Title : Evaluation of the measles surveillance system in zamfara state Nigeria, 2026

Introduction: Measles remains a significant public health challenge in Zamfara State, Nigeria, with recurrent outbreaks despite ongoing immunization and surveillance efforts. Surveillance System Evaluation (SSE) is critical for determining whether the surveillance system effectively supports case detection, reporting, laboratory confirmation, and outbreak response. This study evaluated the performance and key attributes of the measles surveillance system in Zamfara State.

Methods: A cross-sectional SSE was conducted using the updated CDC guidelines for evaluating public health surveillance systems. Mixed methods were employed, including review of surveillance records and reports from 2020-2024, structured questionnaires administered to surveillance officers, and key informant interviews with stakeholders at state and LGA levels. Attributes assessed included simplicity, acceptability, sensitivity, representativeness, timeliness, usefulness, flexibility, and data quality. Quantitative data were analyzed using Microsoft Excel, while qualitative data were analyzed thematically.

Results: Between 2020 and 2024, 3,733 suspected measles cases and 10 deaths were reported. The system was integrated within the IDSR framework and supported by SORMAS. Most respondents reported that the system was simple to operate (96.8%) and surveillance procedures were easy to follow (93.5%). Acceptability was high, with 96.8% indicating willingness to participate in surveillance activities. The system demonstrated good sensitivity and representativeness, with broad LGA coverage and effective outbreak detection. Timeliness was satisfactory, with 95.2% of suspected cases reportedly notified within 24 hours. However, inconsistencies between paper-based and electronic records, incomplete data, delayed laboratory feedback, and limited surveillance activities in hard-to-reach areas were identified.

Conclusion and Public Health Implications: The measles surveillance system in Zamfara State is functional, useful, and effective for outbreak detection and response. Strengthening data quality, improving laboratory feedback mechanisms, and expanding surveillance activities in hard-to-reach communities will enhance system performance and support progress toward measles elimination goals.

Keywords: Measles; Surveillance System Evaluation; Public Health Surveillance; IDSR; SORMAS; Nigeria.

To be updated shortly..