Professional Assessment of Integrated Disease Surveillance and Response System Functionality in Cross River State

The Integrated Disease Surveillance and Response system is the backbone of Nigeria's public health security infrastructure, and its functionality at the state and LGA levels determines the speed and effectiveness of epidemic detection and response. This study assessed IDSR system functionality in Cross River State, South South Nigeria. A health systems assessment design was employed across 18 sentinel sites, nine LGA health information system offices, and the State Epidemiology Department. Assessment tools included structured IDSR functionality checklists adapted from the WHO AFRO standards, document review of weekly disease notification reports for 2022 to 2023, and structured interviews with 27 disease surveillance and notification officers. IDSR functionality was scored across eight core capacities: case detection, reporting, data quality, analysis, feedback, response preparedness, resource availability, and coordination. Results showed that only 44.4 percent of sentinel sites achieved acceptable scores across all eight capacities. Case detection timeliness (notifiable disease reports within 24 hours of suspicion) was achieved in 55.6 percent. Report completeness across the 52-week review period was 68.4 percent. Epidemic investigation capacity was present at state level but absent at 77.8 percent of LGA offices. Communication equipment for alert transmission was functional in 61.1 percent of sites. The study recommends a state IDSR strengthening action plan, annual DSNO refresher training, and emergency communication equipment provision to all LGA-level IDSR focal persons in Cross River State.

Keywords: IDSR, disease surveillance, epidemic preparedness, Cross River State, health systems