Publication:

Integrated epidemiological surveillance in Chad: data from 2010 to 2024

Background Despite the adoption of the integrated disease surveillance and response strategy (IDSRS), Chad faces various health challenges, particularly regarding the detection and recording of events; case notification; data collection, processing and transmission; and response. The main of this study is to analyse the evolution and effectiveness of the integrated epidemiological surveillance system in Chad between 2010 and 2024.

Methods This is a retrospective descriptive study. It considers the 6 priority diseases with epidemic potential under surveillance in Chad between 2010 and 2024. The main indicator for monitoring the epidemiological situation is the annual case fatality.

Results Between 2010 and 2024 in Chad, meningitis mortality doubled from 6% to 12% despite a decline in cases, while measles (1.1% mortality before 2019) experienced a surge linked to COVID-19, which was quickly brought under control. There were four cholera outbreaks with fatality rates of 3% (2010-2011), 5.8% (2014), 6.4% (2017) and 4.1% (2019). Neonatal tetanus remained rare but highly fatal (approximately 30% mortality on average), and yellow fever had an average mortality rate of 2.7%. Malaria causes approximately 1,843 deaths each year out of more than 1.2 million suspected cases (mortality rate=0.15%).

Conclusions To strengthen Chad's resilience to epidemiological threats, it is crucial to improve the integration and representativeness of real-time data, training, vaccination coverage, access to difficult areas, infrastructure, and intersectoral coordination, while regularly evaluating the integrated surveillance system.