Evaluation of respiratory pathogens sentinel surveillance system, Jasikan Municipality, Ghana, 2025

Introduction: Following the COVID-19 pandemic, Ghana expanded the Respiratory Pathogen Sentinel Surveillance (RPSS) system and incorporated SARS-CoV-2 testing into the existing influenza surveillance platform. However, the performance of the newly established sentinel site in Jasikan Municipality had not been formally evaluated. We assessed whether the system met its objectives, was useful, and its attributes to provide targeted recommendations. Methods: We conducted a descriptive evaluation using the updated CDC guidelines for public health surveillance systems. Influenza-like illness (ILI) and severe acute respiratory infection (SARI) records from April 2022 to December 2024 were extracted from Surveillance Outbreak Response Management and Analysis System (SORMAS) and validated against case investigation forms and other records. Data collection included stakeholder interviews using semi-structured questionnaires, direct observation, and document review. Quantitative data were analysed descriptively, while qualitative data underwent deductive thematic analysis. Surveillance attributes were assessed using indicators scored from 1 to 3, with mean scores classified as weak (1.0–<1.8), moderate (1.8–<2.4), or good (≥2.4–3.0). Results: A total of 555 suspected respiratory pathogen cases were reported, including 83 laboratory-confirmed influenza cases (15.0%) and 16 SARS-CoV-2 cases (2.9%). Three outbreak signals were detected during the period. Core variables were >95% complete, although completeness was lower for traceable address 389/555 (70.1%) and reporting time 362/555 (65.2%). Weekly reporting was timely on 154/156 (98.7%) of expected reporting weeks, and 93.7% of laboratory results were returned within 7 days. Samples were transported in 71.8% of expected weeks, while the weekly ILI sampling target was achieved in 80.0% of expected sampling weeks. Attribute scores were good for acceptability (3.0), flexibility (3.0), representativeness (2.7), simplicity (2.7), sensitivity (2.7) and stability (2.6), but moderate for data quality (2.3). The system supported three outbreak investigations and 12 public health actions. Conclusion: The RPSS system in Jasikan Municipality met its objectives and is useful, with good performance in acceptability, flexibility, representativeness, simplicity, timeliness, sensitivity, and stability. However, moderate data quality, incomplete sample transportation coverage, and suboptimal achievement of sampling targets indicate areas requiring improvement to strengthen surveillance performance and ensure consistent case detection and laboratory confirmation.