Evaluation of the leprosy surveillance system in Central Region, Ghana, 2025

Abstract

Introduction: Ghana met the target of one case of leprosy per 10,000 population by WHO decades ago, yet new cases are recorded every year. Between 2017 and 2022, Ghana recorded a total of 1614 cases of leprosy. An effective surveillance system is essential for early detection, prompt treatment, and eventual elimination of leprosy. This evaluation determined whether the leprosy surveillance system is meeting its objectives, assessed its attributes and usefulness in the Central Region of Ghana. Methods: A descriptive cross-sectional design was used for this evaluation from 2019 to 2024 The Centre for Disease Control and Prevention (CDC) updated guidelines for evaluating public health surveillance systems was adopted. Data was obtained through document reviews, interviews with key health personnel. Quantitative data was analyzed descriptively into frequencies and percentages using Epi-Info version 7 – tables and charts used to present the results. Qualitative data was analyzed thematically, identifying recuring themes and patterns within the interviews and the results presented in text. Results: Overall, 177 suspected leprosy cases were reported from 2019 to 2024 in the Central Region of Ghana, 57 were confirmed via Ziehl-Neelsen staining resulting in a positive predictive value (PPV) of 32.2% (57/177). The system had data completeness of 99% and improvement in timeliness from 82% in 2019 to nearly 100% in 2024. About 28.6% (6/21) health workers knew leprosy case definitions. The system is challenged by inadequate sample taking skills at the district level. Data from the system informed activities like community sensitization. Conclusion: The leprosy surveillance system in the Central Region of Ghana is partially meeting its objectives, yet useful in influencing public health decisions. The system has good timeliness and data quality but demonstrated weakness in simplicity and stability, with low PPV. We recommend sensitisation of health workers on Leprosy case definition.