Lessons From the Implementation of Mo-Buzz, a Mobile Pandemic Surveillance System for Dengue

Facilitators and barriers to engaging communities in health service research on dengue control in Indo-Pacific region: a systematic review

BACKGROUND

Dengue is a public health problem in the Indo-Pacific countries. There are concerns over the facilitators and barriers to community engagement in health service research aimed at dengue control. The objective of his study was to identify and synthesize facilitators and barriers to community engagement in health service research aimed at dengue control.

METHODOLOGY

The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) checklist was used to perform this review. Health-related databases including PubMed, Ovid, and Google Scholar were searched for relevant studies. A consolidated framework with five domains was developed after undertaking a six-phase reflective thematic assessment of the data.

RESULTS

Thirteen studies were identified, spanning eight low-and middle-income countries of the Indo-Pacific region including Cambodia, India, Indonesia, Myanmar, Philippines, Sri Lanka, Thailand, and Vietnam. The studies in this review covered the period from 2002 to 2021. A broad range of study designs and objectives were revealed across these 13 studies. An array of communities such as the local government, project-related health staff, local health services staff, community leaders, local communities/residences/general public, heads of households, community health volunteers, school teachers, and schoolchildren participated in these dengue related studies. The five Consolidated Framework for Implementation Research (CFIR) domains of 'intervention characteristics', 'inner setting', 'outer setting',' individual characteristics', and 'program implementations' were used to identify and describe barriers and facilitators.

CONCLUSIONS

The findings indicate a range of barriers and facilitators to community engagement in dengue control in the selected LMIC in the Indo-Pacific countries. Future health services research on dengue control approaches should be carefully planned, methodologically constructed, aligned with community engagement principles, and involve considerable community participation at all stages of the research.

Emerging data inputs for infectious diseases surveillance and decision making

Infectious diseases create a significant health and social burden globally and can lead to outbreaks and epidemics. Timely surveillance for infectious diseases is required to inform both short and long term public responses and health policies. Novel data inputs for infectious disease surveillance and public health decision making are emerging, accelerated by the COVID-19 pandemic. These include the use of technology-enabled physiological measurements, crowd sourcing, field experiments, and artificial intelligence (AI). These technologies may provide benefits in relation to improved timeliness and reduced resource requirements in comparison to traditional methods. In this review paper, we describe current and emerging data inputs being used for infectious disease surveillance and summarize key benefits and limitations.

Entomological Surveillance of the Invasive Aedes Species at Higher-Priority Entry Points in Northern Iran: Exploratory Report on a Field Study

Background

Arboviral diseases such as dengue, Zika, and chikungunya are transmitted by Aedes aegypti and Ae albopictus and are emerging global public health concerns.

Objective

This study aimed to provide up-to-date data on the occurrence of the invasive Aedes species in a given area as this is essential for planning and implementing timely control strategies.

Methods

Entomological surveillance was planned and carried out monthly from May 2018 to December 2019 at higher-priority entry points in Guilan Province, Northern Iran, using ovitraps, larval collection, and human-baited traps. Species richness (R), Simpson (D), evenness (E), and Shannon-Wiener indexes (H̕) were measured to better understand the diversity of the Aedes species. The Spearman correlation coefficient and regression models were used for data analysis.

Results

We collected a total of 3964 mosquito samples including 17.20% (682/3964) belonging to the Aedes species, from 3 genera and 13 species, and morphologically identified them from May 2018 to December 2019. Ae vexans and Ae geniculatus, which showed a peak in activity levels and population in October (226/564, 40.07% and 26/103, 25.2%), were the eudominant species (D=75.7%; D=21.2%) with constant (C=100) and frequent (C=66.7%) distributions, respectively. The population of Ae vexans had a significant positive correlation with precipitation (r=0.521; P=.009) and relative humidity (r=0.510; P=.01), whereas it was inversely associated with temperature (r=−0.432; P=.04). The Shannon-Wiener Index was up to 0.84 and 1.04 in the city of Rasht and in July, respectively. The rarefaction curve showed sufficiency in sampling efforts by reaching the asymptotic line at all spatial and temporal scales, except in Rasht and in October.

