AVADAR (Auto-Visual AFP Detection and Reporting): demonstration of a novel SMS-based smartphone application to improve acute flaccid paralysis (AFP) surveillance in Nigeria

Shuaib, Faisal; Musa, Philip F.; Gashu, Sisay Tegegne; Onoka, Chima; Ahmed, Salihu Abdullahi; Bagana, Murtala; Galway, Michael; Braka, Fiona; Muluh, Ticha Johnson; Banda, Richard; Akpan, Godwin Ubong; Tunji, Ajiboye; Idris, Umar Kabo; Olusoga, Adedolapo; Briand, Patrick; Obiako, Nwanyibuife; Nebechukwu, Tonia; Mkanda, Pascal

doi:10.1186/s12889-018-6187-x

Cited by 20 publications

(26 citation statements)

References 2 publications

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“…However, in further analysis, it is clearly shown notification within 24 hours increased over the period in 2.4% change. This reflects the contribution of the effects of weekly feedback to countries for the improved surveillance decisions, community AFP surveillance and the use of innovative adaptive surveillance strategies such as AVADAR [ 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, extensive environmental surveillance have been initiated around the world to supplement AFP surveillance and in the East and Southern Africa sub region where by December 2019 was already being implemented in 9 countries [ 9 , 10 ]. The use of adaptive innovative surveillance strategies such as electronic surveillance and geographical information system platforms provided surveillance information and intelligence against security threats and made polio eradication easier, more accountable, more focused/targeted and effective than in the previous years, studies evidence in Nigeria, Liberia, Papua New Guinea and other many countries to mention few [ 11 - 14 ]. The available evidence is supporting that poliomyelitis will remain to be the second disease to be eradicated globally even though the pathway had more programmatic and strategic program environment huddles than it was for smallpox eradication.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of acute flaccid paralysis surveillance performance in East and Southern African countries 2012 - 2019

Manyanga

Byabamazima

Masvikeni

et al. 2020

PAMJ

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Introduction: polio eradication initiatives started in 1988, this is almost the past 32 years following the WHA resolution 41.8 of eradicating polio by the year 2000. As of 2019, only 3 countries remained to be polio endemic globally, Afghanistan, Pakistan and Nigeria. The east and southern sub-region countries had shown progressive achievement towards polio eradication and to start with the African regional certification. The availability of sensitive AFP surveillance performance is among important strategies in the achievement of polio eradication. We, therefore, decided to conduct this assessment of AFP performance from 2012 to 2019 in the ESA sub-region have evidence documentation and support the certification process of the WHO AFRO region. Methods: we reviewed all reported acute flaccid paralysis (AFP) cases from 19 countries in the ESA sub region with the date of onset of paralysis from 1 January 2012 to 31 December 2019. The data were run to descriptive analysis based on the personal characteristics and AFP surveillance performance indicators parameters. Results: a total of 46,014 AFP cases were reported from 19 countries in the ESA countries who were paralyzed from 1 January 2012 to 31 December 2019. The most affected age group was children aged 0 to 3 years old where 19,740 children with acute paralysis were reported representing 42.9% of the total reported AFP for the period. The overall assessment of the non-polio AFP rate, there is an increase from a rate of 2.7 in 2012 to 3.5 in 2019 per 100,000 population aged less than 15 years, reflects a significant change with a p-value of 0.040 (95% C.I. ranges from 0.035 to 1.564). Furthermore, the percentage of stool adequacy raised from 86.4% in 2012 to 88.5% in 2019, with an observed 2.1% difference and no significant change over the 8 years. Conclusion: we observed an overall increase in the sensitivity of the AFP surveillance performance for the ESA sub-region countries from 2012 to 2019 using the national performance indicators. The COVID-19 pandemic paused an operational challenge for AFP surveillance performances from 2020. A further subnational surveillance performance analysis is suggested.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of acute flaccid paralysis surveillance performance in East and Southern African countries 2012 - 2019

Manyanga

Byabamazima

Masvikeni

et al. 2020

PAMJ

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“…The technology supported the monitoring and tracking of the movement of immunisation teams and the estimation of immunisation coverage, and included electronic surveillance; integrated supportive supervision, which facilitated active surveillance in health facilities in real time; and AVADAR (auto-visual acute flaccid paralysis detection and reporting)—an SMS-based smartphone application used by community informants in areas with weak health systems. 16 Polio surveillance reviews and retrospective searches for missed cases of acute flaccid paralysis were done and enhanced environmental surveillance for polioviruses was implemented. 5 Regular and rigorous supervision, evaluations, and reviews focusing on surveillance performance at subnational levels were also implemented.…”

