3,792 research outputs found

    Do surveys with paper and electronic devices differ in quality and cost? Experience from the Rufiji Health and demographic surveillance system in Tanzania

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    Data entry at the point of collection using mobile electronic devices may make data-handling processes more efficient and cost-effective, but there is little literature to document and quantify gains, especially for longitudinal surveillance systems.; To examine the potential of mobile electronic devices compared with paper-based tools in health data collection.; Using data from 961 households from the Rufiji Household and Demographic Survey in Tanzania, the quality and costs of data collected on paper forms and electronic devices were compared. We also documented, using qualitative approaches, field workers, whom we called 'enumerators', and households' members on the use of both methods. Existing administrative records were combined with logistics expenditure measured directly from comparison households to approximate annual costs per 1,000 households surveyed.; Errors were detected in 17% (166) of households for the paper records and 2% (15) for the electronic records (p < 0.001). There were differences in the types of errors (p = 0.03). Of the errors occurring, a higher proportion were due to accuracy in paper surveys (79%, 95% CI: 72%, 86%) compared with electronic surveys (58%, 95% CI: 29%, 87%). Errors in electronic surveys were more likely to be related to completeness (32%, 95% CI 12%, 56%) than in paper surveys (11%, 95% CI: 7%, 17%).The median duration of the interviews ('enumeration'), per household was 9.4 minutes (90% central range 6.4, 12.2) for paper and 8.3 (6.1, 12.0) for electronic surveys (p = 0.001). Surveys using electronic tools, compared with paper-based tools, were less costly by 28% for recurrent and 19% for total costs. Although there were technical problems with electronic devices, there was good acceptance of both methods by enumerators and members of the community.; Our findings support the use of mobile electronic devices for large-scale longitudinal surveys in resource-limited settings

    Free and simple GIS as appropriate for health mapping in a low resource setting: a case study in eastern Indonesia

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    Background: Despite the demonstrated utility of GIS for health applications, there are perceived problems in low resource settings: GIS software can be expensive and complex; input data are often of low quality. This study aimed to test the appropriateness of new, inexpensive and simple GIS tools in poorly resourced areas of a developing country. GIS applications were trialled in pilot studies based on mapping of health resources and health indicators at the clinic and district level in the predominantly rural province of Nusa Tenggara Timur in eastern Indonesia. The pilot applications were (i) rapid field collection of health infrastructure data using a GPSenabled PDA, (ii) mapping health indicator data using open source GIS software, and (iii) service availability mapping using a free modelling tool. Results: Through contextualised training, district and clinic staff acquired skills in spatial analysis and visualisation and, six months after the pilot studies, they were using these skills for advocacy in the planning process, to inform the allocation of some health resources, and to evaluate some public health initiatives.Conclusions: We demonstrated that GIS can be a useful and inexpensive tool for the decentralisation of health data analysis to low resource settings through the use of free and simple software, locally relevant training materials and by providing data collection tools to ensure data reliability

    Decision Support System for the Response to Infectious Disease Emergencies Based on WebGIS and Mobile Services in China

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    Background: For years, emerging infectious diseases have appeared worldwide and threatened the health of people. The emergence and spread of an infectious-disease outbreak are usually unforeseen, and have the features of suddenness and uncertainty. Timely understanding of basic information in the field, and the collection and analysis of epidemiological information, is helpful in making rapid decisions and responding to an infectious-disease emergency. Therefore, it is necessary to have an unobstructed channel and convenient tool for the collection and analysis of epidemiologic information in the field. Methodology/Principal Findings: Baseline information for each county in mainland China was collected and a database was established by geo-coding information on a digital map of county boundaries throughout the country. Google Maps was used to display geographic information and to conduct calculations related to maps, and the 3G wireless network was used to transmit information collected in the field to the server. This study established a decision support system for the response to infectious-disease emergencies based on WebGIS and mobile services (DSSRIDE). The DSSRIDE provides functions including data collection, communication and analyses in real time, epidemiological detection, the provision of customized epidemiological questionnaires and guides for handling infectious disease emergencies, and the querying of professional knowledge in the field. These functions of the DSSRIDE could be helpful for epidemiological investigations in the field and the handling of infectious-disease emergencies. Conclusions/Significance: The DSSRIDE provides a geographic information platform based on the Google Maps application programming interface to display information of infectious disease emergencies, and transfers information between workers in the field and decision makers through wireless transmission based on personal computers, mobile phones and personal digital assistants. After a 2-year practice and application in infectious disease emergencies, the DSSRIDE is becoming a useful platform and is a useful tool for investigations in the field carried out by response sections and individuals. The system is suitable for use in developing countries and low-income districts