Conclusions

Although no specimens of the Ae aegypti and Ae albopictus species were collected, this surveillance provides a better understanding of the native Aedes species in the northern regions of Iran. These data will assist the health system in future arbovirus research, and in the implementation of effective vector control and prevention strategies, should Ae aegypti and Ae albopictus be found in the province.

Incentivizing optimal risk map use for Triatoma infestans surveillance in urban environments

In Arequipa, Peru, a large-scale vector control campaign has successfully reduced urban infestations of the Chagas disease vector, Triatoma infestans. In addition to preventing new infections with Trypanosoma cruzi (etiological agent of Chagas disease), the campaign produced a wealth of information about the distribution and density of vector infestations. We used these data to create vector infestation risk maps for the city in order to target the last few remaining infestations, which are unevenly distributed and difficult to pinpoint. Our maps, which are provided on a mobile app, display color-coded, individual house-level estimates of T. infestans infestation risk. Entomologic surveillance personnel can use the maps to select homes to inspect based on estimated risk of infestation, as well as keep track of which parts of a given neighborhood they have inspected to ensure even surveillance throughout the zone. However, the question then becomes, how do we encourage surveillance personnel to actually use these two functionalities of the risk map? As such, we carried out a series of rolling trials to test different incentive schemes designed to encourage the following two behaviors by entomologic surveillance personnel in Arequipa: (i) preferential inspections of homes shown as high risk on the maps, and (ii) even surveillance across the geographical distribution of a given area, which we term, 'spatial coverage.' These two behaviors together constituted what we termed, 'optimal map use.' We found that several incentives resulted in one of the two target behaviors, but just one incentive scheme based on the game of poker resulted in optimal map use. This poker-based incentive structure may be well-suited to improve entomological surveillance activities and other complex multi-objective tasks.

A call for citizen science in pandemic preparedness and response: beyond data collection

The COVID-19 pandemic has underlined the need to partner with the community in pandemic preparedness and response in order to enable trust-building among stakeholders, which is key in pandemic management. Citizen science, defined here as a practice of public participation and collaboration in all aspects of scientific research to increase knowledge and build trust with governments and researchers, is a crucial approach to promoting community engagement. By harnessing the potential of digitally enabled citizen science, one could translate data into accessible, comprehensible and actionable outputs at the population level. The application of citizen science in health has grown over the years, but most of these approaches remain at the level of participatory data collection. This narrative review examines citizen science approaches in participatory data generation, modelling and visualisation, and calls for truly participatory and co-creation approaches across all domains of pandemic preparedness and response. Further research is needed to identify approaches that optimally generate short-term and long-term value for communities participating in population health. Feasible, sustainable and contextualised citizen science approaches that meaningfully engage affected communities for the long-term will need to be inclusive of all populations and their cultures, comprehensive of all domains, digitally enabled and viewed as a key component to allow trust-building among the stakeholders. The impact of COVID-19 on people's lives has created an opportune time to advance people's agency in science, particularly in pandemic preparedness and response.

Utilizing citizen science to model the distribution of Aedes aegypti in West Africa

In the rapidly urbanizing region of West Africa, Aedes mosquitoes pose an emerging threat of infectious disease that is compounded by limited vector surveillance. Citizen science has been proposed as a way to fill surveillance gaps by training local residents to collect and share information on disease vectors. Understanding the distribution of arbovirus vectors in West Africa can inform researchers and public health officials on where to conduct disease surveillance and focus public health interventions. We utilized citizen science data collected through NASA's GLOBE Observer mobile phone application and data from a previously published literature review on Aedes mosquito distribution to examine the contribution of citizen science to understanding the distribution of Ae. aegypti in West Africa using Maximum Entropy modeling. Combining citizen science and literature-derived observations improved the fit of the model compared to models created by each data source alone but did not alleviate location bias within the models, likely due to lack of widespread observations. Understanding Ae. aegypti distribution will require greater investment in Aedes mosquito surveillance in the region, and citizen science should be utilized as a tool in this mission to increase the reach of surveillance.

