
{ "background": "Public health surveillance systems in sub-Saharan Africa are critical for disease control, yet their methodological rigour and yield—the proportion of true cases detected—are often suboptimal. Systematic evaluations quantifying the impact of specific interventions on surveillance yield are lacking.", "purpose and objectives": "This study aimed to methodologically evaluate an enhanced surveillance intervention and quantify its effect on case detection yield within the Tanzanian Integrated Disease Surveillance and Response system. The primary objective was to measure yield improvement across sentinel facilities.", "methodology": "We conducted a quasi-experimental intervention study across four regions. The intervention comprised targeted training, streamlined reporting protocols, and integrated data feedback loops. Performance was assessed using a two-level hierarchical model: $\\logit(\\pi{ij}) = \\beta0 + \\beta1 X{ij} + uj + e{ij}$, where $\\pi{ij}$ is the yield for facility $i$ in district $j$, $X{ij}$ denotes intervention status, and $u_j$ are district-level random effects. Inference was based on robust standard errors.", "findings": "The intervention was associated with a significant increase in mean surveillance yield. Adjusted analysis showed a 17.2 percentage point improvement (95% CI: 12.5 to 21.9) in intervention facilities compared to controls. The multilevel model indicated significant residual variance attributable to district-level factors.", "conclusion": "Methodological enhancements focusing on training and data feedback can substantially improve the yield of public health surveillance. The success of the intervention was moderated by contextual district-level variables.", "recommendations": "National programmes should adopt structured, data-driven feedback mechanisms as a core component of surveillance strengthening. Future interventions must account for and mitigate higher-level administrative heterogeneities to ensure equitable improvements.", "key words": "surveillance evaluation, yield optimisation, multilevel modelling, health systems strengthening, sub-Saharan Africa", "contribution statement": "This study provides a novel methodological framework for
sub-Saharan Africa, methodological evaluation, yield optimisation, multilevel regression, public health surveillance, health systems strengthening
sub-Saharan Africa, methodological evaluation, yield optimisation, multilevel regression, public health surveillance, health systems strengthening
| selected citations These citations are derived from selected sources. This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | 0 | |
| popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network. | Average | |
| influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically). | Average | |
| impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network. | Average |
