Health worker knowledge of Integrated Disease Surveillance and Response standard case definitions: a cross-sectional survey at rural health facilities in Kenya.

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BMC Public Health. 2018 Jan 17;18(1):146. doi: 10.1186/s12889-018-5028-2.

Health worker knowledge of Integrated Disease Surveillance and Response standard case definitions: a cross-sectional survey at rural health facilities in Kenya.

Toda M¹ Zurovac D²³ Njeru I⁴ Kareko D⁴ Mwau M⁵ Morita K⁶.

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Abstract

BACKGROUND:

The correct knowledge of standard case definition is necessary for frontline health workers to diagnose suspected diseases across Africa. However surveillance evaluations commonly assume this prerequisite. This study assessed the knowledge of case definitions for health workers and their supervisors for disease surveillance activities in rural Kenya.

METHODS:

A cross-sectional survey including 131 health workers and their 11 supervisors was undertaken in two counties in Kenya. Descriptive analysis was conducted to classify the correctness of knowledge into four categories for three tracer diseases (dysentery measles and dengue). We conducted a univariate and multivariable logistic regression analyses to explore factors influencing knowledge of the case definition for dysentery.

RESULTS:

Among supervisors 81.8% knew the correct definition for dysentery 27.3% for measles and no correct responses were provided for dengue. Correct knowledge was observed for 50.4% of the health workers for dysentery only 12.2% for measles and none for dengue. Of 10 examined factors the following were significantly associated with health workers correct knowledge of the case definition for dysentery: health workers cadre (aOR 2.71; 95% CI 1.20-6.12; p = 0.017) and display of case definition poster (aOR 2.24; 95% CI 1.01-4.98; p = 0.048). Health workers exposure to the surveillance refresher training supportive supervision and guidelines were not significantly associated with the knowledge.

CONCLUSION:

The correct knowledge of standard case definitions was sub-optimal among health workers and their supervisors which is likely to impact the reliability of routine surveillance reports generated from health facilities.