{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T09:32:35Z","timestamp":1790501555922,"version":"4.1.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Security"],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:p>\n                    Community-based surveillance can be an important component of early warning systems. In 2016, the C\u00f4te d'Ivoire Ministry of Health launched a community-based surveillance project in 3 districts along the Guinea border. Community health workers were trained in detection and immediate reporting of diseases and events using a text-messaging platform. In December 2017, surveillance data from before and after implementation of community-based surveillance were analyzed in intervention and control districts. A total of 3,734 signals of priority diseases and 4,918 unusual health events were reported, of which 420 were investigated as suspect diseases and none were investigated as unusual health events. Of the 420 suspected cases reported, 23 (6%) were laboratory confirmed for a specific pathogen. Following implementation of community-based surveillance, 5-fold and 8-fold increases in reporting of suspected measles and yellow fever clusters, respectively, were documented. Reporting incidence rates in intervention districts for suspected measles, yellow fever, and acute flaccid paralysis were significantly higher after implementation, with a difference of 29.2, 19.0, and 2.5 cases per 100,000 person-years, respectively. All rate differences were significantly higher in intervention districts (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.05); no significant increase in reporting was noted in control districts. These findings suggest that community-based surveillance strengthened detection and reporting capacity for several suspect priority diseases and events. However, the surveillance program was very sensitive, resulting in numerous false-positives. Learning from the community-based surveillance implementation experience, the ministry of health is revising signal definitions to reduce sensitivity and increase specificity, reviewing training materials, considering scaling up sustainable reporting platforms, and standardizing community health worker roles.\n                  <\/jats:p>","DOI":"10.1089\/hs.2019.0062","type":"journal-article","created":{"date-parts":[[2020,1,31]],"date-time":"2020-01-31T14:44:20Z","timestamp":1580481860000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Community-Based Surveillance in C\u00f4te d'Ivoire"],"prefix":"10.1177","volume":"18","author":[{"given":"Alexey","family":"Clara","sequence":"first","affiliation":[{"name":"Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office C\u00f4te d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, C\u00f4te d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, C\u00f4te d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Heal..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serigne M.","family":"Ndiaye","sequence":"additional","affiliation":[{"name":"Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office C\u00f4te d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, C\u00f4te d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, C\u00f4te d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Heal..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benie","family":"Joseph","sequence":"additional","affiliation":[{"name":"Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office C\u00f4te d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, C\u00f4te d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, C\u00f4te d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Heal..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice A.","family":"Nzogu","sequence":"additional","affiliation":[{"name":"Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office C\u00f4te d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, C\u00f4te d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, C\u00f4te d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Heal..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daouda","family":"Coulibaly","sequence":"additional","affiliation":[{"name":"Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office C\u00f4te d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, C\u00f4te d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, C\u00f4te d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Heal..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen A.","family":"Alroy","sequence":"additional","affiliation":[{"name":"Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office C\u00f4te d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, C\u00f4te d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, C\u00f4te d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Heal..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djebo C.","family":"Gourmanon","sequence":"additional","affiliation":[{"name":"Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office C\u00f4te d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, C\u00f4te d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, C\u00f4te d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Heal..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamadou","family":"Diarrassouba","sequence":"additional","affiliation":[{"name":"Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office C\u00f4te d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, C\u00f4te d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, C\u00f4te d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Heal..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramatou","family":"Toure-Adechoubou","sequence":"additional","affiliation":[{"name":"Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office C\u00f4te d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, C\u00f4te d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, C\u00f4te d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Heal..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koffi Ange","family":"Houngbedji","sequence":"additional","affiliation":[{"name":"Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office C\u00f4te d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, C\u00f4te d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, C\u00f4te d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Heal..