Mobile based surveillance platform for detecting Zika virus among Spanish Delegates attending the Rio de Janeiro Olympic Games

Abstract

BackgroundZika virus has created a major epidemic in Central and South America, especially in Brazil, during 2015–16. The infection is strongly associated with fetal malformations, mainly microcephaly, and neurological symptoms in adults. During the preparation of the Rio de Janeiro Olympic Games in 2016, members of Olympic Delegations worldwide expressed their concern about the health consequences of being infected with Zika virus. A major risk highlighted by the scientific community was the impact on the spreading of the virus into new territories immediately after the Games.ObjectivesTo detect real-time incidence of symptoms compatible with arboviral diseases and other tropical imported diseases among the Spanish Olympic Delegation (SOD) attending the Rio Olympic Games in 2016.MethodsWe developed a surveillance platform based on a mobile application installed in participant’s smartphones that monitored the health status of the SOD through a daily interactive check of the user health status including geo-localization data. The results were evaluated by a study physician on-call through a web-based platform monitoring system. Participants presenting severe symptoms or those compatible with Zika infection prompted an alarm in the system triggering specialized medical assistance and allowing early detection and control of the introduction of arboviral diseases in Spain.Summary of the resultsThe system was downloaded by 189 participants and used by 143 of them (76%). Median age was 38 years (IQR 16), and 134 (71%) were male. Mean duration of travel was 19 days (+/-9SD). During the Games the highest accumulated incidence observed was for headache: 6.06% cough: 5.30% and conjunctivitis: 3.03%. The incidence rate of cough during the Olympic Games was 1.1% per day per person, followed by headache 0.8% and 0.4% conjunctivitis or diarrhea. In our cohort we observed that non-athletes experienced more incidence of symptoms, except for incidence of cough which was the same in the two groups (1.1%). No participants reported symptoms fulfilling Zika definition case.ConclusionOur system did not find cases fulfilling Zika definition amongst participants of the SOD during the Games, consistent with limited cases of Zika in Rio during the Games. The app showed good usability and the web based monitoring platform allowed to manage infectious cases in real-time. The overall system has proven to serve as a real-time surveillance platform for detecting symptoms that could be present in tropical imported diseases, especially arboviral diseases, contributing to the preparedness for the introduction of vector borne-diseases in non-endemic countries.

Epihack Sri Lanka: development of a mobile surveillance tool for dengue fever

“…In recent years, with the advancement of wireless technology and mobile phones there have been numerous applications developed in healthcare, however Mo-Buzz+ is unique in its integrated approach. Many of the current infectious disease surveillance applications either solely look at educating and informing, such as the World Health Organisation’s Zika application (https://www.who.int/risk-communication/zika-virus/app/en/) or focus on one of the facets of the Mo-Buzz+ system such as mapping technology [13] or reporting survey [14, 15]. By integrating both the public, health authorities and other stakeholders into one application, the flow of communication, actions can be streamlined and the efficiency can be increased.…”

The use of mobile phones for the prevention and control of arboviral diseases: a scoping review

“…To analyse the support that mobile phones are promoting, we noticed that the included studies in this review were focused on four major purposes: surveillance, prevention, diagnosis, and management which are summarized in table 4. Three studies were identi ed for both purposes: surveillance and prevention [55,59,66], thus those were assigned for both purposes in table 4, resulting in 39 studies. This review also identi ed speci c aims in each purpose which are presented in table 4.…”

“…Mobile applications have also proved to be feasible for early detection of arboviral disease based on participatory surveillance which engages users directly in reporting and monitoring of symptoms [55,57,63]. This approach required medical staff and scienti c experts to validate data reported by users and checked their health status during the intervention.…”

“…Most mobile applications showed a good proportion of active users out of all participants who downloaded the app [55,63,67], but some researchers recommended more incentives, educational campaigns/trainings and constant communication with study/health personnel to keep to users motivated [57,59,63]. Some concerns related to additional expenses of mobile technology (e.g.…”

O programa Aedes em Foco como elemento de combate a arboviroses

“…[Lwin et al 2019] apresenta um sistema de vigilância, comunicação e engajamento também baseado em elementos digitais, sistema este participante de um evento de hackatown ocorrido no Sri Lanka. [Rodriguez-Valero et al 2018] registra uma plataforma de vigilância de sintomas compatíveis com arboviroses focada em participantes da delegação espanhola participante dos jogos olímpicos no Rio de Janeiro, dada a possibilidade de dispersão territorial dos vírus transmissores de arboviroses a partir de atletas infectados na cidade do evento. Já o trabalho [Fernandes Abel Mangueira et al 2019] apresenta um quasi-experimento que trata do estudo comparativo das atitudes e conhecimento relacionados a arboviroses antes e após a aplicação de um curso online em smartphones.…”