Digital Marketing: A Unique Multidisciplinary Approach towards the Elimination of Viral Hepatitis

New technologies are supported by the global implementation of the internet. These improvements have deeply affected various disciplines of sciences and consequently changed services such as daily business, particularly health sectors. Innovative digital marketing strategies utilize the channels of social media and retrieved user data to analyze and improve relevant services. These multidisciplinary innovations can assist specialists, physicians and researchers in diagnostic, prophylaxis and treatment issues in the health sector. Accordingly, compared to recent decades, health decision makers are more accurate and trustful in defining new strategies. Interestingly, using social media and mobile health apps in current pandemics of SARS-CoV-2 could be an important instance of the key role of these platforms at the local and global level of health policies. These digital technologies provide platforms to connect public health sectors and health politicians for communicating and spreading relevant information. Adding influencers and campaigns to this toolbox strengthens the implementation of public health programs. In 2016, the WHO adopted a global program to eliminate viral hepatitis by 2030. Recent constructive measures that have been used in the battle against COVID-19 could be adopted for the elimination of viral hepatitis program. The presented evidence in our narrative review demonstrates that the application of digital marketing tools to create campaigns on social media, armed with professional influencers, can efficiently consolidate this program. The application of different strategies in using these popular tools will raise the public awareness about viral hepatitis. Subsequently, the availability of an effective vaccine for HBV and antiviral medication for HCV can motivate the audience to take steps towards prophylaxis and screening methods against these infectious illnesses. The encouragement of health policy makers to apply digital communication technologies and comprehensive roadmaps to implement this global program will certainly decrease the burden of viral hepatitis worldwide.

Citizen Science Mosquito Surveillance by Ad Hoc Observation Using the iNaturalist Platform

Citizen science mosquito surveillance has been growing in recent years due to both increasing concern about mosquito-borne disease and the increasing popularity of citizen science projects globally. Health authorities are recognising the potential importance of citizen science to expanding or enhancing traditional surveillance programs. Different programs have shown success in engaging communities to monitor species of medical importance through low-cost methods. The Mozzie Monitors project was established on iNaturalist-an open citizen science platform that allows participants to upload photos (i.e., observers) and assist identification (i.e., identifiers). This article describes the likelihood of citizen scientists submitting photos of mosquitoes, assesses user submission behaviour, and evaluates public health utility from these citizen science-derived data. From October 2018 to July 2021, the Mozzie Monitors project on iNaturalist received 2118 observations of 57 different species of mosquitoes across Australia. The number of observers in the system increased over time with more than 500 observers and 180 identifiers being active in the project since its establishment. Data showed species bias with large-bodied and colourful mosquitoes being over-represented. Analyses also indicate regional differentiation of mosquito fauna per state, seasonality of activity, and ecological information about mosquitoes. The iNaturalist citizen science platform also allows connectedness, facilitated communication and collaboration between overall users and expert entomologists, of value to medical entomology and mosquito management.

Development of an Index for the Inspection of Aedes aegypti Breeding Sites in Brazil: Multi-criteria Analysis

BACKGROUND

Aedes aegypti is a vector for the transmission of diseases such as dengue fever, chikungunya, Zika fever, and yellow fever. In 2016, over 1 million cases of these diseases were reported in Brazil, which is an alarming public health issue. One of the ways of controlling this disease is by inspecting and neutralizing the places where A. aegypti lays its eggs. The Ministry of Planning, Development, and Administration of Brazil maintains the inspection statistics.

OBJECTIVE

We propose a multi-criteria analysis to create an index for A. aegypti inspections reported through the Ministry of Planning, Development, and Administration system of Brazil.

