American Journal of Public Health Research
ISSN (Print): 2327-669X ISSN (Online): 2327-6703 Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Public Health Research. 2020, 8(3), 77-86
DOI: 10.12691/ajphr-8-3-1
Open AccessArticle

Completeness 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, Cyril C Ezenyeaku3, Ifeanyi N Udedibia1, Ifeoma C Iloghalu1 and Obiageli F Emelumadu1, 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

Pub. Date: May 11, 2020

Cite this paper:
Chijioke A Ezenyeaku, Chinomnso C Nnebue, Simeon A Nwabueze, Cyril C Ezenyeaku, Ifeanyi N Udedibia, Ifeoma C Iloghalu and Obiageli F Emelumadu. Completeness of Reporting in the Community-based Disease Surveillance and Notification System in Anambra State, Nigeria. American Journal of Public Health Research. 2020; 8(3):77-86. doi: 10.12691/ajphr-8-3-1


Background: Community involvement in the disease surveillance and notification (DSN) systems aids in leveraging community structures for improved disease prevention and control. Objective: To determine the completeness of reporting in the CBSS in Anambra State, Nigeria. Materials and methods: This was a cross sectional descriptive mix method study of the CBSS in Anambra State. Quantitative data were obtained using pre-tested, semi-structured questionnaires, interview-administered on 360 community informants, selected by multistage sampling technique, while data on completeness of filling of the community registers were obtained using observation checklist. Analyses were with SPSS version 20 and associations were tested using Chi square, Fisher’s exact and t tests as appropriate. Level of statistical significance was set at 5%. Key informant interviews (KII) were conducted among selected DSN key officers. Data from KII were transcribed verbatim, thematic content analysis done and key quotes noted. Results: The completeness of reporting in the system was 28.1%. Factors such as the source of information on detected disease, record of detected disease kept by community informant in the last one year, the number of times reports were sent in the last one year, feedback received by community informants given to community members, volunteer benefit and satisfaction with being a community informant had associations with completeness (p < 0.05). At the univariate level, keeping records, giving feedbacks to the community and being satisfied with the CBSS were significant predictors of completeness. The KII findings, showed that the commonest reason for sub-optimal functioning of the CBSS was poor funding. Conclusions: This study revealed low level of completeness of reporting of notifiable diseases and sub-optimal functioning of the CBSS in the State. We recommend improved supervision, record keeping, information transmission process and funding of the CBSS in Anambra State.

