SMS-based smartphone application for disease surveillance has doubled completeness and timeliness in a limited-resource setting – evaluation of a 15-week pilot program in Central African Republic (CAR)

El‐Khatib, Ziad; Shah, Maya; Zallappa, Samuel N.; Nabeth, Pierre; Guerra, José; Manengu, Casimir; Yao, Michel; Philibert, Aline; Massina, Lazare; Staiger, Claes-Philip; Mbaïlao, Raphaël; Kouli, Jean-Pierre; Mboma, Hippolyte; Duc, Géraldine Le; Inagbe, Dago; Barry, Alpha Boubaca; Dumont, Thierry; Cavailler, Philippe; Quéré, Michel; Willett, Brian J.; Reaiche, Souheil; Ribaucourt, Hervé de; Reeder, Bruce

doi:10.1186/s13031-018-0177-6

Cited by 41 publications

(30 citation statements)

References 17 publications

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“…Many countries in the world are now using electronic systems for public health surveillance reporting as these have been shown to improve reporting rates [19][20][21][22][23]. The District Health Information System (DHIS2) is one of the most popular electronic systems for reporting health related data and is currently used in over 40 countries [24].…”

Section: Discussionmentioning

confidence: 99%

Use of technology for public health surveillance reporting: opportunities, challenges and lessons learnt from Kenya

et al. 2020

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Background: Effective public health surveillance systems are crucial for early detection and response to outbreaks. In 2016, Kenya transitioned its surveillance system from a standalone web-based surveillance system to the more sustainable and integrated District Health Information System 2 (DHIS2). As part of Global Health Security Agenda (GHSA) initiatives in Kenya, training on use of the new system was conducted among surveillance officers. We evaluated the surveillance indicators during the transition period in order to assess the impact of this training on surveillance metrics and identify challenges affecting reporting rates. Methods: From February to May 2017, we analysed surveillance data for 13 intervention and 13 comparison counties. An intervention county was defined as one that had received refresher training on DHIS2 while a comparison county was one that had not received training. We evaluated the impact of the training by analysing completeness and timeliness of reporting 15 weeks before and 12 weeks after the training. A chi-square test of independence was used to compare the reporting rates between the two groups. A structured questionnaire was administered to the training participants to assess the challenges affecting surveillance reporting. Results: The average completeness of reporting for the intervention counties increased from 45 to 62%, i.e. by 17 percentage points (95% CI 16.14-17.86) compared to an increase from 49 to 52% for the comparison group, i.e. by 3 percentage points (95% CI 2.23-3.77). The timeliness of reporting increased from 30 to 51%, i.e. by 21 percentage points (95% CI 20.16-21.84) for the intervention group, compared to an increase from 31 to 38% for the comparison group, i.e.by 7 percentage points (95% CI 6.27-7.73). Major challenges for the low reporting rates included lack of budget support from government, lack of airtime for reporting, health workers strike, health facilities not sending surveillance data, use of wrong denominator to calculate reporting rates and surveillance officers having other competing tasks. Conclusions: Training plays an important role in improving public health surveillance reporting. However, to improve surveillance reporting rates to the desired national targets, other challenges affecting reporting must be identified and addressed accordingly.

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Section: Discussionmentioning

confidence: 99%

Use of technology for public health surveillance reporting: opportunities, challenges and lessons learnt from Kenya

et al. 2020

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“…Public health surveillance aims to monitor dengue transmission accurately, triggering the necessary effective preventive measures and programs to prevent the occurrence and spread of diseases [ 8 ]. Recently, the use of mHealth (mobile health) technology, specifically mobile apps, has been gaining prominence as a potential surveillance system that would meet the need for real-time disease surveillance and timely identification of epidemics [ 3 , 10 ]. Mohanty et al [ 3 ] found 26 apps relevant to epidemic surveillance of diseases such as influenza, H1N1, Ebola, Zika, and dengue.…”

Section: Introductionmentioning

confidence: 99%

Early Detection of Dengue Fever Outbreaks Using a Surveillance App (Mozzify): Cross-sectional Mixed Methods Usability Study