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry Banny","family":"Attiey","sequence":"additional","affiliation":[{"name":"Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office C\u00f4te d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, C\u00f4te d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, C\u00f4te d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Heal..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Arunmozhi","family":"Balajee","sequence":"additional","affiliation":[{"name":"Alexey Clara, MD, Karen A. Alroy, DVM, and Djebo C. Gourmanon, MD, are Epidemiologists, and S. Arunmozhi Balajee, PhD, is Associate Director of Global Health Security; all in the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Serigne M. Ndiaye, PhD, is Program Director; Mamadou Diarrassouba, MD, is Emergency Management Lead; and Ramatou Toure-Adechoubou, PharmD, is a Public Health Specialist for Laboratory; all in the Division of Global Health Protection, Country Office C\u00f4te d'Ivoire, Center for Global Health, Centers for Disease Control and Prevention (CDC), Abidjan, C\u00f4te d'Ivoire. Benie Joseph is a Professor and Director of Public Health, and Daouda Coulibaly, MD, MPH, is Deputy Director, Epidemiology Hygiene Research; both at the National Institute of Public Hygiene, Abidjan, C\u00f4te d'Ivoire. Maurice A. Nzogu holds a master's degree in humanitarian aid and international cooperation and is the Deputy Heal..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,1,31]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2019.24.2.1800681"},{"key":"e_1_3_2_3_2","unstructured":"Ministry of Health Liberia. Community Event-based Surveillance Manual for Integrated Disease Surveillance and Response in Liberia. Liberia: Ministry of Health; 2016. https:\/\/www.medbox.org\/liberia\/community-event-based-surveillance-manual-for-integrated-disease-surveillance-and-response-in-liberia\/preview?q=. Accessed November8 2019."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2208.160205"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.5365\/wpsar.2015.6.2.002"},{"key":"e_1_3_2_6_2","first-page":"8","article-title":"Community event-based surveillance for Ebola virus disease in Sierra Leone: implementation of a national-level system during a crisis","author":"Stone E","year":"2016","unstructured":"Stone E, , Miller L, , Jasperse J, et al. Community event-based surveillance for Ebola virus disease in Sierra Leone: implementation of a national-level system during a crisis. PLoS Curr, 2016; 8.","journal-title":"PLoS Curr"},{"key":"e_1_3_2_7_2","volume-title":"Integrated Diseases Surveillance and Response in the African Region: A Guide for Establishing Community-based Surveillance","author":"World Health Organization Regional Office for Africa","year":"2014","unstructured":"World Health Organization Regional Office for Africa. Integrated Diseases Surveillance and Response in the African Region: A Guide for Establishing Community-based Surveillance. Geneva, Switzerland: World Health Organization; 2014."},{"key":"e_1_3_2_8_2","volume-title":"Community Health Workers: What Do We Know about Them? The state of the evidence on programs, activities, costs and impact on health outcomes of using community health workers","author":"Lehmann U","year":"2007","unstructured":"Lehmann U, , Sanders D. Community Health Workers: What Do We Know about Them? The state of the evidence on programs, activities, costs and impact on health outcomes of using community health workers. Geneva, Switzerland: World Health Organization; 2007."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.15.164020"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2409.171851"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/hs.2018.0066"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/18.2.89"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/hs.2015.0062"},{"key":"e_1_3_2_14_2","unstructured":"World Health Organization Regional Office for Africa. Technical Guidelines for Integrated Dissease Surveillance and Response in the African Region. Geneva Switzerland: World Health Organization; 2010. https:\/\/www.afro.who.int\/publications\/technical-guidelines-integrated-disease-surveillance-and-response-african-region-0. Accessed November8 2019."},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/bsp.2013.0032"},{"key":"e_1_3_2_16_2","volume-title":"Integrated Disease Surveillance Quarterly Bulletin","author":"World Health Organization, Regional Office for Africa","year":"2016","unstructured":"World Health Organization, Regional Office for Africa. Status of the implementation of the IDSR second edition in 2010 in the WHO African region. Integrated Disease Surveillance Quarterly Bulletin. Brazzaville, Republic of Congo; 2016."},{"key":"e_1_3_2_17_2","unstructured":"World Health Organization. Early Detection Assessment and Response to Acute Public Health Events: Implementation of Early Warning and Response with a Focus on Event-based Surveillance. Interim version. Geneva Switzerland: World Health Organization; 2014. https:\/\/www.who.int\/ihr\/publications\/WHO_HSE_GCR_LYO_2014.4\/en\/. Accessed November8 2019."},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41256-017-0055-6"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/1478-4491-4-24"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2012.06.005"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2010.0081"}],"container-title":["Health Security"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/hs.2019.0062","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/hs.2019.0062","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/hs.2019.0062","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:39:42Z","timestamp":1777451982000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/hs.2019.0062"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,1]]},"references-count":20,"journal-issue":{"issue":"1_suppl","published-print":{"date-parts":[[2020,1,1]]}},"alternative-id":["10.1089\/hs.2019.0062"],"URL":"https:\/\/doi.org\/10.1089\/hs.2019.0062","relation":{},"ISSN":["2326-5094","2326-5108"],"issn-type":[{"value":"2326-5094","type":"print"},{"value":"2326-5108","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,1]]}}}