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Strengthening Epidemiologic Surveillance in Riyadh City.


Surveillance is the cornerstone of epidemiological services. However, from 1989 to 1994, no epidemiologic investigation had been started from surveillance data in Riyadh city. To improve this situation in 1994, we actively involved the Saudi Arabian Field Epidemiology Training Program in surveillance in Riyadh city.


We obtained tabulated data from the four district reporting centers in Riyadh city in 1993. In mid-1994 we routinely visited these same centers to obtain individual case reports and tabulated these ourselves using EpiInfo. We discussed the surveillance system with the doctors responsible for reporting and insisted that all reports be submitted in the same week.


Total case reports rose from 2,521 in 1993 to 4,196 in 1994 (through week 45). The types of diseases reported increased from 30 to 41. Of 173 reporting sources, 97 (56%) reported cases in 1993 and 161 (93%) reported cases in 1994. The delay from detection of a case to data tabulation and review fell from a median of 7 weeks in 1993 to 2 weeks in 1994. After initiation of this active approach, we began investigations of 3 clusters of disease.


Active participation in surveillance at the local level and personal feedback to reporting sources resulted in important increases in cases reported and timeliness of reporting. In assessing surveillance, this type of active intervention may be considered before attempting a formal evaluation.