Sparks creating light? Strengthening peripheral disease surveillance in the Democratic Republic of Congo

Setting: The Democratic Republic of Congo suffers from an amalgam of disease outbreaks and other medical emergencies. An efficient response to these relies strongly on the national surveillance system. The Pool d'Urgence Congo (PUC, Congo Emergency Team) of Médecins Sans Frontières is a project that responds to emergencies in highly remote areas through short-term vertical interventions, during which it uses the opportunity of its presence to reinforce the local surveillance system.

Objective: To investigate whether the ancillary strengthening of the peripheral surveillance system during short-term interventions leads to improved disease notification.

Design: A descriptive paired study measuring disease notification before and after 12 PUC interventions in 2013–2014.

Results: A significant increase in disease notification was observed after seven mass-vaccination campaigns and was sustained over 6 months. For the remaining five smaller-scaled interventions, no significant effects were observed.

Conclusion: The observed improvements after even short-term interventions underline, on the one hand, how external emergency actors can positively affect the system through their punctuated actions, and, on the other hand, the dire need for investment in surveillance at peripheral level.