Title : Evaluation of the tuberculosis surveillance system in the kouto health district, Côte d'Ivoire, 2025

Introduction: Ivory Coast, like the majority of countries in Sub-Saharan Africa, has a high endemicity of tuberculosis. In 2023, it reported 21,458 cases, including 1,717 deaths. The Kouto health district in Bagoué province is no exception. Surveillance is one of the effective control strategies. However, in Kouto, the tuberculosis surveillance system has never been evaluated. This study was conducted to describe the functioning of the tuberculosis surveillance system in the Kouto health district and to assess its attributes .  Methods: A descriptive cross-sectional study was conducted from April to July 2025. It included stakeholders in the Kouto health system involved in tuberculosis surveillance . The functioning of the surveillance system was described. Its usefulness, simplicity, acceptability, completeness, timeliness, and sensitivity were evaluated. The collected data were processed and analyzed using Excel and Epi Info. The results were presented in text and graphical formats.

Results: Standards and procedures were absent in 93% of facilities. The data notification and management procedure was simple (87%), but insufficient adherence to its steps was observed. The system was acceptable in terms of provider availability and motivation to report detected cases (100%), however, it was not acceptable for active case finding (17%). Completeness was good (93%). Reports were submitted promptly (100%), treatment was initiated (70%), and follow-up examinations were completed (53%). The notification rate was 6 to 11 cases per 100,000 inhabitants, with a positivity rate of 4 to 11%.

Conclusion: The tuberculosis surveillance system complies with national standards and procedures. It is proving useful in the process of eliminating this disease. Its simplicity and completeness are good. Its timeliness and acceptability are average, and its sensitivity is low. Involving all service providers by training them on standards and procedures, and providing adequate material and logistical resources, would improve the operation and performance of this surveillance system in Kouto.

Keywords: Evaluation, System, Surveillance, Tuberculosis, Kouto, Ivory Coast.

After completing my Baccalaureate (Series D), I studied nursing and midwifery at the National Institute for Health Worker Training in Côte d'Ivoire, where I earned my State Diploma in Nursing (2003). I joined the Ministry of Health and Hygiene (2004). I then obtained a Master's degree in Community Health Research from Alassane Ouattara University in Bouaké, Côte d'Ivoire, in 2018. I received certification in Field Epidemiology (Frontline in 2020 and Intermediate in 2025). I have published a book and an article. I was named Best Health Worker for Tuberculosis Management in Poro-TchologoBagoué, Côte d'Ivoire, in 2018.