Contact tracing in the context of COVID-19: a case study from Oman

Abstract

In April 2020, the Ministry of Health (MoH) in Oman, a high-income country in the Eastern Mediterranean Region (EMR), implemented a robust contact tracing (CT) system for COVID-19. To capitalise on Oman’s experience, EMRO has developed a case study presenting the methodology used to conduct the CT activities, main functions of the system, challenges encountered, lessons learnt, and the way forward. To develop the case study, a key informant interview was conducted virtually with the CT focal point in the MoH, using a semistructured questionnaire adapted from the WHO questionnaire for the assessment of CT activities. The Oman MoH launched a CT system based on three complementary digital tools: Tarassud plus, Medical Scout and HMushrif applications. Oman’s CT strategy classifies contacts into close and casual contacts. Only close contacts are listed using the Tarassud plus application, while casual contacts are requested to self-monitor for 14 days using the other two applications. With the evolution of the outbreak, Oman MoH implemented stricter policies and prioritised the follow-up of close contacts to keep the CT activity manageable. Community health workers and volunteers facilitated the CT activities through sensitisation of the local community to the follow-up process and reducing the COVID-19-associated stigma. Challenges encountered revolved around contact data management, given the offline in-operability of the applications, and lack of national risk communication guidelines to address community concerns and widespread rumours.

Evaluation of the implementation of a community health worker-led COVID-19 contact tracing intervention in Chiapas, Mexico, from March 2020 to December 2021

“…However, comparability with these other studies is limited as our program experienced limited availability of COVID-19 tests and consequently considered COVID-19-like symptoms for identification of index cases and incident COVID-19 among contacts while the above studies used diagnostic tests from the start to diagnose COVID-19 among index cases, contacts, or both. In the case of Oman, whose national CHW-led contact tracing program also considered COVID-19 suspicion, the figure was substantially higher than ours, at 45% [ 28 ]. Furthermore, in our study we did not find an association between age and becoming a suspected COVID-19 case, which contrasts with the findings of other studies, according to which a lower incidence of suspected COVID-19 cases would be expected among younger contacts.…”

“…In Nigeria (which included only CHWs) and Western Cape Province, South Africa (which included CHWs and volunteers), government-supported programs reached at least 90% of contacts, whereas in Uganda (which included CHWs, volunteers, students, and epidemiologists) and Rwanda (which included CHWs, volunteers, and students) over 89% of contacts successfully completed contact tracing [ 29 ]. The community engagement specialist workforce, implemented by a public–private partnership in New York, reached 71% of contacts [ 25 ], whereas the govenrment-led intervention in Oman obtained full coverage and follow-up of all contacts [ 28 ]. Other contact tracing programs that did not include CHWs, including interventions led by universities [ 46 , 47 ] and health care institutions and health departments [ 42 ] in the US achieved more than 70% of contact notification.…”

“…Contact tracing by CHWs for COVID-19 has also been reported in other settings, including by PIH-led teams in the United States (US) and Haiti [ 16 , 24 ]; a public–private intervention in New York (US) [ 25 ]; government-led interventions in Bangladesh, India, Nepal, Thailand, and Vietnam [ 26 , 27 ]; government-led interventions in Oman, Nigeria, Uganda, Rwanda, and South Africa [ 28 , 29 ]; and programs supported by the Partnership to Accelerate COVID-19 Testing (PACT) in some African Union countries [ 30 ]. However, the scientific literature evaluating the implementation of these CHW-led contact tracing for COVID-19 remains scarce.…”

Contact tracing in Austria, Georgia, Kyrgyzstan, Ukraine, and Kosovo during the COVID-19 pandemic: response review and good practices

“…Additionally, as documented elsewhere, local media and communication channels were utilized in all five countries and territories to disseminate awareness messages. 19 For example, in Georgia, recommendations for the media were developed by the national health authorities on how to communicate COVID-19-related messages, to avoid any misinformation and inconsistent communications. 14 Given the necessity of effective risk communication and community engagement, a clear strategy is needed, allowing for a two-way dialogue with the communities to ensure they are meaningfully engaged through their representative, leaders, or NGOs in the development and implementation of the risk communication strategy.…”

A comprehensive and healthcare equity promoting response by a civil society–public partnership to COVID-19 in Chiapas, Mexico

“…Interventions had to be designed and implemented in an emergency context without sufficient time for planning, monitoring and evaluating. Identifying our low rates of completion of contact tracing by ACMPs earlier (much lower than community health worker-led interventions in Oman, Nigeria or the USA) [20][21][22] would have allowed us to modify this intervention sooner.…”