Use of technology in malaria prevention and control activities
More than ever, the world relies on technology for everyday activities in the work place. Technology brings us a host of efficiencies – saving us time, resources, and providing real-time response capabilities. Within the realm of global health, programs in the field are finding ways to use new technology for monitoring and evaluation, rapid exchanges of critical data and information, and general logistical purposes. Such efficiencies can equate to lives saved and reduced morbidity, drastically increasing the impact programs have on populations in need.
RTI has implemented a number of technology-based solutions to support the U.S. President’s Malaria Initiative (PMI) malaria prevention and control efforts throughout Africa.
Funding by PMI and other stakeholders, together with the leadership of the Zanzibar Malaria Control Program (ZMCP), has resulted in a dramatic decrease in malaria prevalence in Zanzibar. However, persistence of malaria transmission in surrounding areas (Tanzania mainland and Kenya) leaves the island vulnerable to sudden outbreaks and the re-establishment of ongoing, perennial malaria transmission. Through the USAID-funded Tanzania Vector Control Scale-Up Program, RTI International has worked closely with the ZMCP and PMI to develop Coconut Surveillance, a mobile application that builds on the Malaria Early Epidemic Detection System (MEEDS). MEEDS is an innovative mHealth system used by health facilities to report new malaria cases via simple-feature phone handsets, which ensures that epidemic outbreaks are identified within two weeks of their onset. Coconut Surveillance works through the MEED system by alerting district malaria officers to new local case reports. ZMCP district malaria officers are then guided through an active case detection protocol by Coconut Surveillance, which includes the following steps:
Collect additional case data at reporting health facility,
Visit household to collect family member data and test for malaria infection, and
Record GPS-based household location.
The accumulated data are synchronized with a shared database, enabling program officials to monitor results in real time, detecting cases, identifying localized outbreaks, responding within two weeks of case detection, and developing better strategies for disease elimination. ZMCP officers equipped with Coconut Surveillance on tablet computers receive new case alerts from MEEDS, and use Coconut Surveillance to collect additional data as they follow up on each new case.
MEEDS is currently used by all of Zanzibar’s 150 health facilities. From July to December 2012, Coconut Surveillance followed-up (PDF) on 980 newly reported cases, tested 3,228 household members, and identified 223 previously unidentified malaria cases in Zanzibar. MEEDS and Coconut Surveillance are helping Zanzibar to identify and treat many otherwise undiagnosed malaria cases, identifying hot spots and transmission patterns, and responding rapidly to new outbreaks. These mHealth applications are helping Zanzibar to sustain the remarkable gains it has made against this dangerous and debilitating disease.
Opportunities exist to expand on the lessons learned from these technology-based activities in malaria programs and introduce them as solutions to other global health projects that encounter similar challenges. The value added by these tools offers the opportunity to greatly increase efficiency, accuracy, and impact across the global health spectrum.