Communicable diseases surveillance lessons learned from developed and developing countries: Literature review

Background: Surveillance of infectious diseases is recognized as the cornerstone of public health decision-making and practice. The aim of the evaluation of communicable diseases surveillance systems (CDSS) is ensuring that communicable diseases are monitored efficiently and effectively. The aim of this paper is to reflect on the experiences of both developed and developing countries in the evaluation of CDSS in order to learn lessons from these experiences to improve systems everywhere. Methods: A literature review of studies published in English in PubMed and databases of the World Health Organization (WHO), and Center of Diseases Control (CDC) from 1981 to 2007 was undertaken assessing CDSS. The studies were divided into those from developed and developing countries. Results: A total of 32 studies were included, 20 from developed and twelve from developing countries. Both developed and developing countries faced difficulties in CDSS. Studies from the developed countries have been analysed based on the quality of the system alone. In developing countries, most of the studies have been on the integrated diseases surveillance (IDSR) and have been performed shortly after the adoption of the IDSR. Thus it might be too early to make a fair evaluation. Some of the systems over-centralized, while some lacked private health sector involvement in the system. Further, some of the systems were affected by conflicts and civil wars which are common problems in developing countries. Conclusions: None of the countries had ideal CDSS. The strategy of integrated diseases surveillance seems to be functioning well especially in Africa.