Evaluation of the respiratory pathogens sentinel surveillance system, Jasikan Municipality, Ghana, 2025

Abstract

Introduction: Acute respiratory illnesses, including influenza-like illness and severe acute respiratory infection, remain major causes of morbidity and mortality worldwide, particularly in low- and middle-income countries. Effective surveillance systems are essential for monitoring disease trends, detecting outbreaks, and guiding timely public health action. Following World Health Organization–AFRO recommendations to strengthen respiratory disease surveillance, the Respiratory Pathogens Sentinel Surveillance System (RPSSS) was established in Jasikan Municipality, Ghana, in 2022. However, the system has not undergone a comprehensive evaluation since its implementation. This study evaluated the objectives, key attributes, and usefulness of the RPSSS in Jasikan Municipality. Methods: A descriptive surveillance system evaluation was conducted from January 2022 to December 2024 using updated CDC guidelines. Quantitative data were extracted from SORMAS, DHIMS2, IDSR reports, facility registers, and laboratory records from the National Influenza Sentinel Laboratory. Key informant interviews were conducted with 20 surveillance stakeholders. System attributes assessed included data quality, sensitivity, predictive value positive, representativeness, timeliness, simplicity, flexibility, stability, acceptability, and usefulness. Indicators were categorized as weak (<60%), moderate (60–79%), or good (≥80%). Results: A total of 555 suspected respiratory pathogen cases were reported during the evaluation period, with females representing 59.1% (328/555). The median age was 26 years (range: 1 month–93 years). Influenza viruses were detected in 15.0% (83/555) of samples, declining from 20.4% in 2022 to 13.7% in 2023 and 9.2% in 2024. SARS-CoV-2 positivity ranged from 0.5% in 2022 to 5.2% in 2023 and 2.8% in 2024. Three outbreaks were detected. Data quality, timeliness, representativeness, simplicity, stability, acceptability, and usefulness showed good performance (≥80%), while sensitivity was moderate at 66.7% due to inconsistent weekly sampling targets (59.4%) and sample submission (61.8%). Surveillance findings informed outbreak investigations, training, health education, disease burden estimation, and resource mobilization. Conclusion: The system met objectives but requires improved sensitivity and representativeness for stronger surveillance performance.