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BACKGROUND: Effective surveillance for infectious diseases is an essential component of public health. There are few studies estimating the cost-effectiveness of starting or improving disease surveillance. We present a cost-effectiveness analysis the Integrated Disease Surveillance and Response (IDSR) strategy in Africa. METHODOLOGY/PRINCIPAL FINDINGS: To assess the impact of the IDSR in Africa, we used pre- and post- IDSR meningococcal meningitis surveillance data from Burkina Faso (1996-2002 and 2003-2007). IDSR implementation was correlated with a median reduction of 2 weeks to peak of outbreaks (25 (th) percentile 1 week; 75 (th) percentile 4 weeks). IDSR was also correlated with a reduction of 43 meningitis cases per 100, 000 (25 (th) -40: 75 (th) -129). Assuming the correlations between reductions in time to peak of outbreaks and cases are related, the cost-effectiveness of IDSR was 23 per case averted (25 (th) -30; 75 (th) --cost saving), and 98 per meningitis-related death averted (25 (th) -140: 75 (th) --cost saving). CONCLUSIONS/SIGNIFICANCE: We cannot absolutely claim that the measured differences were due to IDSR. We believe, however, that it is reasonable to claim that IDSR can improve the cost-effectiveness of public health surveillance.
Somda et al. (Tue,) studied this question.