• Asia
  • India
  • Surveillance
  • Enteric fever
  • Site Evaluation
2019 — 2019

Evaluating tier 2 surveillance sites for the National Surveillance System for Enteric Fever in India


An independent site evaluation of a multicentric surveillance project for enteric fever in India.

MMGH/Thomas Cherian
  • New Format
  • To evaluate tier 2 surveillance sites in the National Surveillance System for Enteric Fever in India (NSSEFI) and provide recommendations for improving surveillance at these sites.
MMGH conducted an independent external evaluation of the tier 2 sites of the NSSEFI 3-tier surveillance system for enteric fever (typhoid and paratyphoid) in India. Tier 2 conducts health facility-based passive surveillance. These sites pose special challenges as most of the hospitals are in remote areas where laboratory capacity to perform blood culture had to be established or strengthened. They are secondary level hospitals that conduct surveillance on patients with suspected enteric fever and were purposefully chosen to document the disease and economic burden of enteric fever in areas where access to health care is challenging. Furthermore, conducting high-quality laboratory-based surveillance in settings that normally do not perform research is especially complex. The evaluation was conducted after the completion of one full year of surveillance. It aimed to identify problems with case detection and enrolment, laboratory investigation and data management. The evaluation consisted of document reviews, direct observations, and interviews using standardized questionnaires and forms. Based on the evaluation, recommendations for corrective action were made.

The evaluation enabled the principal investigator to take corrective action to improve surveillance practices.


Focus Area