METHODS

Based on the repository from urban cleaning services combined with data on inspections conducted by government agencies in several Brazilian cities and municipalities, we selected and combined metrics, which we further ranked using the analytic hierarchy process methodology. We also developed risk maps based on the analytic hierarchy process ranking of the A. aegypti breeding sites.

RESULTS

Based on our analysis and the available data, the priority for inspections should consider the number of sick people (weight 0.350), medical evaluations (weight 0.239), inspections (weight 0.201), mosquito breeding sites (weight 0.126), and days of absence from work (weight 0.096).

CONCLUSIONS

The proposed index could aid public health practitioners in preventing the appearance of new A. aegypti breeding sites. This information technology application can help solve such public health challenges.

The role of telemedicine in acute stroke treatment in times of pandemic

PURPOSE OF REVIEW

The coronavirus disease 2019 (COVID-19) pandemic challenges many healthcare systems. This review provides an overview of the advantages of telemedicine during times of pandemic and the changes that have followed the outbreak of the COVID-19 disease.

RECENT FINDINGS

Telemedicine has been utilized during infectious outbreaks for many years. COVID-19 has induced a variety of changes in laws (i.e. data privacy protection) and reimbursement procedures to accelerate new setups of telemedicine. Existing networks provide novel data about teleactivation resulting from social restrictions during the nadir of the lockdown in spring 2020.

SUMMARY

Telemedicine is a safe and ideal expert support system for hospitals during infectious outbreaks. It makes high-quality medical procedures possible, limits potentially contagious interhospital transfers, saves critical resources such as protective gear and rescue/emergency transport services, and offers safe home office work for medical specialists.

Establish a Real-time Responsible Home Quarantine and Monitoring Management mHealth Platform

Due to the global spreading of the COVID-19 virus, countries all over the world are faced with the need to conduct centralized quarantine or home quarantine for "persons who have been in contact with individuals diagnosed with the COVID-19 virus" and "visitors who have travel histories via COVID-19 hot zones". We have presented the community home quarantine service platform design that was utilized in Nanjing, China when the first wave of citizens returns to work after the Chinese New Year holidays on 10th Feb 2020. The main functions of the home quarantine monitoring system include (1) community grid management,(2) GPS positioning application in home isolation movement management,(3) Bluetooth body temperature patch data transmission integration, (4) health assessment scale (physical and mental health state) and (5) multilingual language options.

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

BACKGROUND

The rapid expansion of dengue, Zika and chikungunya with large scale outbreaks are an increasing public health concern in many countries. Additionally, the recent coronavirus pandemic urged the need to get connected for fast information transfer and exchange. As response, health programmes have -among other interventions- incorporated digital tools such as mobile phones for supporting the control and prevention of infectious diseases. However, little is known about the benefits of mobile phone technology in terms of input, process and outcome dimensions. The purpose of this scoping review is to analyse the evidence of the use of mobile phones as an intervention tool regarding the performance, acceptance, usability, feasibility, cost and effectiveness in dengue, Zika and chikungunya control programmes.

METHODS

We conducted a scoping review of studies and reports by systematically searching: i) electronic databases (PubMed, PLOS ONE, PLOS Neglected Tropical Disease, LILACS, WHOLIS, ScienceDirect and Google scholar), ii) grey literature, using Google web and iii) documents in the list of references of the selected papers. Selected studies were categorized using a pre-determined data extraction form. Finally, a narrative summary of the evidence related to general characteristics of available mobile health tools and outcomes was produced.

RESULTS

The systematic literature search identified 1289 records, 32 of which met the inclusion criteria and 4 records from the reference lists. A total of 36 studies were included coming from twenty different countries. Five mobile phone services were identified in this review: mobile applications (n = 18), short message services (n=7), camera phone (n = 6), mobile phone tracking data (n = 4), and simple mobile communication (n = 1). Mobile phones were used for surveillance, prevention, diagnosis, and communication demonstrating good performance, acceptance and usability by users, as well as feasibility of mobile phone under real life conditions and effectiveness in terms of contributing to a reduction of vectors/ disease and improving users-oriented behaviour changes. It can be concluded that there are benefits for using mobile phones in the fight against arboviral diseases as well as other epidemic diseases. Further studies particularly on acceptance, cost and effectiveness at scale are recommended.

