Tuberculosis surveillance system evaluation: case of Ga West municipality, Ghana, 2011 to 2016

BACKGROUND: Evaluate the Tuberculosis (TB) surveillance system in the Ga West Municipality to determine if it is achieving its objectives, and to assess its attributes and usefulness. DESIGN: Descriptive analysis of primary and secondary data DATA SOURCE: Stakeholder interviews and record reviews on the objectives and operation of the surveillance system at all levels of the system. INTERVENTION: We evaluated the system's operation from 2011–2015 using the Centers for Disease Control and Prevention (CDC) updated guidelines for evaluating public health surveillance systems and the World Health Organisation (WHO) TB surveillance checklist for assessing the performance of national surveillance systems. RESULTS: The TB surveillance system in the municipality was functional and operated at all levels for timely detection of cases, accurate diagnosis, and case management. The system improved management of TB/HIV co-infections. The average time taken to confirm a suspected TB case was one day. The registration of a confirmed case and subsequent treatment happen immediately after confirmation. The municipality detected 109 of 727 TB cases in 2015 (case detection rate=15%). The positive predictive value (PPV) was 6.4%. There was one diagnostic centre in the municipality. Private facilities involvement in TB surveillance activities was low (1/15). CONCLUSION: The Tuberculosis surveillance system in the Ga West Municipality is well structured but partially meeting its objectives. The system is timely, stable and acceptable by most stakeholders and useful at all levels. It has no major data quality issues. Private health facilities in the municipality should be well incorporated into TB surveillance. FUNDING: This work was supported by Ghana Field Epidemiology and Laboratory Training Program (GFELTP), University of Ghana through the support of the West Africa Health Organization (Ref.: Prog/A17IEpidemSurveillN° 57212014/mcrt) to B-YA