A Qualitative study of volunteer experiences with a mobile community event- based surveillance (CEBS) system in Sierra Leone

Abstract

enabled Red Cross staff and partners to decide whether follow up, investigation or response was required for alerts. Scripts in Rstudio were furthermore used to generate automatic epidemiological reports based on SMS database and case investigation data, and shared with stakeholders to monitor trends over time.Results: The CBS system had the sensitivity and specificity required to detect cholera outbreaks, as evidenced by comparing temporal variation in the rate of occurrence of cases in the CBS data with available line-list data from cholera treatment facilities. However, the data from the CBS system is noisy. Our results show positive proof of concept for disease surveillance by volunteers with mobile phones, and the ability, for the first time, to detect cholera in rural areas that are often missed in formal surveillance. Furthermore, our results illustrate that community-based surveillance works best when integrated with the formal healthcare system-coupling the high sensitivity and low specificity of community surveillance with the high specificity and low sensitivity of formal surveillance, which cannot always penetrate rural areas, or areas recently affected by environmental or humanitarian emergencies.Conclusion: Community-based surveillance is an important strategy to broaden the reach of public health surveillance to rural communities in resource poor settings, especially during outbreaks. The project demonstrates the potential for scale and sustainability by utilising existing volunteer networks in response to disease outbreaks.http://dx.

Event-based surveillance at health facility and community level in low-income and middle-income countries: a systematic review

“…The 17 identified records referred to 15 studies (based on individual sets of data) and 13 different EBS systems 8–24. For the quality appraisal, we assessed each of the 15 studies.…”

“…We identified five CBS systems that were functioning as routine EBS systems in Vietnam,13 14 Ghana,12 Ethiopia,22 Cambodia26 and Sierra Leone 15 16. CVs were already in place before the implementation of all five systems 10 12 13 19–22.…”

“…CVs were already in place before the implementation of all five systems 10 12 13 19–22. CVs notified defined syndromes to IBS in addition to events to EBS in four systems 12–16 26. CVs working in EBS-only systems were instructed to report any outbreak or unusual event22; CVs working in combined IBS and EBS systems had specific definitions for the events (table 4).…”

“…CVs working in EBS-only systems were instructed to report any outbreak or unusual event22; CVs working in combined IBS and EBS systems had specific definitions for the events (table 4). 12–16 26 All EBS systems in communities were built on existing IBS systems and infrastructure. No verification or assessment algorithm was specified for any of the systems.…”

“…In addition, 74% of district stakeholders agreed that CEBS increased case detection and benefited their district through increased linkage with communities 17. CEBS was based on community health worker (CHW) and Red Cross volunteer networks that are largely known to the community prior to CEBS 16 17 19…”