Mobile health interventions in developing countries: A systematic review

This study reviews the quality of evidence reported in mobile health intervention literature in the context of developing countries. A systematic search of renowned databases was conducted to find studies related to mobile health applications published between a period of 2013 and 2018. After a methodological screening, a total of 31 studies were included for data extraction and synthesis. The mobile health Evidence Reporting and Assessment checklist developed by the World Health Organization was then used to evaluate the rigor and completeness in evidence reporting. We report several important and interesting findings. First, there is a very low level of familiarity with the mobile health Evidence Reporting and Assessment checklist among the researchers and mobile health intervention designers from developing countries. Second, most studies do not adequately meet the essential criteria of evidence reporting mentioned in the mobile health Evidence Reporting and Assessment checklist. Third, there is a dearth of application of design science-based methods and theory-based frameworks in developing mobile health interventions. Fourth, most of the mobile health interventions are not ready for interoperability and to be integrated into the existing health information systems. Based on these findings, we recommend for robust and inclusive study plans to deliver highly evidence-based reports by mobile health intervention studies that are conducted in the context of developing countries.

Participatory Surveillance Based on Crowdsourcing During the Rio 2016 Olympic Games Using the Guardians of Health Platform: Descriptive Study

Background

With the evolution of digital media, areas such as public health are adding new platforms to complement traditional systems of epidemiological surveillance. Participatory surveillance and digital epidemiology have become innovative tools for the construction of epidemiological landscapes with citizens’ participation, improving traditional sources of information. Strategies such as these promote the timely detection of warning signs for outbreaks and epidemics in the region.

Objective

This study aims to describe the participatory surveillance platform Guardians of Health, which was used in a project conducted during the 2016 Olympic and Paralympic Games in Rio de Janeiro, Brazil, and officially used by the Brazilian Ministry of Health for the monitoring of outbreaks and epidemics.

Methods

This is a descriptive study carried out using secondary data from Guardians of Health available in a public digital repository. Based on syndromic signals, the information subsidy for decision making by policy makers and health managers becomes more dynamic and assertive. This type of information source can be used as an early route to understand the epidemiological scenario.

Results

The main result of this research was demonstrating the use of the participatory surveillance platform as an additional source of information for the epidemiological surveillance performed in Brazil during a mass gathering. The platform Guardians of Health had 7848 users who generated 12,746 reports about their health status. Among these reports, the following were identified: 161 users with diarrheal syndrome, 68 users with respiratory syndrome, and 145 users with rash syndrome.

Conclusions

It is hoped that epidemiological surveillance professionals, researchers, managers, and workers become aware of, and allow themselves to use, new tools that improve information management for decision making and knowledge production. This way, we may follow the path for a more intelligent, efficient, and pragmatic disease control system.

An Integrated mHealth App for Dengue Reporting and Mapping, Health Communication, and Behavior Modification: Development and Assessment of Mozzify

Background

For the last 10 years, mobile phones have provided the global health community with innovative and cost-effective strategies to address the challenges in the prevention and management of dengue fever.

Objective

The aim is to introduce and describe the design and development process of Mozzify, an integrated mobile health (mHealth) app that features real-time dengue fever case reporting and mapping system, health communication (real-time worldwide news and chat forum/timeline, within-app educational videos, links to local and international health agency websites, interactive signs and symptoms checker, and a hospital directions system), and behavior modification (reminders alert program on the preventive practices against dengue fever). We also aim to assess Mozzify in terms of engagement and information-sharing abilities, functionality, aesthetics, subjective quality, and perceived impact.

