Original Research Evaluation of diphtheria surveillance system in Kaduna State, Nigeria, July 2023 – December 2023

Uwaifiokun J. Okhuarobo, Samuel A. Owoicho, Jeremiah Daikwo, Isiaq H. Shehu, Emmanuel Omomoh, Mfon-obong P. Ibara, Abiola O. Oshunniyi, Oladipo O. Ogunbode, Fatima Saleh

Journal of Public Health in Africa | Vol 16, No 1 | a1379 | DOI: https://doi.org/10.4102/jphia.v16i1.1379 | © 2025 Uwaifiokun J. Okhuarobo, Samuel A. Owoicho, Jeremiah Daikwo, Isiaq H. Shehu, Emmanuel Omomoh, Mfon-obong P. Ibara, Abiola O. Oshunniyi, Oladipo O. Ogunbode, Fatima Saleh | This work is licensed under CC Attribution 4.0
Submitted: 18 March 2025 | Published: 27 August 2025

About the author(s) Uwaifiokun J. Okhuarobo, Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; and, Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
Samuel A. Owoicho, Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; and, Federal Ministry of Agriculture and Food Security, Abuja, Nigeria
Jeremiah Daikwo, Kaduna State Ministry of Health, Kaduna, Nigeria
Isiaq H. Shehu, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
Emmanuel Omomoh, Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
Mfon-obong P. Ibara, Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria; and, Department of Community Health, University of Uyo, Uyo, Nigeria
Abiola O. Oshunniyi, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria; and, Clinton Health Access Initiative, Abuja, Nigeria
Oladipo O. Ogunbode, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria
Fatima Saleh, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria

Abstract

Background: The re-emergence of the diphtheria outbreak in Nigeria raises concern about the surveillance system’s capability to detect, prepare for and respond to outbreaks.
Aim: To evaluate the usefulness and attributes of the diphtheria surveillance system in Kaduna State, Nigeria.
Setting: Kaduna State, northwest Nigeria.
Methods: An observational study, using a mixed-method approach, was adopted. It comprised a survey, a record review of the 2023 outbreak and key informant interviews. A pre-tested semi-structured self-administered questionnaire and an interview guide, adapted from the Centres for Disease Control and Prevention (CDC) (2001) guidelines on surveillance evaluation, were utilised. Three stakeholders were interviewed, 21 surveillance officers were surveyed, and eight surveillance attributes were assessed.
Results: The outbreak data had 67% (n = 382/573) missing values. Eighty-two per cent (n = 432/525) of cases had an investigation initiated within 48 hours. All 21 (100%) respondents reported ease in filling in forms and a willingness to continue participating in the system, which could correctly identify cases. Twelve (57%) of the 21 respondents stated that private health facilities submitted their reports. Of the 12 respondents who reported modifications in the system, six (50%) stated < 1 month for implementation. Nineteen (90%) of the 21 respondents reported inadequate resources, while six (67%) of the nine respondents who reported receiving stipends indicated these were provided by partner organisations.
Conclusion: The system was acceptable to stakeholders, useful in detecting outbreaks, simple in data collection, flexible in accommodating changes and sensitive in identifying cases. However, resource constraints pose a threat to its stability. We recommend providing adequate resources, improving data quality and reporting from private health facilities.
Contribution: The study underscores areas for improvement in the diphtheria surveillance system, highlighting the potential for targeted interventions to overhaul the system.

Keywords

data accuracy; diphtheria; surveys and questionnaires; disease outbreaks; health facilities; Nigeria

Sustainable Development Goal

Goal 3: Good health and well-being

Metrics Total abstract views: 495
Total article views: 257

Crossref Citations

No related citations found.