Herbuela¹,

Karita²,

Carvajal³

et al. 2021

JMIR Public Health Surveill

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Background While early detection and effective control of epidemics depend on appropriate surveillance methods, the Philippines bases its dengue fever surveillance system on a passive surveillance method (notifications from barangay/village health centers, municipal or city health offices, hospitals, and clinics). There is no available mHealth (mobile health) app for dengue fever that includes all the appropriate surveillance methods in early detection of disease outbreaks in the country. Objective This study aimed to evaluate the usability of the Mozzify app in terms of objective quality (engagement, functionality, aesthetics, information) and app subjective and app-specific qualities and compare total app mean score ratings by sociodemographic profile and self and family dengue fever history to see what factors are associated with high app mean score rating among school-based young adult samples and health care professionals. Individual interviews and focus group discussions were also conducted among participants to develop themes from their comments and suggestions to help structure further improvement and future development of the app. Methods User experience sessions were conducted among participants, and the Mobile Application Rating Scale (MARS) professional and user versions (uMARS) were administered followed by individual interviews and focus group discussions. Descriptive statistical analysis of the MARS and uMARS score ratings was performed. The total app mean score ratings by sociodemographic and dengue fever history using nonparametric mean difference analyses were also conducted. Thematic synthesis was used to develop themes from the comments and suggestions raised in individual interviews and focus group discussions. Results Mozzify obtained an overall >4 (out of 5) mean score ratings in the MARS and uMARS app objective quality (4.45), subjective (4.17), and specific (4.55) scales among 948 participants (79 health care professionals and 869 school-based samples). Mean difference analyses revealed that total app mean score ratings were not significantly different across ages and gender among health care professionals and across age, income categories, and self and family dengue fever history but not gender (P<.001) among the school-based samples. Thematic syntheses revealed 7 major themes: multilanguage options and including other diseases; Android version availability; improvements on the app’s content, design, and engagement; inclusion of users from low-income and rural areas; Wi-Fi connection and app size concerns; data credibility and issues regarding user security and privacy. Conclusions With its acceptable performance as perceived by health care professionals and school-based young adults, Mozzify has the potential to be used as a strategic health intervention system for early detection of disease outbreaks in the Philippines. It can be used by health care professionals of any age and gender and by school-based samples of any age, socioeconomic status, and dengue fever history. The study also highlights the feasibility of school-based young adults to use health-related apps for disease prevention.

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“… 24 , 36 , 39 , 40 Mobile phones and smartphones have increased timeliness and completeness of surveillance reporting by health workers in the Central African Republic and Papua New Guinea, which are affected by conflict and fragility, and through mobile EWARS in Cox's Bazar and northern Nigeria. 52 , 53 , 54 , 55 However, for CBS, it is imperative that mobile apps be purpose built for use by community members who might be unfamiliar with mobile phones. 56 Particular to crisis settings, several challenges exist, including poor cellular penetration in remote areas 57 and the costs of providing infrastructure (eg, telephone fleet, solar chargers, and software development) where it does not exist or has been disrupted.…”

Section: Discussionmentioning

confidence: 99%

People-centred surveillance: a narrative review of community-based surveillance among crisis-affected populations

Ratnayake

Tammaro

Tiffany³

et al. 2020

The Lancet Planetary Health

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Outbreaks of disease in settings affected by crises grow rapidly due to late detection and weakened public health systems. Where surveillance is underfunctioning, community-based surveillance can contribute to rapid outbreak detection and response, a core capacity of the International Health Regulations. We reviewed articles describing the potential for community-based surveillance to detect diseases of epidemic potential, outbreaks, and mortality among populations affected by crises. Surveillance objectives have included the early warning of outbreaks, active case finding during outbreaks, case finding for eradication programmes, and mortality surveillance. Community-based surveillance can provide sensitive and timely detection, identify valid signals for diseases with salient symptoms, and provide continuity in remote areas during cycles of insecurity. Effectiveness appears to be mediated by operational requirements for continuous supervision of large community networks, verification of a large number of signals, and integration of community-based surveillance within the routine investigation and response infrastructure. Similar to all community health systems, community-based surveillance requires simple design, reliable supervision, and early and routine monitoring and evaluation to ensure data validity. Research priorities include the evaluation of syndromic case definitions, electronic data collection for community members, sentinel site designs, and statistical techniques to counterbalance false positive signals.

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SMS-based smartphone application for disease surveillance has doubled completeness and timeliness in a limited-resource setting – evaluation of a 15-week pilot program in Central African Republic (CAR)

Cited by 41 publications

References 17 publications

Use of technology for public health surveillance reporting: opportunities, challenges and lessons learnt from Kenya

Use of technology for public health surveillance reporting: opportunities, challenges and lessons learnt from Kenya

Early Detection of Dengue Fever Outbreaks Using a Surveillance App (Mozzify): Cross-sectional Mixed Methods Usability Study

People-centred surveillance: a narrative review of community-based surveillance among crisis-affected populations

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