Original ResearchDaily zero-reporting for suspect Ebola using short message service (SMS) in Guinea-Bissau
Section snippets
Background
As of February 2016, the Ebola outbreak in West Africa has claimed over 10,000 lives; a number greater than the combined number of lives claimed by all previous reported outbreaks.1 The last confirmed Ebola case in Sierra Leone was reported on January 20, 2016. Currently, both Liberia and Guinea have been without confirmed cases for more than 42 days (two incubation periods) with Liberia having experienced reemergence of Ebola twice after initially being declared Ebola-free in May 2015. West
STEP training and SMS instruction
Five weeks of STEP training were conducted for two sequential groups during January 19–March 27, 2015 in Bissau, Guinea-Bissau. Because of its small size, a region in Guinea-Bissau is more equivalent geographically to district levels in other West African countries. Training on SMS daily reported lasted one hour during the first week of the didactic portion of training of each group (January 23 for group 1; February 24 for group 2). One participant from each region and a representative from the
Results
The SMS system took about eight hours to set up and was operational the day immediately following the training (January 24). Fig. 2 summarises the daily frequency of reporting (regardless of whether the report was a ‘zero’ or other number) during January 24–March 24, 2015, demonstrating high compliance levels. Nine public health officials, representing each of eight regions included in the study and the national laboratory, were the initial reporters selected from the first STEP group. An
Discussion
Our preliminary results from this pilot initiative demonstrate that real-time, daily zero-reporting can be implemented in a rapid, cost-effective way in a low resource country. We believe that the high compliance rates were due to the simplicity and familiarity of SMS and heightened sensitivity resulting from STEP to the importance of zero-reporting in the midst of an Ebola epidemic. The system is being considered for reporting of other epidemic-prone diseases.
The finding of not having any
Acknowledgements
We would like to acknowledge the invaluable contributions of the surveillance officers and other public health staff in Guinea-Bissau who participated in this project as well as staff of the CDC (Fred Angulo, Tim Doyle, Nicholas Gaffga, Jay McAuliffe, Russell Gerber, Tyson Volkmann, Kristin Delea, Amy Kasper, Linda Quick, Laura Martin), Magpi (Joel Selanikio, George Njuguna, Facundo Alberdi), and the CDC Foundation (Reema Bhakta, Verla Neslund).
Ethical approval
This investigation did not undergo IRB approval
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