Effectiveness of 24-h mobile reporting tool during a malaria outbreak in Mpumalanga Province, South Africa

Abstract

Background As surveillance is a key strategy for malaria elimination in South Africa, ensuring strong surveillance systems is a National Department of Health priority. Historically, real time tracking of case trends and reporting within 24 h—a requirement in South Africa’s National surveillance guidelines—has not been possible. To enhance surveillance and response efficiency, a mobile surveillance tool, MalariaConnect, was developed using Unstructured Supplementary Service Data (USSD) technology. It was rolled out in health facilities in malaria endemic areas of South Africa to provide 24-h reporting of malaria cases. Methods To evaluate the efficiency of the mobile tool to detect an outbreak data were extracted from the paper based and MalariaConnect reporting systems in Bushbuckridge from 1 January to 18 June 2017. These data were subject to time series analyses to determine if MalariaConnect provided sufficient data reliably to detect increasing case trends reported through the paper system. The Chi squared test was used to determine goodness of fit between the following indicator data generated using MalariaConnect and paper reporting systems: timeliness, completeness, and precision. Results MalariaConnect adequately tracked case trends reported through the paper system. Timeliness of reporting increased significantly using MalariaConnect with 0.63 days to notification compared to 5.65 days using the paper-system (p < 0.05). The completeness of reporting was significantly higher for the paper system (100% completion; p < 0.05), compared to confirmed MalariaConnect cases (61%). There was a moderate association between data precision and the reporting system (p < 0.05). MalariaConnect provided an effective way of reliably and accurately identifying the onset of the malaria outbreak in Bushbuckridge. Conclusion Timeliness significantly improved using MalariaConnect and in a malaria elimination setting, can be used to markedly improve case investigation and response activities within the recommended 72-h period. Although data completeness and precision were lower compared to paper reporting, MalariaConnect data can be used to trigger outbreak responses.

Analysis of the Electronic Implementation of A Malaria Surveillance Information System (E-SISMAL) in the Lahat District

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The effects of mobile health on emergency care in low- and middle-income countries: A systematic review and narrative synthesis

“…Population level epidemiological monitoring was improved in all four studies evaluating mHealth data collection tools in the setting of disease outbreaks, such as EVD or malaria. When compared to the standard paper method, there was improved timeliness of submission and data completeness [ 17 , 18 , 21 , 22 ]. Two observational studies found short messaging service (SMS) an effective means to obtain individual level symptom and health seeking data [ 19 , 20 ].…”

Effectiveness and cost-effectiveness of reactive, targeted indoor residual spraying for malaria control in low-transmission settings: a cluster-randomised, non-inferiority trial in South Africa

“…In this trial, case investigations were frequently delayed when cases were more numerous, consistent with previous findings in South Africa. 20 Case reporting using mobile phones 56 , 42 has since been implemented and has helped improve response times. Sufficient standby capacity of case investigation teams in a targeted IRS strategy will be essential to ensure that health services are prepared for unexpected surges in cases.…”