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Revision of Meningitis Surveillance System in Jordan during 2001 and 2014 Years

Kariman Al-Zain

Background: Since 2002 a specific categorization of meningitis cases was initiated in Directorate of Communicable Diseases (DCD). Analyzing data reveals severe underreporting of meningitis cases from some reporting sites ( up to zero), therefore it is important to conduct a study that measures sensitivity of the system( data quality, predictive value positive and representativeness).

Objective: To determine proportion of cases that fit adopted case definition (by WHO) and to determine completeness of data received by DCD from hospitals.

Methodology: The researcher adopted a case definition based on WHO criteria for suspected and probable cases and applied it to viral meningitis in order to determine what proportion of cases fits case definition. To calculate the sensitivity of the surveillance system, clinical records of all meningitis cases admitted to four major hospitals from different health sectors were reviewed during the study period and compared to reported cases to the DDC.

Results: The researcher identified and evaluated all meningitis cases in 2001 and 2014 years, 7% fit the suspected WHO case definition for viral meningitis in ages < 2 years and 1.3% fit the probable. For ages >= 2 years 76% fit the suspected cases and 26.8% fit probable. The sensitivity for all types for hospital A=10%, hospital B=50%, hospital C=63% and hospital D=99%. Hospital A is the largest referral hospital in Jordan.

Conclusions: Non-standardized case definition by clinicians plagues the meningitis surveillance system. Targeted efforts to strengthen the system should be adopted by the Ministry of Health (National Clinical Guidelines, Active System Versus Passive).