandan experience. BMC Med Inform Decis Mak. 2014; 14(1): 40.
[14]  Sarti E, M, M, P, JB, E, et al. A comparative study on active and passive epidemiological surveillance for dengue in five countries of Latin America. Int J Infect Dis. 2016;44:44-49
[15]  Adokiya MA, JK. Ebola virus disease surveillance and response preparedness in northern Ghana. Glob Health Action. 2016;9(1):1-10
[16]  Alexander KA, Sanderson CE, Marathe M, Lewis BL, Rivers CM, Shaman J, et al. What factors might have led to the emergence of Ebola in West Africa? PLoS Negl Trop Dis. 2015; 9: e0003652.
[17]  Kebede S, Duale S, Yokouide A, Alemu W. Trends of major disease outbreaks in the African Region, 2003-2007. East Afr J Public Health. 2010; 7: 20-29.
[18]  World Health Organisation. Lassa fever – Nigeria. 2016. Available from: [Accessed October 13, 2016].
[19]  Nnebue CC, Onwasigwe CN, Adogu POU, Onyeonoro UU. Awareness and knowledge of disease surveillance and notification by health-care workers and availability of facility records in Anambra state, Nigeria. Niger Med J. 2012; 53(4): 220-225.
[20]  Isere EE, Fatiregun AA, Ajayi IO. An overview of disease surveillance and notification system in Nigeria and the roles of clinicians in disease outbreak prevention and control. Niger Med J. 2015; 56(3): 161-8.
[21]  Abubakar AA, Sambo MN, Idris SH, Sabitu K, Nguku P. Assessment of integrated disease surveillance and response strategy implementation in selected local government areas of Kaduna state. Ann Nigerian Med. 2013; 7(1): 14-19.
[22]  Nigeria data portal. Nigeria population census. 2006. Available from: https:/ /www. [Accessed June 8, 2017].
[23]  National bureau of statistics. Nigeria’s population now 193.3 million. 2016. Available from: [Accessed November 12, 2017).
[24]  Anambra State Ministry of Health. Anambra State government strategic health development plan (2010-2015). 2010. Available [Accessed August 15, 2016].
[25]  International Federation of Red Cross and Red Crescent Societies. Community-based surveillance - Guiding principles. 2017. Available from: October 20, 2017]
[26]  World Health Organization. International Health Regulations (2005). 3rd ed. Geneva: The Organization; 2016. Available from: http://www.who .int/topics / international_health_regulations/en/. [Accessed July 29, 2016].
[27]  Araoye MO. Research methodology with statistics for health and social sciences. 2nd ed. Illorin: Nathadex Publications; 2008. p.115-22.
[28]  Maes E, Zimicki S. An evaluation of community-based surveillance in the northern region of Ghana. 2000. Available from: http/www.unicef. org/evaldatabase/index_14293.html. [Accessed July 26, 2016].
[29]  Anambra State Ministry of Health - Office of the state Epidemiologist. Community informants profile. 2016. p.1- 20.
[30]  Bowler’s proportional allocation formula. In. Pandey R, Verma MR. Samples allocation in different strata for impact evaluation of developmental programme. Rev. Bras. Biom. São Paulo, 2008; 26(4), p.103-112.
[31]  WHO/CDS/CSR/ISR. Protocol for the Assessment of National Communicable Disease Surveillance and Response Systems. 2001. Available from: [Accessed January 26, 2017].
[32]  Aniwada EC, Obionu CN. Disease surveillance and notification, knowledge and practice among private and public primary health care workers in Enugu State, Nigeria: A comparative study. Br J Med Med Res. 2016; 13(3): 1-10.
[33]  Federal Ministry of Health. National policy on integrated disease surveillance and response. Abuja, Nigeria. 2005. Available from: [Accessed December 12, 2016].
[34]  International Business Machines Corporation. IBM-Statistical Package for the Social Sciences (SPSS) Statistics 20. Somers New York: IBM Corporation; 2011.
[35]  Blignault I, Ritchie J. Revealing the wood and the trees: Reporting qualitative research. Health Promot J Austr. 2009; 20(2): 140-5
[36]  Diaz-Quijano FA, Martínez-Vega RA, Rodriguez-Morales AJ, Rojas-Calero RA, Luna-González ML, Díaz-Quijano RG. Association between the level of education and knowledge, attitudes and practices regarding dengue in the Caribbean region of Colombia. BMC Public Health 2018; 18: 143.
[37]  Toda M, Zurovac D, Njeru I, Kareko D, Mwau M, Morita K. Health worker knowledge of Integrated Disease Surveillance and Response standard case definitions: a cross-sectional survey at rural health facilities in Kenya. BMC Public Health 2018; 18: 146
[38]  Javanparast S, Baum F, Labonte R, Sanders D. Community health workers’ perspectives on their contribution to rural health and well-being in Iran. Am J Public Health. 2011; 101: 2287-92
[39]  Alam K, Tasneem S, Oliveras E. Retention of female volunteer community health workers in Dhaka urban slums: A case–control study. Health Policy Plan. 2012; 27: 477-486.
[40]  Hamisu AW, Johnson TM, Craig K, Mkande P, Banda R, Tegegne SG, et al. Strategies for improving polio surveillance performance in the security-challenged Nigerian states of Adamawa, Borno, and Yobe during 2009-2014. J. Infect. Dis. 2016; 213(3): S136-S139.
[41]  Patel U, Pharr JR, Ihesiaba C, Oduenyi FU, Hunt AT, Patel D, et al. Ebola Outbreak in Nigeria: Increasing Ebola Knowledge of Volunteer Health Advisors. Glob J Health Sci. 2016; 8(1): 72-78.
[42]  Strachan DL, Kallander K, Ten-Asbroek AH, Kirkwood B, Meek S, Lorna B, et al. Interventions to improve motivation and retention of community health workers delivering integrated community case management (iCCM): Stakeholder perceptions and priorities. Am J Trop Med Hyg. 2012; 87(5): 111-9.
[43]  Pascoe L, Lungo J, Kaasboll J, Koleleni I. Collecting integrated disease surveillance and response data through mobile phones. In: Proceedings of the IST-Africa 2012 conference proceedings. 2012. Presented at: IST-Africa 2012 conference and exhibitions; 2012; Dar es Salaam, Tanzania.
[44]  Nsubuga P, Brown WG, Groseclose SL, Ahadzie L, Talisuna AO, Mmbuji P, et al. Implementing integrated disease surveillance and response: Four African countries’ experience, 1998–2005. Glob. Public Health. 2010; 5(4): 364-80.
[45]  Kuijk A. Two factor theory by Frederick Herzberg. 2018. Available from: of-motivation/two-factor-theory-herzberg/. [Accessed October 30, 2018].