Incorporating selected non-communicable diseases into facility-based surveillance systems from a resource-limited setting in Africa

Abstract

BackgroundAs Mozambique faces a double burden of diseases, with a rise of Non Communicable Diseases (NCD) superimposed to uncontrolled communicable diseases (CD), routine disease surveillance system does not include NCD. The objectives of our study were to i) upgrade of the current surveillance system by adapting the data collection tools to NCD; ii) describe the occurrence and profile of selected NCD using these data collection tools.MethodsWorkshops were implemented in a first referral urban hospital of Mozambique to train clinical staff, administrative workers and nurses on NCD surveillance, as well as select conditions to be prioritized. Based on the WHO Global Action Plan and Brazaville Declaration for NCD prevention and control, we selected arterial hypertension, diabetes, stroke, chronic respiratory diseases, mental illness and cancers. Data collection tools used for CD were changed to include age, gender, outcome and visit type. Between February/2014 and January/2015 we collected data at an urban hospital in Mozambique’s capital.ResultsOver 12 months 92,018 new patients were assisted in this hospital. Data was missing or diagnosis was unreadable in 2637 (2.9%) thus only 89,381 were used for analysis; of these 6423 (median age 27 years; 58.4% female) had at least one selected NCD as their primary diagnosis: arterial hypertension (2397;37.31%), mental illness (1497;23.30%), asthma (1495;23.28%), diabetes (628;9.78%), stroke (299;4.66%), chronic obstructive pulmonary disease 61 (0.95%) and cancers 46 (0.72%). Emergency transfers were needed for 76 patients (1.2%), mainly due to hypertensive emergencies (31; 40.8%) and stroke (18;23.7%). Twenty-four patients died at entry points (0.3%); 10 of them had hypertensive emergencies.ConclusionChanges in existing surveillance tools for communicable diseases provided important data on the burden and outcomes of the selected NCD helping to identify priority areas for training and health care improvement. This information can be used to design the local NCD clinics and to strengthen the health information system in resource-limited settings in a progressive and sustainable way.Electronic supplementary materialThe online version of this article (10.1186/s12889-019-6473-2) contains supplementary material, which is available to authorized users.

Assessment of Care Provision for Hypertension at Emergency Department of an Urban Hospital in Mozambique

“…Purposeful surveillance of ED presentations was conducted during the pilot phase of the MOZambique snApshot of emeRging Trends (MOZART) Disease Surveillance Study cohort [9],, in October 2017. We did a pragmatic and prospective, single centre, 30-day snapshot study (with 24 hour surveillance) with random profiling of one-in-five presentations to the ED of Hospital Geral De Mavalane, Maputo.…”

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“…In Mozambique, existing data collection tools have been successfully adapted to include tracking of NCDs in addition to communicable diseases in a hospital setting. 110 In India, primary care registries have been successfully applied toward diabetes surveillance. 111 In areas with limited patient access to care facilities, syndromic surveillance may be facilitated by mobile digital technologies 112 , 113 or community healthcare workers.…”

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