Evaluation of the Measles Surveillance System Performance in the Mbandaka Health Zone, Équateur Province, Democratic Republic of Congo: January to December 2025
Abstract
Background
Measles remains a major public health problem in the Democratic Republic of Congo, particularly in the city of Mbandaka, where outbreaks are regularly reported despite the availability of an effective vaccine. The evaluation of surveillance systems is essential to determine their capacity to detect cases early, report alerts, and implement appropriate control measures.
Objective
This study aimed to evaluate the measles surveillance system in the Mbandaka Health Zone, Équateur Province, to assess its performance and propose evidence-based recommendations for strengthening epidemic preparedness and response.
Methods
A descriptive cross-sectional study was conducted from January to December 2025, following the Centers for Disease Control and Prevention (CDC) guidelines for surveillance system evaluation. Data were collected from 15 health facilities, the Provincial Health Division, the Expanded Program on Immunization (EPI) office, and 22 healthcare providers involved in measles surveillance. A standardized questionnaire was administered, and surveillance records were reviewed. Key attributes analyzed included usefulness, simplicity, sensitivity, specificity, representativeness, timeliness, data quality, acceptability, and stability.
Results
The surveillance system demonstrated high usefulness (100%) and specificity (100%), with all health facilities reporting suspected cases. However, important gaps were identified. Simplicity was rated at 71%, with some providers reporting difficulties in completing notification forms. Sensitivity was 64%, indicating under-detection of community cases. Acceptability was 72%, limited by lack of financial motivation and feedback. Stability was very low (14%) due to frequent stockouts of surveillance materials and dependence on external funding. Data quality was poor (27% completeness). Timeliness showed that 78% of cases met the 72-hour notification-to-analysis target. Among 127 suspected cases, 56% were laboratory-confirmed, and 70% of samples met quality standards for collection and transport.
Conclusion
The measles surveillance system in the Mbandaka Health Zone is useful and functional but faces significant challenges in stability, data quality, sensitivity, and timeliness. Strengthening provider training, ensuring adequate logistics, improving feedback mechanisms, and securing sustainable financing are essential to enhance system performance and progress toward measles elimination goals.
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How to cite
Engesu Bobala, F. (2026). Evaluation of the Measles Surveillance System Performance in the Mbandaka Health Zone, Équateur Province, Democratic Republic of Congo: January to December 2025. SDF Journal of Public Health. https://sfoundation.one/articles/sdf-2026-0050-evaluation-of-the-measles-surveillance-system-performance-in-the-mband