Methods

The main goals of the Mozzify app were to increase awareness, improve knowledge, and change attitudes about dengue fever, health care-seeking behavior, and intention-to-change behavior on preventive practices for dengue fever among users. It was assessed using the Mobile Application Rating Scale (MARS) among 50 purposively sampled individuals: public health experts (n=5), environment and health-related researchers (n=23), and nonclinical (end users) participants (n=22).

Results

High acceptability and excellent satisfaction ratings (mean scores ≥4.0 out of 5) based on the MARS subscales indicate that the app has excellent user design, functionality, usability, engagement, and information among public health experts, environment and health-related researchers, and end users. The app’s subjective quality (recommending the app to other people and the app’s overall star rating), and specific quality (increase awareness, improve knowledge, and change attitudes about dengue fever; health care-seeking behavior; and intention-to-change behavior on preventive practices for dengue fever) also obtained excellent satisfaction ratings from the participants. Some issues and suggestions were raised during the focus group and individual discussions regarding the availability of the app for Android devices, language options limitations, provision of predictive surveillance, and inclusion of other mosquito-borne diseases.

Conclusions

Mozzify may be a promising integrated strategic health intervention system for dengue fever case reporting and mapping; increase awareness, improve knowledge, and change attitude about dengue fever; and disseminating and sharing information on dengue fever among the general population and health experts. It also can be an effective aid in the successful translation of knowledge on preventive measures against dengue fever to practice.

Event Detection System Based on User Behavior Changes in Online Social Networks: Case of the COVID-19 Pandemic

People use Online Social Networks (OSNs) to express their opinions and feelings about many topics. Depending on the nature of an event and its dissemination rate in OSNs, and considering specific regions, the users' behavior can drastically change over a specific period of time. In this context, this work aims to propose an event detection system at the early stages of an event based on changes in the users' behavior in an OSN. This system can detect an event of any subject, and thus, it can be used for different purposes. The proposed event detection system is composed of the following main modules: (1) determination of the user's location, (2) message extraction from an OSN, (3) topic identification using natural language processing (NLP) based on the Deep Belief Network (DBN), (4) the user behavior change analyzer in the OSN, and (5) affective analysis for emotion identification based on a tree-convolutional neural network (tree-CNN). In the case of public health, the early event detection is very relevant for the population and the authorities in order to be able take corrective actions. Hence, the new coronavirus disease (COVID-19) is used as a case study in this work. For performance validation, the modules related to the topic identification and affective analysis were compared with other similar solutions or implemented with other machine learning algorithms. In the performance assessment, the proposed event detection system achieved an accuracy higher than 0.90, while other similar methods reached accuracy values less than 0.74. Additionally, our proposed system was able to detect an event almost three days earlier than the other methods. Furthermore, the information provided by the system permits to understand the predominant characteristics of an event, such as keywords and emotion type of messages.

The prevention of arboviral diseases using mobile devices: a preliminary study of the attitudes and behaviour change produced by educational interventions

OBJECTIVES

In Brazil, the National Policy for Dengue Control seeks to incorporate the lessons of national and international experience in dengue control, emphasising the need for health education activities. The objective of this study was to evaluate and compare knowledge, attitudes and behaviours related to the prevention of arboviruses before and after a two-month educational intervention using a learning platform on mobile devices.

METHODS

This quasi-experimental study corresponds to the first phase of the project 'Impact of mobile learning in the prevention and management of complications caused by arboviruses (Zika, Dengue, Chikungunya) - ZIKAMOB', sponsored as part of the British Council Newton Fund.

RESULTS

Thirty of the 93 participants were first-year undergraduate university students (36.7% male), and 63 were police officers (84.1% male). The pattern of attitudes and behaviour was very similar in both groups before the intervention. The students changed their attitudes and behaviour (P = 0.032) in relation to their engagements in actions for the prevention of arboviral diseases and several other activities related to house inspections and precautions with water tanks (P < 0.01). However, recycling and surveillance activities were not as effective in changing behaviour. Female participants showed more motivation to participate in preventive activities, but living alone and working were barriers to participation. Individuals who already perform selective waste collection and are cultivating gardens demonstrated both a positive attitude and a positive behaviour towards actions for the prevention of arboviral diseases.

