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.