Improving disease surveillance data analysis, interpretation, and use at the district level in Tanzania

Figures & data

Figure 1. The implementation phases and activities of the capacity-building package.

Box 1. Details on setup of practical exercise to strengthen district capacities in surveillance data analysis, interpretation and use¥.

Figure 2. Surveillance readiness dynamics in data availability, analytical capacity, relations and feedback and capacity enhancement.

Table 1. Performance of surveillance programme dynamics by district.

Dynamics	Ilala			Kinondoni			% Difference between districts’ means
	Average	Minimum	Maximum	Average	Minimum	Maximum
Data availability and value	59.7%	35.4%	70.8%	60.2%	37.5%	70.8%	0.46%
Analytical capacity	51.9%	12.5%	83.3%	61.1%	33.3%	83.3%	9.26%
Relations and feedback	63.6%	22.7%	90.9%	83.3%	50.0%	100.0%	19.70%
Capacity enhancement	68.4%	30.8%	100.0%	91.5%	61.5%	100.0%	23.08%

Table 2. Pre- and post-training scores and percentage difference increase by district.

		Pre-test			Post test			Post – Pre
Category		Ilala	Kinondoni	Diff	Ilala	Kinondoni	Diff	Ilala	Kinondoni
General understanding
Mean		84.1%	90.3%	6.3%	91.3%	93.1%	1.9%	7.2%	2.8%
Minimum		27.3%	63.6%		40.0%	80.0%
Maximum		100.0%	100.0%		100.0%	100.0%
The WWH of epidemiology and public health
Mean		63.6%	75.0%	11.4%	95.0%	90.0%	5.0%	31.4%	15.0%
Minimum		54.5%	72.7%		90.0%	85.0%
Maximum		72.7%	77.3%		100.0%	95.0%
The WWH of data analysis
Mean		75.8%	87.9%	12.1%	93.3%	91.7%	1.7%	17.6%	3.8%
Minimum		63.6%	72.7%		90.0%	75.0%
Maximum		86.4%	100.0%		100.0%	100.0%
Common epidemiological measures
Mean		41.8%	49.1%	7.3%	87.0%	86.0%	1.0%	45.2%	36.9%
Minimum		22.7%	18.2%		70.0%	80.0%
Maximum		72.7%	90.9%		100.0%	100.0%
Uncommon epidemiological measures
Mean		54.5%	61.4%	6.8%	88.8%	85.0%	3.8%	34.2%	23.6%
Minimum		22.7%	27.3%		70.0%	75.0%
Maximum		81.8%	81.8%		95.0%	95.0%

Diff. = Difference; WWH = What, Why and How

Figure 3. The number of reported cases of VHF in Ilala and Kinondoni districts, 2013–2020.

Figure 4. Quarterly number of cases of severe pneumonia in Ilala and Kinondoni districts, 2016–2020.

Table 3. Assessment of VHF data analysis, expected actions and expected actions by district.

Variable	Expected action	Ilala	Kinondoni
Attribute
Threshold for action	Single case	Threshold met	Threshold met
Age category	All years	Analysis by age not determined	Analysis by age not determined
Spatial coverage	All facilities must be included	Affected areas/facilities not determined	Affected areas/facilities not determined
Required reporting	Immediate, Weekly and Monthly	Data available in the system	Data available in the system
Required action	Immediately within 24 hours	None	None
Assessment criterion
Interpretation	Outbreak if threshold met	Outbreak occurred in all years	Outbreak occurred in all years
Detection of the thresholds	Guided by threshold	Not done	Not done
Response	Respond if a case reported	Not done	Not done
Suggested next steps	Continuous monitoring	Improve alert system	Improve alert system

Table 4. Assessment of severe pneumonia data analysis and the expected actions by district.

Variable	Expected action	Ilala	Kinondoni
Attribute
Threshold for action	Number of cases for the period clearly exceeds cases of previous year/season	Threshold met	Threshold met
Age category	Under 5 years	Analysis by age not determined	Analysis by age not determined
Spatial coverage	All facilities must be included	All facilities were included	All facilities were included
Required reporting	Monthly, Quarterly	Data available in the system	Data available in the system
Required action	Appropriate treatment at health facility, appropriate and rapid referral for hospitalization	Follow up check was not done	Follow up check was not done
Assessment criterion
Interpretation	Outbreak if threshold met	Outbreak occurred in some quarter	Outbreak occurred in some quarter
Detection of the thresholds	Guided by threshold	Not done	Not done
Response	Respond if an outbreak reported	Not done	Not done
Suggested next steps	Continuous monitoring	Improve alert system	Improve alert system