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McKay Michael

Description

Zanzibar is comprised primarily of two large islands with a population of 1.3 million. Indoor Residual Spraying (IRS) campaigns, distribution of long-lasting insecticide treated bed nets (LLINs), ensuring treatment medication is available, and use of Rapid Diagnostic Tests (RDTs) have reduced Malaria prevalence from 39% in 2005[1] to less than 1% in 2011-2012. This is the third time Zanzibar has been close to eliminating malaria, but there are serious challenges. These include vector resistance to pyrethroids, the shortlived efficacy of LLINs, and resistance to behavior change. Constant traffic with mainland Tanzania and foreign countries also poses the risk of outbreaks. An effective and sustained surveillance and rapid response system is essential to control outbreaks and optimize interventions.

Objective

This presentation aims to share the results of a six-year effort to use mobile health (mHealth) technology to help eliminate malaria from a well-defined geographic area. This presentation will review the history, technology, results, lessons-learned, and applicability to other contexts.

Submitted by uysz on
Description

Zanzibar is comprised primarily of two large islands with a population of 1.3 million. Indoor Residual Spraying (IRS) campaigns, distribution of long-lasting insecticide treated bed nets (LLINs), and use of Rapid Diagnostic Tests (RDTs) have reduced Malaria prevalence from 39% in 2005 to less than 1% in 2011-2012. As malaria burden decreases, there is an increasing need to track and follow up individual cases to contain transmission that could lead to resurgence. One method being used to achieve these aims is reactive case detection (RACD). RACD is generally understood to be triggered whenever a case is identified by passive case detection. The response involves visiting the household of the newly reported case and screening family members. Depending on program protocol, it may also involve screening neighbors within a defined radius. RACD has been used or tested in Cambodia, China, India, Peru, Senegal, Swaziland, Tanzania, and Zambia. RACD can be resource intensive. Several studies raise questions concerning whether and how RACD can be prioritized and targeted effectively as case numbers continue to decline.

Objective

This presentation will share findings from more than three years of using mobile technology for reactive case detection (RACD) to help eliminate malaria in a well-defined geographic area. It will review the concepts of RACD, the application of mobile technology, lessons learned from more than three years of application, and considerations in applying this technology in other malaria elimination contexts.

 

Submitted by Magou on
Description

Improving surveillance and response is a critical component of the Global Health Security Agenda. While it is impossible to predict where the next Ebola outbreak will occur, it is very likely that another outbreak will occur in the DRC. Of the 20 known outbreaks, 7 have occurred in the DRC, one as recently as 2014. To rapidly detect and respond to an Ebola outbreak, we sought to develop a real-time surveillance and response system for use in DRC and similar settings. RTI International developed Coconut Surveillance mobile software, which is currently used for real-time malaria surveillance and response in Zanzibar, Africa, where malaria elimination efforts are underway. We took this system and adapted it for Ebola as a possible tool for surveillance and response to Ebola and other (re)emerging diseases. Plans include pilot testing functionality at clinical sites in DRC, where surveillance infrastructure is limited at the local level. Coconut Surveillance is a mobile disease surveillance and rapid response system currently used for malaria elimination activities. It receives suspected positive case alerts from the field via mobile phones and uses mobile software to guide surveillance officers through a follow-up process. Coconut Surveillance runs on Android mobile devices that are used to coordinate work in the field as well as provide decision support during data collection and case management. In addition to standard case information, the GPS coordinates of the case’s household are captured as well as malaria status of all household members. Data are collected and accessed off-line, and are synchronized with a shared database when Internet connectivity is available. This tool has been used successfully in Zanzibar for more than three years and has been recognized as one of the most advanced applications of its kind.

Objective

We will describe a real-time mobile surveillance and case management system designed to organize data collected by multiple officers about cases and their contacts. We will discuss this surveillance system and its application for Ebola and other infectious diseases in the Democratic Republic of the Congo (DRC) and other similar settings. We will review the technology, results, challenges, lessons-learned, and applicability to other contexts.

Submitted by teresa.hamby@d… on
Description

RTI International has worked on enhancing health information and disease surveillance systems in many countries, including The Democratic Republic of the Congo (DRC), Guinea, Indonesia, Kenya, Nepal, Philippines, Tanzania, Zambia, and Zimbabwe. Strengthening these systems is critical for all three of the Prevent, Detect and Respond domains within the Global Health Security Agenda. 

We have deep experience in this area, ranging from implementing District Health Information Software (DHIS), electronic medical records, health facility registries, eHealth national strategies, electronic Integrated Disease Surveillance and Response system (eIDSR), mobile real-time malaria surveillance and response, national weekly disease surveillance, patient referral system, and community based surveillance. These experiences and lessons learned can inform work being done to advance the GHSA.

We will discuss several examples, including activities in Zimbabwe and Tanzania. RTI has been working in Zimbabwe for over six years to strengthen the national health information system. This work has included the configuration and roll-out of DHIS 2, the national electronic health information system. In doing so, RTI examined and revitalized the weekly disease surveillance system, improving disease reporting timeliness and completeness from 40% to 90%. Additionally, RTI has integrated mobile technology to help more rapidly communicate laboratory test results, a laboratory information management systems to manage and guide test sample processing, and various other patient level systems in support of health service delivery at the local level. This work has involved capacity building within the ministry of health to allow for sustainable support of health information systems practices and technology and improvements to data dissemination and use practices. 

Objective

The objective is to discuss two decades of international experience in health information and disease surveillance systems strengthening and synthesize lessons learned as applicable to implementation of the Global Health Security Agenda (GHSA). 

Submitted by uysz on