CONCLUSION

Mobile learning and behaviour change theories might be successful as the basis for school-based and community-based interventions to avoid arboviruses. These outcomes need to be confirmed in broader future studies.

Developing a Digital Solution for Dengue Through Epihack: Qualitative Evaluation Study of a Five-Day Health Hackathon in Sri Lanka

Background

Dengue is a mosquito-borne viral disease that has increasingly affected Sri Lanka in recent years. To address this issue, dengue surveillance through increasingly prevalent digital surveillance applications has been suggested for use by health authorities and the general public. Epihack Sri Lanka was a 5-day hackathon event organized to develop a digital dengue surveillance tool.

Objective

The goal of the research was to examine the effectiveness of a collaborative hackathon that brought together information technology (IT) and health experts from around the globe to develop a solution to the dengue pandemic in Sri Lanka.

Methods

Ethnographic observation and qualitative informal interviews were conducted with 58 attendees from 11 countries over the 5-day Epihack to identify the main factors that influence a collaborative hackathon. Interviews were transcribed and coded based on grounded theory.

Results

Three major themes were identified during the Epihack Sri Lanka event: engagement, communication, and current disease environment. Unlike other hackathons, Epihack had no winners or prizes and was collaborative rather than competitive, which worked well in formulating a variety of ideas and bringing together volunteers with a sense of civic duty to improve public health. Having health and IT experts work together concurrently was received positively and considered highly beneficial to the development of the product. Participants were overall very satisfied with the event, although they thought it could have been longer. Communication issues and cultural differences were observed but continued to decrease as the event progressed. This was found to be extremely important to the efficiency of the event, which highlighted the benefit of team-bonding exercises. Bringing expert knowledge and examples of systems from around the world benefited the creation of new ideas. However, developing a system that can adapt and cater to the local disease environment is important in successfully developing the concepts.

Conclusions

Epihack Sri Lanka was successful in bringing together health and IT experts to develop a digital solution for dengue surveillance. The collaborative format achieved a variety of fruitful ideas and may lead to more hackathons working in this way in the future. Good communication, participant engagement, and stakeholder interest with adaptation of ideas to complement the current environment are vital to achieve the goals of the event.

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

Background

Dengue is a serious problem around the globe, with 3.9 billion people at risk of the disease. Sri Lanka has recently seen unprecedented rates of dengue with 4.3 times more cases than during the same period over the previous six years. The paper discusses the development of an integrated health systems framework, aided by mobile technology, to combat and contain dengue via a health hackathon in Sri Lanka.

Results

The framework addresses the key functions of surveillance, health communication and civic engagement through innovations including digitisation of hospital forms; digital aid to Public Health Inspectors (PHIs); data consolidation and analytics; education for construction workers, GPs, and schools; and educating the general public.

Conclusions

We present the impact of the disease burden in tropical countries, such as Sri Lanka, current technological solutions, and the process of developing the mobile application modules developed via the health hackathon.

VECTOS: An Integrated System for Monitoring Risk Factors Associated With Urban Arbovirus Transmission

To strengthen local surveillance of mosquito-borne viral diseases such as dengue and Zika, a multidisciplinary team developed an integrated web-based information system called VECTOS that captures geo-referenced entomological, epidemiological, and social data. The system has revealed previously unidentified features, such as specific neighborhoods, at persistently high risk.

