Evaluation of HIV/AIDS Case-Based Surveillance System – DireDawa City Administration, Ethiopia, July/2021-June/2022

Abstract Background Ethiopia started Human Immunodeficiency Virus ( HIV) Case-Based Surveillance (CBS) system along with the Research Electronic Data Capture (REDCap) in June 2019. For the period January-June 2022, only five out of 14 CBS implementing health facilities in DireDawa reported 35 newly diagnosed HIV patients through the REDCap Database compared to 314 in the District Health Information System (DHIS-2). This study aimed to describe the case-based surveillance system attributes, usefulness, reasons for under-reporting and provide recommendations. Methods We followed a descriptive cross-sectional study design. We customized the data collection tools from the Centers for Disease Control guidelines (CDC) for evaluating public health surveillance systems. Questionnaires were administered to 36 healthcare workers involved in HIV testing services. Completed HIV CBS case reporting forms were assessed for completeness. Statistics like frequencies and proportions are used to describe the findings between August - October 2022. Results lack of reporting guidelines through the REDCap was 22(61%). limited coordination between technical staff and health facilities 19 (53%). limited competency in the REDCap 23(64%). Timeliness, completeness, and validity were 89%, 87%, and 99% in the REDCap respectively. There was a lack of standard operating procedures during system interruptions. Overall representativeness was 368(49%) of 757. Acceptability was 100% due to reduced paperwork and the ability to generate simple reports. The information generated was used to identify new infection hotspots in 31(86%). Conclusions The HIV cases-based surveillance system was timely and acceptable. Representativeness was poor due to limited competency in the REDCap. We recommended health workers need further training.