community-based surveillance completeness community informants Nigeria

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


[1]  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].
[2]  World Health Organisation. Global eradication of poliomyelitis: Report of the technical consultation. 1997. Available from: / 63319/1/WHO_EPI_GEN_96.04.pdf. [Accessed May 25, 2017].
[3]  Nigeria global polio eradication initiative. Meeting of the expert review committee on polio eradication and routine immunization in Nigeria. Abuja, Nigeria; 2009. Available from: [Accessed October 15, 2017].
[4]  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.
[5]  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.
[6]  Overhage JM, Grannis S, McDonald CJ. A comparison of the completeness and timeliness of automated electronic laboratory reporting and spontaneous reporting of notifiable conditions. Am J Public Health. 2008; 98(2): 344-350.
[7]  Nnebue CC, Onwasigwe CN, Ibeh CC, Adogu 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.
[8]  World Health Organisation. Communicable Disease Surveillance and Response Systems: Guide monitoring and evaluating. 2006. Available from: R_LYO_2006_2.pdf . [Accessed March 11, 2016].
[9]  Garcell HG, Hernandez TMF, Abdo EAB, Arias AV. Evaluation of the timeliness and completeness of communicable disease reporting: Surveillance in the Cuban hospital, Qatar. Qatar Med J. 2014; 2014(1): 50-56.
[10]  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.
[11]  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.
[12]  Lafond KE, Dalhatu I, Shinde V, Ekanem EE, Ahmed S, Peebles P, et al. Notifiable disease reporting among public sector physicians in Nigeria: A cross sectional survey to evaluate possible barriers and identify best sources of information. BMC Health Serv Res. 2014; 14: 568.
[13]  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.
[14]  Nigeria data portal. Nigeria population census. 2006. Available from: [Accessed June 8, 2017].
[15]  National bureau of statistics. Nigeria’s population now 193.3 million. 2016. Available from: [Accessed November 12, 2017).
[16]  Anambra State Ministry of Health. Anambra State government strategic health development plan (2010-2015). 2010. Available from: [Accessed August 15, 2016].
[17]  International Federation of Red Cross and Red Crescent Societies. Community-based surveillance - Guiding principles. 2017. Available from:[Accessed October 20, 2017].
[18]  World Health Organization. International Health Regulations (2005). 3rd ed. Geneva: The Organization; 2016. Available from: [Accessed July 29, 2016].
[19]  Araoye MO. Research methodology with statistics for health and social sciences. 2nd ed. Illorin: Nathadex Publications; 2008. p. 115-22.
[20]  Maes E, Zimicki S. An evaluation of community-based surveillance in the northern region of Ghana. 2000. Available from: http/ index _ 14293.html. [Accessed July 26, 2016].
[21]  Anambra State Ministry of Health - Office of the state Epidemiologist. Community informants profile. 2016. Pg 1- 20.
[22]  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.
[23]  WHO/CDS/CSR/ISR. Protocol for the Assessment of National Communicable Disease Surveillance and Response Systems. 2001. Available from: [Accessed January 26, 2017].
[24]  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.
[25]  Federal Ministry of Health. National policy on integrated disease surveillance and response. Abuja, Nigeria. 2005. Available from: Surveillance-and-Response.pdf. [Accessed December 12, 2016].
[26]  International Business Machines Corporation. IBM-Statistical Package for the Social Sciences (SPSS) Statistics 20. Somers New York: IBM Corporation; 2011.].
[27]  Blignault I, Ritchie J. Revealing the wood and the trees: Reporting qualitative research. Health Promot J Austr. 2009; 20(2): 140-5.
[28]  Kyei-Faried S, Appiah-Denkyira E, Brenya D, Akuamoa-Boateng A, Visser L. The role of community-based surveillance in health outcomes measurement. Ghana Med J. 2006; 40(1): 26-30.
[29]  Stone E, Miller L, Jasperse J, Privette G, Diez-Beltran JC, Jambai A, et al. Community event-based surveillance for Ebola virus disease in Sierra Leone: Implementation of a national-level system during a crisis. PLoS Curr. 2016; 1. Available from: [Accessed July 26, 2017].
[30]  Ratnayake R, Crowe SJ, Jasperse J, Privette G, Stone E, Miller L, et al. Assessment of community event-based surveillance for Ebola virus disease, Sierra Leone, 2015. Emerg Infect Dis. 2016; 22(8): 1431-1437.
[31]  Okiror SO, Bisrat F, Lutukai M, Bhui BR. Community-based surveillance on polio eradication in the Horn of Africa. African health monitor. 2015; 10: 44-45
[32]  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.
[33]  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.
[34]  Sanders D, Lehmann U. Community health workers: What do we know about them? The state of the evidence on programmes, activities, costs and impact on health outcomes of using community health workers. Evidence and Information for Policy 2007. Available from: [Accessed March 17, 2016].
[35]  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.
[36]  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.
[37]  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.
[38]  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.
[39]  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.
[40]  Curry D, Bisrat F, Coates E, Altman P. Reaching beyond the health post: Community based surveillance for polio eradication. Dev Pract. 2013; 23(1): 69-78.
[41]  Malaviya P, Picado A, Hasker E, Ostyn B, Kansal S, Pratap R, et al. Health and demographic surveillance system profile: The Muzaffarpur-TMRC health and demographic surveillance system. Int. J. Epidemiol. 2014; 43(5): 1450-1457.
[42]  Hyman P. 'Peace technologies' enable eyewitness reporting when disasters strike. Communications of the ACM 2014; 57(1): 27-29.
[43]  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.
[44]  Dil Y, Strachan D, Cairncross S, Korkor AS, Hill Z. Motivations and challenges of community-based surveillance volunteers in the northern region of Ghana. J Community Health. 2012; 37: 1192-98.
[45]  Kuijk A. Two factor theory by Frederick Herzberg. 2018. Available from: [Accessed October 30, 2018].