what is the strength of this paper The team conducted a systematic active casefinding survey based on the above field case definition. The team visited the two main hospitals of the affected area (Nertiti rural hospital and Nyala) and actively assessed the present medical records, admission sheets, laboratory registers and pharmacy logbooks. Additionally, ‘‘shoe-leather epidemiology’’ was used for active case finding at the village and household levels within the residential areas from which the index cases were reported. The investigation team visited the following villages during the field outbreak investigation missions: • Khour Ramla, • Fukodoko, • Rijl Aldalaba, • Toor, • Tibbi, • Jurfambari, • Norma. Based on the above-mentioned case definition, the investigation team generated the initial outbreak line list. Nine additional cases were added as a result of active case finding, bringing the total to 16 cases for the initial line list. Fresh blood samples were collected from the acutely febrile patients during the household visits (the samples were used for serology and blood films for malaria

The strength of this paper lies in its comprehensive and systematic approach to active case finding. The team not only visited the two main hospitals in the affected area, but also meticulously assessed medical records, admission sheets, laboratory registers, and pharmacy logbooks. This thorough examination of data sources increases the reliability and validity of the findings.

Moreover, the team employed "shoe-leather epidemiology," actively seeking out cases at the village and household levels. This hands-on approach allows for a more accurate and complete picture of the outbreak, as it includes cases that may not have sought medical attention and thus would not be included in hospital data.

The paper also demonstrates a clear and consistent case definition, which is crucial for accurate identification and reporting of cases. The team's generation of an initial outbreak line list, and their subsequent addition of cases found through active case finding, shows a systematic and organized approach to data collection.

Finally, the collection of fresh blood samples from acutely febrile patients during household visits allows for immediate and accurate diagnosis, further strengthening the study's findings.

In summary, the strengths of this paper include its systematic and comprehensive approach to data collection, its hands-on case finding at the community level, its clear case definition, and its immediate and accurate diagnostic testing.