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. 2021 Jun 8;7(6):e27625.
doi: 10.2196/27625.

The Rotavirus Surveillance System in Yemen: Evaluation Study

Eman Abdullah Lardi  1 , Sharaf Sharaf Al Kuhlani  2 , Mohammed Abdullah Al Amad  1 , Abdulwahed Abduljabar Al Serouri  1 , Yousef Saleh Khader  3
Affiliations

The Rotavirus Surveillance System in Yemen: Evaluation Study

Eman Abdullah Lardi et al. JMIR Public Health Surveill. .

Abstract

Background: Rotavirus (RV) kills over 185,000 children <5 years every year and is responsible for over one-third of all child diarrheal deaths worldwide. The Rotavirus Surveillance System (RVSS) in Yemen was launched in 2007 at five sentinel sites to monitor the impact of the vaccine on RV morbidity and mortality.

Objective: This study aimed to determine the usefulness of the RVSS, assess its performance, and identify the strengths and weaknesses of its implementation.

Methods: The Centers for Disease Control and Prevention's updated guidelines on evaluating a public health surveillance system were used to evaluate the RVSS. In this assessment, qualitative indicators, such as usefulness, flexibility, stability, simplicity, and acceptability, were assessed through in-depth interviews with stakeholders at the central level and semistructured questionnaires with the sentinel site coordinators. The indicators for quantitative attributes-sensitivity, positive predictive value (PPV), completeness, and timeliness-were assessed by reviewing the results of laboratory samples and a random sample of case report forms. The scores for the indicators were expressed as poor (<60%), average (60% to <80%), and good (≥80%).

Results: The overall usefulness score of the RVSS was 73%, indicating an average rank. The RVSS was rated as having good flexibility (91%) and stability (81%), and average simplicity (77%) and acceptability (76%). In terms of quantitative attributes, the system was poor for sensitivity (16%), average for PPV (73%), and good for completeness (100%) and timeliness (100%).

Conclusions: Although the system attributes were flexible, stable, capable of providing quality data, and performing timely data reporting, some attributes still needed improvements (eg, usefulness, simplicity, acceptability, and PPV). There is a need for a gradual replacement of donor funds with government funds to ensure sustainability. The RVSS in Yemen strongly requires a progressive increase in the number of sites in governorates and sensitivity enhancement.

Keywords: Rotavirus; evaluation, Yemen; surveillance system.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Flow chart for RVSS data collection methods employed in phases 1 and 2. CDC: Centers for Disease Control and Prevention, EMRO: Regional Office for the Eastern Mediterranean, MoPH&P: Ministry of Public Health and Population, NCPHL: National Central Public Health Laboratory, RVSS: Rotavirus Surveillance System, WHO: World Health Organization.
See this image and copyright information in PMC

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