Positive predictive value and effectiveness of measles case-based surveillance in Uganda, 2012-2015

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dc.contributor.authorNsubuga, Fred
dc.contributor.authorAmpaire, Immaculate
dc.contributor.authorKasasa, Simon
dc.contributor.authorLuzze, Henry
dc.contributor.authorKisakye, Annet
dc.date.accessioned2025-04-12T06:04:32Z
dc.date.available2025-04-12T06:04:32Z
dc.date.issued2017
dc.description.abstractDisease surveillance is a critical component in the control and elimination of vaccine preventable diseases. The Uganda National Expanded Program on Immunization strives to have a sensitive surveillance system within the Integrated Disease Surveillance and Response (IDSR) framework. We analyzed measles surveillance data to determine the effectiveness of the measles case-based surveillance system and estimate its positive predictive value in order to inform policy and practice. Methods An IDSR alert was defined as ≥1 suspected measles case reported by a district in a week, through the electronic Health Management Information System. We defined an alert in the measles case-based surveillance system (CBS) as ≥1 suspected measles case with a blood sample collected for confirmation during the corresponding week in a particular district. Effectiveness of CBS was defined as having ≥80% of IDSR alerts with a blood sample collected for laboratory confirmation. Positive predictive value was defined as the proportion of measles case-patients who also had a positive measles serological result (IgM +). We reviewed case-based surveillance data with laboratory confirmation and measles surveillance data from the electronic Health Management Information System from 2012–2015. Results A total of 6,974 suspected measles case-persons were investigated by the measles case-based surveillance between 2012 and 2015. Of these, 943 (14%) were measles specific IgM positive. The median age of measles case-persons between 2013 and 2015 was 4.0 years. Between 2013 and 2015, 72% of the IDSR alerts reported in the electronic Health Management Information System, had blood samples collected for laboratory confirmation. This was however less than the WHO recommended standard of ≥80%. The PPV of CBS between 2013 and 2015 was 8.6%. Conclusion In conclusion, the effectiveness of measles case-based surveillance was sub-optimal, while the PPV showed that true measles cases have significantly reduced in Uganda. We recommended strengthening of case-based surveillance to ensure that all suspected measles cases have blood samples collected for laboratory confirmation to improve detection and ensure elimination by 2020.
dc.identifier.citation: Nsubuga F, Ampaire I, Kasasa S, Luzze H, Kisakye A (2017) Positive predictive value and effectiveness of measles case-based surveillance in Uganda, 2012-2015. PLoS ONE 12(9): e0184549. https://doi.org/10.1371/journal.pone.0184549
dc.identifier.urihttps://doi.org/10.1371/journal.pone.0184549
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/10545
dc.language.isoen
dc.publisherPLoS ONE
dc.titlePositive predictive value and effectiveness of measles case-based surveillance in Uganda, 2012-2015
dc.typeArticle
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