Section: The Road To Certificationmentioning

confidence: 99%

Certifying the interruption of wild poliovirus transmission in the WHO African region on the turbulent journey to a polio-free world

Leke¹,

King²,

Pallansch³

et al. 2020

The Lancet Global Health

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Summary On Aug 25 2020, the Africa Regional Commission for the Certification of Poliomyelitis Eradication declared that the WHO African region had interrupted transmission of all indigenous wild polioviruses. This declaration marks the African region as the fifth of the six WHO regions to celebrate this extraordinary achievement. Following the Yaoundé Declaration on Polio Eradication in Africa by heads of state and governments in 1996, Nelson Mandela launched the Kick Polio out of Africa campaign. In this Health Policy paper, we describe the long and turbulent journey to the certification of the interruption of wild poliovirus transmission, focusing on 2016–20, lessons learned, and the strategies and analyses that convinced the Regional Commission that the African region is free of wild polioviruses. This certification of the WHO African region shows the feasibility of polio eradication in countries with chronic insecurity, inaccessible and hard-to-reach populations, and weak health systems. Challenges have been daunting and the sacrifices enormous—dozens of health workers and volunteers have lost their lives in the pursuit of a polio-free Africa.

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“…In addition, performance indicators for AFP surveillance require that reporting be timely and complete, and represent the geography of the country. [2]. All cases of AFP should be investigated and two stool samples should be collected from each AFP case at least 24 hours apart for viral isolation in a WHO-accredited laboratory [2].…”

Section: Introductionmentioning

confidence: 99%

“…[2]. All cases of AFP should be investigated and two stool samples should be collected from each AFP case at least 24 hours apart for viral isolation in a WHO-accredited laboratory [2]. The quality of AFP surveillance is therefore critical in countries moving toward the final phases of polio eradication [3].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of the Deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) System for Strengthening Polio Surveillance in Africa From 2017 to 2018: Evaluation Study

Ticha

Akpan

Paige

et al. 2020

JMIR Public Health Surveill

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Background As we move toward a polio-free world, the challenge for the polio program is to create an unrelenting focus on smaller areas where the virus is still present, where children are being repeatedly missed, where immunity levels are low, and where surveillance is weak. Objective This article aimed to describe a possible solution to address weak surveillance systems and document the outcomes of the deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) project. Methods This intervention was implemented in 99 targeted high-risk districts with concerns for silent polio circulation from eight countries in Africa between August 1, 2017, and July 31, 2018. A total of 6954 persons (5390 community informants and 1564 health workers) were trained and equipped with a smartphone on which the AVADAR app was configured to allow community informants to send alerts on suspected acute flaccid paralysis (AFP) and allow health worker to use electronic checklists for investigation of such alerts. The AVADAR and Open Data Kit ONA servers were at the center of the entire process. A dashboard system and coordination teams for monitoring and supervision were put in place at all levels. Results Overall, 96.44% (24,142/25,032) of potential AFP case alerts were investigated by surveillance personnel, yielding 1414 true AFP cases. This number (n=1414) reported through AVADAR was higher than the 238 AFP cases expected during the study period in the AVADAR districts and the 491 true AFP cases reported by the traditional surveillance system. A total of 203 out of the 1414 true AFP cases reported were from special population settings, such as refugee camps and insecure areas. There was an improvement in reporting in silent health areas in all the countries using the AVADAR system. Finally, there were 23,473 reports for other diseases, such as measles, diarrhea, and cerebrospinal meningitis, using the AVADAR platform. Conclusions This article demonstrates the added value of AVADAR to rapidly improve surveillance sensitivity. AVADAR is capable of supporting countries to improve surveillance sensitivity within a short interval before and beyond polio-free certification.

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AVADAR (Auto-Visual AFP Detection and Reporting): demonstration of a novel SMS-based smartphone application to improve acute flaccid paralysis (AFP) surveillance in Nigeria

Cited by 20 publications

References 2 publications

Assessment of acute flaccid paralysis surveillance performance in East and Southern African countries 2012 - 2019

Assessment of acute flaccid paralysis surveillance performance in East and Southern African countries 2012 - 2019

Certifying the interruption of wild poliovirus transmission in the WHO African region on the turbulent journey to a polio-free world

Outcomes of the Deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) System for Strengthening Polio Surveillance in Africa From 2017 to 2018: Evaluation Study

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