Performance and Trends in Measles Case-Based Surveillance in the North West Region of Cameroon, 2009 to 2015

Background: Measles is a highly contagious viral disease associated with high morbidity and mortality in developing countries. As an infection with no specific treatment, its control is most importantly through vaccination and adequate disease surveillance. National immunization coverage for the first dose of measles/rubella vaccine in 2019 was 71%. As a result, measles continues to rage with outbreaks not sparing the North West Region (NWR) of Cameroon, hence the need for proper surveillance. Objective: Assess performance of measles case-based surveillance in the NWR of Cameroon. Methods: This was a cross-sectional, descriptive study with retrospective collection of measles surveillance records carried out at the Regional Delegation of Public Health from 2009 to 2015. The data collected using a structured form were: number of persons suspected of measles;number of persons reported to district service;number of persons whose samples were collected and forwarded to the laboratory;number whose results reached the Expanded Programme on Immunization (EPI) Central unit and the time lapse between successive phases. Results: Although not all planned activities were carried out, a constant increase in planned and carried out monitoring activities was found. The average time taken from onset of signs and symptoms in a measles case to consultation at a health facility, from consultation to notification of case to district service, from notification to investigation, from investigation to receipt of biological sample at laboratory, from receipt of sample to provision of results to the EPI Central unit, and from collection of sample to reception of results at the Central EPI unit was 2.59 days, 1.5 days, 1.5 days, 2.6 days, 4 days and 6.6 days respectively. Conclusion: There was an overall rising trend in the performance of measles case-based surveillance, although the high priority site visits witnessed a stagnation during the period, a large scale measles epidemic occurred (2015). The duration between phases of the surveillance system was within acceptable limits of WHO standards for an effective system. However, the proportion of samples reaching the laboratory and whose results are received at EPI Central Unit was 77.6%, which is lower than ≥80% prescribed by WHO.