Abstract:
Background: The correct knowledge of standard case definition is necessary for frontline
health workers to diagnose suspected diseases across Africa. However, surveillance
evaluations commonly assume this prerequisite. This study assessed the knowledge of
case definitions for health workers and their supervisors for disease surveillance
activities in rural Kenya.
Methods: A cross-sectional survey including 131 health workers and their 11 supervisors
was undertaken in two counties in Kenya. Descriptive analysis was conducted to classify
the correctness of knowledge into four categories for three tracer diseases (dysentery,
measles, and dengue). We conducted a univariate and multivariable logistic regression
analyses to explore factors influencing knowledge of the case definition for dysentery.
Results: Among supervisors, 81.8% knew the correct definition for dysentery, 27.3% for
measles, and no correct responses were provided for dengue. Correct knowledge was
observed for 50.4% of the health workers for dysentery, only 12.2% for measles, and
none for dengue. Of 10 examined factors, the following were significantly associated
with health workers' correct knowledge of the case definition for dysentery: health
workers' cadre (aOR 2.71; 95% CI 1.20-6.12; p = 0.017), and display of case definition
poster (aOR 2.24; 95% CI 1.01-4.98; p = 0.048). Health workers' exposure to the
surveillance refresher training, supportive supervision and guidelines were not
significantly associated with the knowledge.
Conclusion: The correct knowledge of standard case definitions was sub-optimal among
health workers and their supervisors, which is likely to impact the reliability of routine
surveillance reports generated from health facilities.