    A comparative study on the benefits and challenges of the application of mobile technology in health

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    Background: The application of mobile technology in the health domain i.e mobile health (mhealth) commonly refers to the use of mobile telecommunication and multi-media technologies for providing health services and public health systems. Some scholars consider mobile health as a subsystem of health technology which, due to the existing conditions, has become more significant compared to other interventions in this field. The present study intends to investigate the global approach on mobile health technology on the one hand, and its benefits and challenges on the other. Materials and Methods: As a comparative-descriptive study conducted in 2011, the present study has tried to explore mhealth technology strategies in public health domain, different types of mhealth interventions and benefits of using mhealth as well as its challenges and obstacles. The data were collected through informational sources such as articles, books, magazines and valid websites. Then, the status of the countries were compared and analyzed as far as the development of this technology is concened. Results:Based on the findings of the study, one of the criteria affecting the development of mhealth is the high penetration of mobile phone. By October, 2011, the estimated number of mobile users has been over 5 billion showing a penetration coefficient of 76. The review of the research on the obstacles and challenges experienced in moving towards the development of this technology by World Health Organization revealed that prioritization and increasing knowledge level are the most significant obstacles in the way to develop this technology. Discussions: Mhealth technology has been provided in most countries with the aim of promoting public health and accelerating the supply of health services. Having a penetration coefficient of over 90 in Iran, it can be predicted that this country can take effective steps towards development of this technology

    Health System Metrics : Tanzania Case Studies of Current Practices

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    Use of personal digital assistants in household surveys in demographic surveillance systems : final report

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    The project aimed to ensure better resource allocation decisions for health purposes in Least Developed Countries (LDC) such as Tanzania, by improving data gathering and analysis using Personal Digital Assistants (PDAs). As well, it helped establish the feasibility of employing paperless data collection methods in demographic surveillance systems (DSS). This paper reports on the project activities and outcomes. It focuses on methodology as well as experiences of researchers and survey respondents

    Economics of Robust Surveillance on Exotic Animal Diseases: the Case of Bluetongue

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    Control of emerging animal diseases critically depends on their early detection. However, designing surveillance programs for exotic and emerging diseases is very challenging because of knowledge gaps on the probability of incursion and mechanisms of spread. Using the example of Bluetongue Virus, which is exotic to the UK, we develop a metapopulation epidemic-economic modelling framework that considers the incursion, detection, spread and control of a disease in a livestock production system composed of heterogeneous subpopulations. The model is then embedded in an information gap (info-gap) framework to assess the robustness of surveillance and vaccination policies to unacceptable outbreaks losses and applied to the case of Bluetongue in the UK. The results show that active reporting of suspect clinical signs by farmers is a very robust way to reduce unacceptable outcomes. Vaccination of animals in high risk regions led to robustly protective programs. If vaccines are not available, surveillance targeted to the high risk region is very robust even if the extent of the high risk region is not known and effectiveness of detection is very low. Surveillance programs focusing in all regions with the same intensity are in general not robust unless the dispersal of the vector connecting both regions is very high.compartmental epidemic model, emergent animal disease, Knightian uncertainty, sentinel surveillance system, Livestock Production/Industries,

    Geo-spatial reporting for monitoring of household immunization coverage through mobile phones: Findings from a feasibility study

