Evaluation of Measles Surveillance System, Bono Region, Ghana

Background Measles remains a global public health problem despite the availability of a safe and effective vaccine, it is one of the leading causes of childhood morbidity and mortality. Hence, this study assessed the performance of the measles surveillance system in the Bono Region of Ghana. Methods A descriptive evaluation study was employed using the updated Centers for Disease Control (CDC) guideline for evaluating public health surveillance systems. The data collection methods employed were observation checklists, questionnaires, and measles records review Results Out of the 12 districts, 83.3% had case definitions. Three-quarters had IDSR reporting forms while 66.7% could transport measles specimens for confirmation. The performance of the supportive functions of the system was sub-optimal. The study revealed that half of the districts were not able to meet most of the standards for the support function. Moreover, timeliness of weekly and monthly reports above 90% was found in the study to be 66.7% and 25% respectively, and just about half of the districts attained over 90% timeliness. Also, the measles surveillance system was simple, flexible, useful, and acceptable despite its low positive predictive value of 1.5%. Conclusion The results of the study suggest that the general performance of the measles surveillance system in the Bono Region was sub-optimal. The performance of the core functions of the surveillance system is considered to be satisfactory. About half of the districts performed satisfactorily for the supportive functions. The completeness and timeliness of the reports were also satisfactory. Also, the Measles surveillance system was simple, flexible, useful, and quite acceptable despite its low positive predictive value. There is a need for capacity building on measles surveillance for surveillance officers and community volunteers, effective supportive supervision, and effective communication at all levels to improve the activities of the surveillance system and ultimately eliminate measles. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ghana Health Service Ethics Review Committee (GHS-ERC) (GHS-ERC 024/06/20) I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors