Dengue epidemiological surveillance in the Golfe Health District, Togo: A performance evaluation following the 2024 outbreak

Introduction: Dengue is a mosquito-borne viral disease that has emerged as a growing public health concern in West Africa. The 2024 dengue outbreak in Togo highlighted important weaknesses in epidemiological surveillance, particularly at the district level. This study evaluated the performance of dengue epidemiological surveillance in the Golfe Health District (HD) in 2024. Methods: A mixed-methods study was conducted from August 2024 to April 2025 to evaluate the dengue surveillance system in the Golfe HD. Data were collected from all health facilities in the district and from key surveillance stakeholders. Surveillance performance was assessed across three components: structure, process, and outcomes, using a standardised performance evaluation framework. Results: The overall performance score of the dengue surveillance system was 38.5%, indicating poor performance. The structure, process, and outcome components achieved scores of 42.6%, 52.8%, and 19.9%, respectively. Major weaknesses included the absence of epidemic thresholds and displayed dengue case definitions, insufficiently trained personnel (7.4%), weak feedback mechanisms (22.2%), limited response capacity (22.2%), and the lack of dedicated financial resources. However, case detection (96.3%), laboratory confirmation (96.3%), notification (85.2%), and supervision (100%) showed satisfactory performance. Conclusion: Dengue epidemiological surveillance in the Golfe Health District showed poor overall performance following the 2024 outbreak. Strengthening staff training, improving feedback mechanisms, enhancing coordination among surveillance actors, and ensuring dedicated financial resources are essential to improve dengue surveillance and outbreak preparedness in Togo.