Community-based field implementation scenarios of a short message service reporting tool for lymphatic filariasis case estimates in Africa and Asia

Abstract

Background: Lymphatic filariasis (LF) is a neglected tropical disease (NTD) targeted for global elimination by 2020. Currently there is considerable international effort to scale-up morbidity management activities in endemic countries, however there remains a need for rapid, cost-effective methods and adaptable tools for obtaining estimates of people presenting with clinical manifestations of LF, namely lymphoedema and hydrocele. The mHealth tool 'MeasureSMS-Morbidity' allows health workers in endemic areas to use their own mobile phones to send clinical information in a simple format using short message service (SMS). The experience gained through programmatic use of the tool in five endemic countries across a diversity of settings in Africa and Asia is used here to present implementation scenarios that are suitable for adapting the tool for use in a range of different programmatic, endemic, demographic and health system settings. Methods: A checklist of five key factors and sub-questions was used to determine and define specific community-based field implementation scenarios for using the MeasureSMS-Morbidity tool in a range of settings. These factors included: (I) tool feasibility (acceptability; community access and ownership); (II) LF endemicity (high; low prevalence); (III) population demography (urban; rural); (IV) health system structure (human resources; community access); and (V) integration with other diseases (co-endemicity). Results: Based on experiences in Bangladesh, Ethiopia, Malawi, Nepal and Tanzania, four implementation scenarios were identified as suitable for using the MeasureSMS-Morbidity tool for searching and reporting LF clinical case data across a range of programmatic, endemic, demographic and health system settings. These include: (I) urban, high endemic setting with two-tier reporting; (II) rural, high endemic setting with onetier reporting; (III) rural, high endemic setting with two-tier reporting; and (IV) low-endemic, urban and rural setting with one-tier reporting. Conclusions: A decision-making framework built from the key factors and questions, and the resulting four implementation scenarios is proposed as a means of using the MeasureSMS-Morbidity tool. This framework will help national LF programmes consider appropriate methods to implement a survey using this tool to improve estimates of the clinical burden of LF. Obtaining LF case estimates is a vital step towards the elimination of LF as a public health problem in endemic countries.

Mapping and modelling the impact of mass drug adminstration on filariasis prevalence in Myanmar

“…Integrating alternative methods of monitoring and evaluation into the existing health system structure will also be important to ensure that surveillance is sustainable long-term, and sufficiently sensitive and targeted to find potential problem areas or hotspots of transmission [ 36 , 37 ]. In parallel, MMDP mapping and related activities, and additional integrated post-TAS activities need be initiated and could be conducted using new tools and field scenarios [ 7 , 38 ]. The districts with high burden of chronic disease and high baseline infection should be prioritized, and the key activities integrated with health system.…”

Mobile Health Strategies to Tackle Skin Neglected Tropical Diseases With Recommendations From Innovative Experiences: Systematic Review

“…Six (46%) studies [ 32 - 37 ] were reported to be community-based cross-sectional studies with the main objective of epidemiologically mapping a specific disease based on its clinical symptoms. Four out of 13 (31%) studies had different designs as follows: a mixed-methods approach to define challenges to be considered [ 38 ]; different implementation scenarios for a specific mHealth intervention [ 39 ]; the sustainability of an intervention [ 40 ]; and the process of developing a specific mHealth tool or assessing its usability [ 10 , 38 ]. One trial was a cross-sectional study analyzing the accuracy of a new diagnosis strategy [ 41 ], and another was a prospective cohort study testing the efficacy of an mHealth strategy in training health care workers [ 42 ].…”

Developing the first national database and map of lymphatic filariasis clinical cases in Bangladesh: Another step closer to the elimination goals

“…This may be challenging when cases are sparse, but the LF programme should aim to learn as much as possible from implementing MMDP activities in these low endemic communities, as they may reflect the future situation in highly endemic areas as case numbers progressively decline to zero. The use of the adapted patient searching method may be better use of human and financial resources [19].…”

“…Data collection was conducted over a 10-day period using paper forms as in the endemic districts. Summary data for each case was also reported using the mHealth system MeasureSMS-morbidity [15–19] and cross-checked against the paper forms to ensure no duplication. Health workers reported a summary of each case identified via a mobile phone short message service (SMS) text, reporting the location (upazila, union), age, sex, condition (lymphoedema, hydrocoele or both conditions), the severity (for lymphoedema) and number of acute attacks in the last six months.…”