Port Loko District has had over 1400 confirmed EVD cases during this outbreak. However, transmission declined rapidly in early 2015; by mid-April, a few weeks had passed with no known cases. Simultaneously, reporting of sick persons had plummeted across the district and the number of deaths reported in some areas was fewer than expected. These circumstances signaled the need for the EVD surveillance system to broaden its focus from using district surveillance officers (DSOs) to respond to reports of ill and deceased persons (hereafter, “sick and death alerts”) to a more proactive and comprehensive system that relied strongly on community engagement and surveillance through existing structures such as Peripheral Health Units (PHUs), schools and local authorities. While the involvement of local authorities and the community had been central to reporting suspected EVD cases earlier in the outbreak, the decrease in alerts suggested that engagement was diminishing. The reopening of schools and reemergence of the primary healthcare system provided opportunities to decentralize surveillance and strengthen the involvement of these structures. The primary objective was improving EVD surveillance, but the effort was also used to bolster routine surveillance, in preparation for implementating Integrated Disease Surveillance and Reporting.
Objective
Describe the evolution of Ebola Virus Disease (EVD) surveillance from a largely reactive system structured primarily around responding to reports of illness and death, to one that was more methodical, proactive and comprehensive