Spotlight: Smartphones Connect Disease Data Faster
As our world becomes increasingly connected by smartphones, CDC experts are helping countries harness the power of technology. According to a 2018 report, “the number of global smartphone unique subscribers will surpass 3 billion in 2018.” This presents an unprecedented opportunity to engage individuals in protecting our collective health. Across the globe, CDC experts are using smartphones to find and stop outbreaks at the source.
The DGHP-Farmer & Rabies smartphone app allows people who work with poultry and swine to report human and animal sicknesses or deaths with the click of a few buttons. Recognizing that those who are regularly in close contact with animals are often the first affected when a zoonotic disease strikes, the Thai Ministry of Public Health’s (MOPH) Bureau of Epidemiology partnered with CDC in 2017 to develop a new app and website for use by farmers, local health volunteers, and health officers. The reporting tool quickly informs the MOPH of increases in animal illness and deaths; illness in people possibly linked to animals; or other abnormal events. A provincial One Health team monitors the reports and initiates rapid response to control outbreaks. In its pilot year, the app led to successful investigations of potential Strepotococcus suis infection and Japanese encephalitis. In 2018, the app expanded to include reporting of dog and cat bites to help catch rabies outbreaks. By putting surveillance into the hands of the community, the app helps contain zoonotic diseases before they spiral into epidemics.
A new mobile app called the Kenya Animal Biosurveillance System (KABS) allows veterinary practitioners to enter, transmit, and analyze surveillance data, right from the palm of their hand. Developed by Washington State University and supported by the Global Health Security Agenda, the app enables early detection of outbreaks in livestock and wildlife to prevent spillover of diseases into humans. The app is part of the recently launched Kenya Livestock and Wildlife Syndromic Surveillance system – the country’s first near real-time electronic surveillance and reporting system for zoonotic diseases. Data collected through KABS have already been used to detect outbreaks: in late 2017, a trainee from Nakuru County sent a report on sudden death syndrome in cattle through the KABS platform. The Zoonotic Disease Unit rapidly deployed to investigate, confirming an outbreak of anthrax in livestock, wildlife, and humans.
Zambia is the first country to conduct a new mobile phone survey to track noncommunicable diseases (NCDs) and related risk factors by gathering information on topics like tobacco use, alcohol use, diet, hypertension, and diabetes. The NCD Mobile Phone Survey is a component of Bloomberg Philanthropies’ Data for Health initiative and was recently implemented by Zambia’s Ministry of Health with technical assistance from CDC’s Global NCD Branch, RTI International, InSTEDD, and other global partners. The platform uses an adaptable, open-source technology, allowing countries to carry out surveys on topics of interest. Zambia’s success offers a model for how to effectively roll out the program in other countries. In the next year, seven additional low- and middle-income countries or sites will conduct NCD Mobile Phone Surveys.
In February 2018, thousands of Guatemalans received text messages asking for help in tracking potential outbreaks of flu. The message was sent by CDC and Guatemalan public health officials, with support from a leading telecom company. Message recipients were offered one of two rewards – a series of free health tips or a chance at a $15 phone credit – in exchange for providing weekly reports on any symptoms of “Influenza-like illness” (ILI) they experience. The data was used to pinpoint when and where flu outbreaks might be occurring. To collect the information, CDC experts created an app called “Nuestra Gripe” (“Our Flu”) that allows Android phone users to complete a weekly report by answering a set of questions. Information was also collected using a mobile accessible web-based survey. A total of 1,594 reports from 1,075 participants were received between February and May, with over 500 reporting symptoms of ILI across nearly all country departments. Public participation in flu surveillance has the potential to strengthen limited and delayed information from hospital and laboratory-based surveillance across Latin America.
In May 2018, the Western Area rural district of Sierra Leone rolled out a program that enables workers to report critical health information to the country’s surveillance network via a smartphone app. The rollout followed a period of pilot testing in the Port Loko district, after which the app underwent a series of updates and improvements for national release. Health workers use the app to submit weekly reports to the country’s electronic Integrated Disease Surveillance and Response system, which is designed to capture data on any device, including desktops, laptops, tablets, and smartphones. Most systems also have the capability to be used offline, which is especially helpful in rural areas with poor connectivity. Fast and accurate information from local health facilities can help us get ahead of diseases and stop outbreaks.