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Timelier notification and action with mobile phones–towards malaria elimination in South Africa

机译:通过手机及时通知和采取行动,以消除南非的疟疾

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Background Surveillance with timely follow-up of diagnosed cases is a key component of the malaria elimination strategy in South Africa. The strategy requires each malaria case to be reported within 24 hours, and a case should be followed up within 48 hours. However, reporting delays are common in rural parts of the country. Methods A technical framework was implemented and for eight months a nurse was hired to use a smartphone to report malaria cases to the provincial malaria control programme, from selected primary health care clinics in a rural, malaria-endemic area in South Africa. In addition, a short text message (SMS) notification was sent to the local malaria case investigator for each positive case. The objective was to assess whether reporting over the smartphone led to timelier notification and follow-up of the cases. An evaluation on the simplicity, flexibility, stability, acceptability, and usability of the framework was conducted. Results Using mobile reporting, 18 of 23 cases had basic information entered into the provincial malaria information system within 24 hours. For the study period, the complete case information was entered two to three weeks earlier with the mobile reporting than from other clinics. A major improvement was seen in the number of positive cases being followed up within 48 hours. In 2011/2012, only one case out of 22 reported from the same study clinics was followed up within this timeframe. During the study period in 2012/2013, 15 cases out of 23 were followed up within two days. For the other clinics in the area, only a small improvement was seen between the two periods, in the proportion of cases that was followed up within 48 hours. Conclusions SMS notification for each diagnosed malaria case improved the timeliness of data transmission, was acceptable to users and was technically feasible in this rural area. For the malaria case investigations, time to follow-up improved compared to other clinics. Although malaria case numbers in the study were small, the results of the qualitative and quantitative evaluations are convincing and consideration should be given to larger-scale use within the national malaria control programme.
机译:背景技术对南非确诊病例的及时随访是消除疟疾战略的关键组成部分。该策略要求在24小时内报告每例疟疾病例,并应在48小时内对病例进行跟进。但是,报告延迟在该国农村地区很普遍。方法实施了技术框架,并雇用了八个月的护士使用智能手机从南非农村疟疾流行地区的部分初级卫生保健诊所向省级疟疾控制计划报告疟疾病例。此外,针对每个阳性病例,还向本地疟疾病例调查员发送了一条短消息(SMS)通知。目的是评估通过智能手机进行报告是否导致及时通知和跟踪案件。对框架的简单性,灵活性,稳定性,可接受性和可用性进行了评估。结果通过移动报告,在23个病例中有18个在24小时内将基本信息输入了省级疟疾信息系统。在研究期间,与其他诊所相比,使用移动报告输入的完整病例信息要早两到三周。在48小时内随访的阳性病例数方面,看到了重大改善。在2011/2012年,在同一时间范围内,仅随访了同一研究诊所报告的22例病例。在2012/2013年的研究期间,两天内对23例中的15例进行了随访。对于该地区的其他诊所,在两个时期之间仅观察到很小的改善,在48小时内得到随访的病例比例。结论对于每个诊断出的疟疾病例,通过SMS通知可以提高数据传输的及时性,用户可以接受,并且在该农村地区在技术上是可行的。与其他诊所相比,对于疟疾病例调查,随访时间有所缩短。尽管该研究中的疟疾病例数很少,但定性和定量评估的结果令人信服,应考虑在国家疟疾控制计划中大规模使用。

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