Online reporting for malaria surveillance using micro-monetary incentives, in urban India 2010-2011

Abstract

BackgroundThe objective of this study was to investigate the use of novel surveillance tools in a malaria endemic region where prevalence information is limited. Specifically, online reporting for participatory epidemiology was used to gather information about malaria spread directly from the public. Individuals in India were incentivized to self-report their recent experience with malaria by micro-monetary payments.MethodsSelf-reports about malaria diagnosis status and related information were solicited online via Amazon's Mechanical Turk. Responders were paid $0.02 to answer survey questions regarding their recent experience with malaria. Timing of the peak volume of weekly self-reported malaria diagnosis in 2010 was compared to other available metrics such as the volume over time of and information about the epidemic from media sources. Distribution of Plasmodium species reports were compared with values from the literature. The study was conducted in summer 2010 during a malaria outbreak in Mumbai and expanded to other cities during summer 2011, and prevalence from self-reports in 2010 and 2011 was contrasted.ResultsDistribution of Plasmodium species diagnosis through self-report in 2010 revealed 59% for Plasmodium vivax, which is comparable to literature reports of the burden of P. vivax in India (between 50 and 69%). Self-reported Plasmodium falciparum diagnosis was 19% and during the 2010 outbreak and the estimated burden was between 10 and 15%. Prevalence between 2010 and 2011 via self-reports decreased significantly from 36.9% to 19.54% in Mumbai (p = 0.001), and official reports also confirmed a prevalence decrease in 2011.ConclusionsWith careful study design, micro-monetary incentives and online reporting are a rapid way to solicit malaria, and potentially other public health information. This methodology provides a cost-effective way of executing a field study that can act as a complement to traditional public health surveillance methods, offering an opportunity to obtain information about malaria activity, temporal progression, demographics affected or Plasmodium-specific diagnosis at a finer resolution than official reports can provide. The recent adoption of technologies, such as the Internet supports self-reporting mediums, and self-reporting should continue to be studied as it can foster preventative health behaviours.

Crowdsourcing—Harnessing the Masses to Advance Health and Medicine, a Systematic Review

“…Data from existing studies show that crowdsourcing has the potential to beneficially address the following points: quality, cost, volume, speed, and novel science. Crowdsourcing has been demonstrated to be a viable way to increase the accuracy of computer recognition of RBCs infected with malaria parasites 25 (quality), be a low cost alternative to more traditional behavioral research and epidemiology studies 15,20,22,30 (cost), engage over one hundred thousand people in a research problem 14 (volume), allow research to progress much faster than if processed by investigators alone 14,15,20,[22][23][24][26][27][28][29][30][31][32] (speed), and produce new scientific discoveries 13,18,19,21,23 (novel science). Additionally, there is the advantage of an untapped expertise of the crowd.…”

“…One of the papers used AMT to ask users about their malaria symptoms in order to assess malaria prevalence in India. 20 Another used a mobile phone application that allowed users to report potential flu-like symptoms along with GPS coordinates and other details, which enabled researchers to chart incidence of flu symptoms that matched relatively well with Centers for Disease Control and Prevention data. 14 The last paper created a map of automated external defibrillators (AEDs) by having users of a mobile phone application locate and take pictures of AEDs.…”

Lessons Learned About Public Health from Online Crowd Surveillance

“…In a survey of workers on Amazon.com's Mechanical Turk, the crowd workforce was surveyed for malarial symptoms as part of a study to assess the prevalence of malaria in India. 46 Another survey provided a mobile phone application that allowed users to report potential flulike symptoms along with GPS coordinates and other details. Response data from the survey enabled researchers to chart the incidence of flu symptoms that matched relatively well with Centers for Disease Control data.…”

New technologies for reporting real-time emergent infections

“…Two recent examples demonstrate this for malaria detection. Firstly, in order to gain a better understanding of where people were being affected by an outbreak and factors that may have made them more vulnerable, an online service, Amazon Mechanical Turk (AMT), was harnessed to survey residents of Mumbai (Chunara et al 2012). Reports on the number of malaria cases, deaths and other statistics, aggregated by state, are published monthly by government bodies such as the National Vector Borne Disease Control Programme (NVBDCP 2011).…”

“…Techniques in anonymization and encryption ensure that data that might be used to identify individuals is not collected nor stored. The biases associated with particular technologies as well as how security of informally reported health information is maintained have been discussed in detail in papers describing specific instances of these novel applications (Ginsberg et al 2009; Freifeld et al 2010; Chunara, 2012). Some communicable diseases are also more suited than others to informal and public-based reporting channels, due to characteristic symptoms and accessible treatment and prevention measures (Atkinson et al 2011).…”