In Colombia, as in many Latin American countries, decision making and development of effective strategies for vector control of urban diseases such as dengue, Zika, and chikungunya is challenging for local health authorities. The heterogeneity of transmission in urban areas requires an efficient risk-based allocation of resources to control measures. With the objective of strengthening the capacity of local surveillance systems to identify variables that favor urban arboviral transmission, a multidisciplinary research team collaborated with the local Secretary of Health officials of 3 municipalities in Colombia (Giron, Yopal, and Buga), in the design of an integrated information system called VECTOS from 2015 to 2018. Information and communication technologies were used to develop 2 mobile applications to capture entomological and social information, as well as a web-based system for the collection, geo-referencing, and integrated information analysis using free geospatial software. This system facilitates the capture and analysis of epidemiological information from the Colombian national surveillance system (SIVIGILA), periodic entomological surveys—mosquito larvae and pupae in premises and peridomestic breeding sites—and surveys of knowledge, attitudes, and practices (KAP) in a spatial and temporal context at the neighborhood level. The data collected in VECTOS are mapped and visualized in graphical reports. The system enables real-time monitoring of weekly epidemiological indicators, entomological indices, and social surveys. Additionally, the system enables risk stratification of neighborhoods, using selected epidemiological, entomological, demographic, and environmental variables. This article describes the VECTOS system and the lessons learned during its development and use. The joint analysis of epidemiological and entomological data within a geographic information system in VECTOS gives better insight to the routinely collected data and identifies the heterogeneity of risk factors between neighborhoods. We expect the system to continue to strengthen vector control programs in evidence-based decision making and in the design and enhanced follow-up of vector control strategies.

The Promise of Mobile Technologies for the Health Care System in the Developing World: A Systematic Review

Evolution of mobile technologies and their rapid penetration into people's daily lives, especially in the developing countries, have highlighted mobile health, or m-health, as a promising solution to improve health outcomes. Several studies have been conducted that characterize the impact of m-health solutions in resource-limited settings and assess their potential to improve health care. The aim of this review is twofold: 1) to present an overview of the background and significance of m-health and 2) to summarize and discuss the existing evidence for the effectiveness of m-health in the developing world. A systematic search in the literature was performed in Pubmed, Scopus, as well as reference lists, and a broad sample of 98 relevant articles was identified, which were then categorized into five wider m-health categories. Although statistically significant conclusions cannot be drawn since the majority of studies relied on small-scale trials and limited assessment of long-term effects, this review provides a systematic and extensive analysis of the advantages, disadvantages, and challenges of m-health in developing countries in an attempt to determine future research directions of m-health interventions.

Contributions of citizen scientists to arthropod vector data in the age of digital epidemiology

Citizen-collected arthropod vectors are useful for epidemiological studies of vector-borne disease, especially since the vectors encountered by the public are the subset of vectors in nature that have a disproportionate impact on health. Programs integrating educational efforts with collecting efforts may be particularly effective for public health initiatives, resulting in an empowered public with knowledge of vector-borne disease prevention. Citizen science programs have been successfully implemented for the collection of unprecedented sample sets of mosquitos, ticks, and triatomines. Cyber infrastructure employed in digital epidemiology-including websites, email, mobile phone apps, and social media platforms-has facilitated vector citizen science initiatives to assess disease risk over vast spatial and temporal scales, advancing research to mitigate vector-borne disease risk.

Participatory Disease Surveillance: Engaging Communities Directly in Reporting, Monitoring, and Responding to Health Threats

BACKGROUND

Since 2012, the International Workshop on Participatory Surveillance (IWOPS) has served as an informal network to share best practices, consult on analytic methods, and catalyze innovation to advance the burgeoning method of direct engagement of populations in voluntary monitoring of disease.

OBJECTIVE

This landscape provides an overview of participatory disease surveillance systems in the IWOPS network and orients readers to this growing field of practice.

METHODS

Authors reviewed participatory approaches that include human and animal health surveillance, both syndromic (self- reported symptoms) and event-based, and how these tools have been leveraged for disease modeling and forecasting. The authors also discuss benefits, challenges, and future directions for participatory disease surveillance.

RESULTS

There are at least 23 distinct participatory surveillance tools or programs represented in the IWOPS network across 18 countries. Organizations supporting these tools are diverse in nature.

CONCLUSIONS

Participatory disease surveillance is a promising method to complement both traditional, facility-based surveillance and newer digital epidemiology systems.