Home | Supplements | Volume ARTVOL | This supplement | Article number 11


Conducting a surveillance problem analysis on poor feedback from Reference Laboratory, Liberia, February 2016

Conducting a surveillance problem analysis on poor feedback from Reference Laboratory, Liberia, February 2016

Joseph Asamoah Frimpong1,&, Maame Pokuah Amo-Addae1, Peter Adebayo Adewuyi1, Meeyoung Mattie Park2, Casey Daniel Hall2, Thomas Knue Nagbe3


1Liberia Field Epidemiology Training Program, Monrovia, Liberia, 2Rollins School of Public Health, Emory University, Atlanta, USA, 3Ministry of Health, Monrovia, Liberia



&Corresponding author
Joseph Asamoah Frimpong, Liberia Field Epidemiology Training Program, Monrovia, Liberia




The laboratory plays a major role in surveillance, including confirming the start and end of an outbreak. Knowing the causative agent for an outbreak informs the development of response strategies and management plans for a public health event. However, issues and challenges may arise that limit the effectiveness or efficiency of laboratories in surveillance. This case study applies a systematic approach to analyse gaps in laboratory surveillance, thereby improving the ability to mitigate these gaps. Although this case study concentrates on factors resulting in poor feedback from the laboratory, practise of this general approach to problem analysis will confer skills required in analysing most public health issues. This case study was developed based on a report submitted by the district surveillance officer in Grand Bassa County, Liberia, as a resident of the Liberian Frontline Field Epidemiology Training Program in 2016. This case study will serve as a training tool to reinforce lectures on surveillance problem analysis using the fishbone approach. It is designed for public health training in a classroom setting and can be completed within 2 hours 30 minutes.



How to use this case study    Down

General instructions: ideally, 1 to 2 instructors facilitate the case study for 8 to 20 students in a classroom or conference room. The instructor should direct participants to read a paragraph out loud, going around the room to give each participant a chance to read. When the participant reads a question, the instructor directs all participants to answer or engage in discussions. The instructor may split the class to play different roles or take different sides in answering a question. As a result, participants learn from each other, not just from the instructors. Specific instructor’s notes are included with each question in the instructor’s version of this case study.


Audience: residents in Frontline Field Epidemiology Training Programs (FETP-Frontline), Field Epidemiology and Laboratory Training Programs (FELTPs), and others who are interested in this topic.


Prerequisites: before using this case study, case study participants should have received lectures or other instruction in surveillance problem analysis using the fishbone approach.


Materials needed: laptop with Microsoft Office applications, flipchart or white board with markers


Level of training and associated public health activity: basic – public health surveillance


Time required: approximately 2 hours 30 minutes


Language: English



Case study material Up    Down



Competing interests Up    Down

The authors declare no competing interest.



Acknowledgments Up    Down

We wish to thank African Field Epidemiology Network and Emory University for supporting African-based case study development. We acknowledge residents of the Liberia Field Epidemiology Training Program and Ministry of Health, Liberia for allowing us to use their data for this case study.



References Up    Down

  1. Liberia Field Epidemiology Training Program. Problem analysis on poor feedback on laboratory results from central laboratory, Owensgrove District, Grand Bassa County. Monrovia, Liberia. 2016.