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

WhatsApp-based intervention in urban Colombia to support the prevention of arboviral diseases: a feasibility study

Arboviral diseases remain a significant health concern worldwide, with over half the world's population at risk for dengue alone. Without a vaccine or targeted treatment, the most effective strategy of prevention is vector management with community involvement. mHealth interventions, like WhatsApp, offer promising results for engaging communities and promoting healthier behaviors. This study explores the feasibility of integrating WhatsApp in vector control activities to improve arbovirus prevention in Colombia. A mixed-methods approach was employed to assess the WhatsApp-based intervention. WhatsApp messages were sent to 45 community women for 5 weeks to increase their knowledge and practices about dengue, Zika, and chikungunya. Pre-and-post surveys and focus group discussions were conducted in community settings to measure the feasibility and acceptability of this intervention. Chat reviews were done to assess the usability of users. A total of 1566 messages were exchanged in 45 WhatsApp chats. High acceptance and good usability (82% of users used the app for replying) were reported in this study. WhatsApp messages were perceived as short, clear, and enjoyable. Users liked the frequency, and design of messages. Pre- and post-surveys demonstrated improvements in the knowledge and practices of arboviral diseases. The intention to apply this knowledge in practice was reflected in a significant improvement, particularly in cleaning the laundry tank once a week (pre 62.1% to post 89.6%, p < 0.008). This study suggests that using WhatsApp as an additional tool could be a feasible, acceptable, and affordable strategy for improving the adoption of better practices in the prevention of arboviral diseases.

A Qualitative Analysis of the Perceptions of Stakeholders Involved in Vector Control and Vector-Borne Disease Research and Surveillance in Orinoquia, Colombia

Colombia has a tropical climate and environmental conditions that favour the circulation of most of the known vector-borne diseases (VBDs). Protocols have been established and implemented to address the threats of these diseases, but they are for country-wide use and do not take into consideration the nuances of the different environments of the country. Almost the entire population is vulnerable to infection with one or more VBD. This study aims to characterise the perceptions and experiences of stakeholders involved in vector control and VBDs in the Orinoquia region in Colombia. Two panel discussions, and 12 semi-structured interviews, were conducted. Experts from the Colombian National Health Institute (INS), health secretaries from Meta, Guaviare and Vichada Departments, academic researchers, and individuals from private vector control companies participated. All sessions were recorded, transcribed, and translated, and then subject to thematic analysis. Three major themes emerged: involvement, limitations, and recommendations. Results showed that participants are engaged in vector surveillance activities, education, and vector control research. Participants focused on problems of disjointed efforts towards VBD control between health secretaries and the health ministry, as well as societal issues, such as socioeconomic, cultural, and political issues, which became the rationale for the lack of vector control resources. Responses in the panel discussions and interviews overlapped in opinions, and suggested that vector control could be improved through better communication between vector control bodies, strengthened engagement with vulnerable communities, more collaborative actions, and a more balanced distribution of resources.

Medición de parámetros de signos vitales para emisión de alertas móviles

Una preocupación en las personas, consiste en cómo conocer su inmediato estado de salud. Un indicador clave para ello, lo reportan los parámetros de signos vitales: temperatura, frecuencia cardíaca y oxigenación; Los dispositivos wearables, permiten ese monitoreo mediante conexión con un móvil; sin embargo, muchos usuarios desconocen o no logran la interpretación adecuada de tales reportes. Por esta razón, además de monitorear automáticamente los signos vitales (en periodos determinados de tiempo), el objetivo del sistema propuesto, consiste en emitir alertas que se envían automáticamente, no solo al usuario del dispositivo, sino también a un acompañante mediante mensaje de texto, cada vez que alguno de estos parámetros se encuentra fuera del rango normal permitido.  Esto se logra con un modelo de categorización de usuarios soportado por un sistema de reglas que describe los rangos normales, estableciendo criterios para emitir las alertas. El beneficio principal del sistema propuesto, es tener información específica y en tiempo real, de un parámetro corporal permitiendo advertir un estado alterado de salud, insumo importante, para tomar decisiones médicas. Abstract, one of the main concerns of people, is how to know their immediate state of health. A key indicator for this is reported by vital signs parameters such as temperature, heart rate and oxygenation; The wearable devices, allow such monitoring by connecting to a cell phone; however, many users are unaware or fail to achieve the proper interpretation of such reports. For this reason, in addition to monitoring vital signs, the objective of this proposed system is to issue alerts that are sent automatically, not only to the user of the device, but also to a companion via text message whenever any of these parameters is outside the normal allowed range.  This is achieved with a user categorization model supported by a system of rules that describes the normal allowed ranges, establishing criteria for issuing alerts. The main benefit of the proposed system is to have specific information in real time, of a body parameter that allows warning of an altered state of health, which is useful as information for making medical decisions. 

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.