Evaluation of the weekly disease surveillance system for epidemic-prone diseases in Makonde District, Zimbabwe 2020: a descriptive cross-sectional study.

Introduction: the weekly disease surveillance system (WDSS) is a tool used to provide an early warning of potential public health threats in Zimbabwe. In 2020, Makonde District failed to detect an anthrax outbreak at one of its facilities, this untimely and poor response of the district increased morbidity. We evaluated the weekly disease surveillance system to determine reasons for missing outbreaks and determine the usefulness of the system in the detection of outbreaks. Methods: we conducted descriptive cross-sectional study using updated Centres for Disease Control and Prevention guidelines for surveillance system evaluation. We recruited 46 health workers. A structured pretested interviewer-administered questionnaire was used to collect data on reasons for missing outbreaks, knowledge, usefulness and surveillance system attributes. Data were cleaned and bivariate analysis was conducted. Results: health workers found the system simple (85%), acceptable (75%) and flexible (60%). However, we found only 5 (11%) health workers could correctly describe the surveillance system, only 2 (3%) were trained in disease surveillance, only 31 (65%) sent data on time, 57% of clinics had stock outs of forms, 60% of forms had entries with 100% of the data filled out and 22 (46%) of health workers analysed the data gathered and used it in meetings. Conclusion: the surveillance system was simple, flexible, acceptable, but unstable, untimely and not useful. There was poor knowledge on the surveillance system, health workers were not trained on disease surveillance, and quality of data was poor. Health workers should be trained in surveillance and data validation and adequate reporting tools provided.