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    Background: The addition of Global Positioning System (GPS) to a mobile phone makes it a very powerful tool for surveillance and monitoring coverage of health programs. This technology enables transfer of data directly into computer applications and cross-references to Geographic Information Systems (GIS) maps, which enhances assessment of coverage and trends.Objective: Utilization of these systems in low and middle income countries is currently limited, particularly for immunization coverageassessments and polio vaccination campaigns. We piloted the use of this system and discussed its potential to improve the efficiency of field-based health providers and health managers for monitoring of the immunization program.Methods: Using 30×7 WHO sampling technique, a survey of children less than five years of age was conducted in random clusters of Karachi, Pakistan in three high risk towns where a polio case was detected in 2011. Center point of the cluster was calculated by the application on the mobile. Data and location coordinates were collected through a mobile phone. This data was linked with an automated mHealth based monitoring system for monitoring of Supplementary Immunization Activities (SIAs) in Karachi. After each SIA, a visual report was generated according to the coordinates collected from the survey.Result: A total of 3535 participants consented to answer to a baseline survey. We found that the mobile phones incorporated with GIS maps can improve efficiency of health providers through real-time reporting and replacing paper based questionnaire for collection of data at household level. Visual maps generated from the data and geospatial analysis can also give a better assessment of the immunizationcoverage and polio vaccination campaigns.Conclusion: The study supports a model system in resource constrained settings that allows routine capture of individual level data through GPS enabled mobile phone providing actionable information and geospatial maps to local public health managers, policy makers and study staff monitoring immunization coverage

    An affordable, quality-assured community-based system for high-resolution entomological surveillance of vector mosquitoes that reflects human malaria infection risk patterns.

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    ABSTRACT: BACKGROUND: More sensitive and scalable entomological surveillance tools are required to monitor low levels of transmission that are increasingly common across the tropics, particularly where vector control has been successful. A large-scale larviciding programme in urban Dar es Salaam, Tanzania is supported by a community-based (CB) system for trapping adult mosquito densities to monitor programme performance. Methodology An intensive and extensive CB system for routine, longitudinal, programmatic surveillance of malaria vectors and other mosquitoes using the Ifakara Tent Trap (ITT-C) was developed in Urban Dar es Salaam, Tanzania, and validated by comparison with quality assurance (QA) surveys using either ITT-C or human landing catches (HLC), as well as a cross-sectional survey of malaria parasite prevalence in the same housing compounds. RESULTS: Community-based ITT-C had much lower sensitivity per person-night of sampling than HLC (Relative Rate (RR) [95% Confidence Interval (CI)] = 0.079 [0.051, 0.121], P < 0.001 for Anopheles gambiae s.l. and 0.153 [0.137, 0.171], P < 0.001 for Culicines) but only moderately differed from QA surveys with the same trap (0.536 [0.406,0.617], P = 0.001 and 0.747 [0.677,0.824], P < 0.001, for An. gambiae or Culex respectively). Despite the poor sensitivity of the ITT per night of sampling, when CB-ITT was compared with QA-HLC, it proved at least comparably sensitive in absolute terms (171 versus 169 primary vectors caught) and cost-effective (153USversus187US versus 187US per An. gambiae caught) because it allowed more spatially extensive and temporally intensive sampling (4284 versus 335 trap nights distributed over 615 versus 240 locations with a mean number of samples per year of 143 versus 141). Despite the very low vectors densities (Annual estimate of about 170 An gambiae s.l bites per person per year), CB-ITT was the only entomological predictor of parasite infection risk (Odds Ratio [95% CI] = 4.43[3.027,7. 454] per An. gambiae or Anopheles funestus caught per night, P =0.0373). Discussion and conclusion CB trapping approaches could be improved with more sensitive traps, but already offer a practical, safe and affordable system for routine programmatic mosquito surveillance and clusters could be distributed across entire countries by adapting the sample submission and quality assurance procedures accordingly
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