Using Mobile Health (mHealth) and Geospatial Mapping Technology in a Mass Campaign for Reactive Oral Cholera Vaccination in Rural Haiti

Abstract

BackgroundIn mass vaccination campaigns, large volumes of data must be managed efficiently and accurately. In a reactive oral cholera vaccination (OCV) campaign in rural Haiti during an ongoing epidemic, we used a mobile health (mHealth) system to manage data on 50,000 participants in two isolated communities.MethodsData were collected using 7-inch tablets. Teams pre-registered and distributed vaccine cards with unique barcodes to vaccine-eligible residents during a census in February 2012. First stored on devices, data were uploaded nightly via Wi-fi to a web-hosted database. During the vaccination campaign between April and June 2012, residents presented their cards at vaccination posts and their barcodes were scanned. Vaccinee data from the census were pre-loaded on tablets to autopopulate the electronic form. Nightly analysis of the day's community coverage informed the following day's vaccination strategy. We generated case-finding reports allowing us to identify those who had not yet been vaccinated.ResultsDuring 40 days of vaccination, we collected approximately 1.9 million pieces of data. A total of 45,417 people received at least one OCV dose; of those, 90.8% were documented to have received 2 doses. Though mHealth required up-front financial investment and training, it reduced the need for paper registries and manual data entry, which would have been costly, time-consuming, and is known to increase error. Using Global Positioning System coordinates, we mapped vaccine posts, population size, and vaccine coverage to understand the reach of the campaign. The hardware and software were usable by high school-educated staff.ConclusionThe use of mHealth technology in an OCV campaign in rural Haiti allowed timely creation of an electronic registry with population-level census data, and a targeted vaccination strategy in a dispersed rural population receiving a two-dose vaccine regimen. The use of mHealth should be strongly considered in mass vaccination campaigns in future initiatives.

Use of Oral Cholera Vaccine and Knowledge, Attitudes, and Practices Regarding Safe Water, Sanitation and Hygiene in a Long-Standing Refugee Camp, Thailand, 2012-2014

“…The high anticipated acceptability (97%) and OCV campaign coverage (first dose: 91%; second dose: 85%) observed were similar to evaluations from other OCV campaigns [12, 14, 16, 18, 24, 29–33], but higher than previously published coverage estimates from the Maela OCV campaign based on a vaccination registry (first dose: 83%; second dose: 61%) [19]. Although assessing vaccination history from recall may introduce bias [34], we observed similarly high coverage (first dose: 93%; second dose: 84%) among those retaining vaccination cards distributed before the campaign.…”

“…Since 2010, OCVs have been recommended by the World Health Organization (WHO) as an additional tool for control of endemic and epidemic cholera [5]. OCV campaigns have been conducted in multiple settings [6–14], including refugee camps in Uganda, South Sudan, and Tanzania [15–18]. …”

Routine immunization services in Pakistan: seeing beyond numbers

“…Adaptation of modern technology, including mobile-device supported health initiatives to reduce workload must be considered for rapid data collection, making data-based decision-making faster and easier and allowing efficient management of scarce resources (59). Bottlenecks in vaccine delivery and storage must be identified, and sustainable solutions developed, for ensuring uninterrupted vaccine supplies at local levels.…”

Current Landscape and Potential of Mobile Computing Research in the Least Developed Countries

“…However, the majority of these studies were 'action research', with no clear theoretical underpinnings. The studies explored the capability of mobile technologies such as support in monitoring, case detection and health interventions (Callaway et al, 2012;Chang et al, 2008;Deribe and Roda, 2012;Haq, 2013;Lund et al, 2012;Modi, 2013;Nchise et al, 2012;Nyamawe and Seif, 2014;Prue et al, 2013;Shao et al, 2015;Teng et al, 2014), medical supplies inventory (Asiimwe et al, 2011;Barrington et al, 2010), community-based health training (Chang et al, 2012) and health science research (Glickman et al, 2012).…”