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1.
BMC Public Health ; 18(Suppl 4): 1305, 2018 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-30541508

RESUMO

BACKGROUND: Eradication of polio requires that the acute flaccid paralysis (AFP) surveillance system is sensitive enough to detect all cases of AFP, and that such cases are promptly reported and investigated by disease surveillance personnel. When individuals, particularly community informants, are unaware of how to properly detect AFP cases or of the appropriate reporting process, they are unable to provide important feedback to the surveillance network within a country. METHODS: We tested a new SMS-based smartphone application (App) that enhances the detection and reporting of AFP cases to improve the quality of AFP surveillance. Nicknamed Auto-Visual AFP Detection and Reporting (AVADAR), the App creates a scenario where the AFP surveillance network is not dependent on a limited number of priority reporting sites. Being installed on the smartphones of multiple health workers (HWs) and community health informants (CHIs) makes the App an integral part of the detection and reporting system. RESULTS: Results from two phases of tests conducted in Nigeria point to the effectiveness of the App in the surveillance of AFP. CONCLUSION: We posit that appropriate use of the App can soon bring about a worldwide eradication of poliomyelitis.


Assuntos
Aplicativos Móveis , Hipotonia Muscular/epidemiologia , Paralisia/epidemiologia , Vigilância da População/métodos , Smartphone , Envio de Mensagens de Texto , Doença Aguda , Criança , Erradicação de Doenças , Humanos , Nigéria/epidemiologia , Poliomielite/prevenção & controle
2.
JMIR Public Health Surveill ; 6(4): e18950, 2020 12 02.
Artigo em Inglês | MEDLINE | ID: mdl-33263550

RESUMO

BACKGROUND: As we move toward a polio-free world, the challenge for the polio program is to create an unrelenting focus on smaller areas where the virus is still present, where children are being repeatedly missed, where immunity levels are low, and where surveillance is weak. OBJECTIVE: This article aimed to describe a possible solution to address weak surveillance systems and document the outcomes of the deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) project. METHODS: This intervention was implemented in 99 targeted high-risk districts with concerns for silent polio circulation from eight countries in Africa between August 1, 2017, and July 31, 2018. A total of 6954 persons (5390 community informants and 1564 health workers) were trained and equipped with a smartphone on which the AVADAR app was configured to allow community informants to send alerts on suspected acute flaccid paralysis (AFP) and allow health worker to use electronic checklists for investigation of such alerts. The AVADAR and Open Data Kit ONA servers were at the center of the entire process. A dashboard system and coordination teams for monitoring and supervision were put in place at all levels. RESULTS: Overall, 96.44% (24,142/25,032) of potential AFP case alerts were investigated by surveillance personnel, yielding 1414 true AFP cases. This number (n=1414) reported through AVADAR was higher than the 238 AFP cases expected during the study period in the AVADAR districts and the 491 true AFP cases reported by the traditional surveillance system. A total of 203 out of the 1414 true AFP cases reported were from special population settings, such as refugee camps and insecure areas. There was an improvement in reporting in silent health areas in all the countries using the AVADAR system. Finally, there were 23,473 reports for other diseases, such as measles, diarrhea, and cerebrospinal meningitis, using the AVADAR platform. CONCLUSIONS: This article demonstrates the added value of AVADAR to rapidly improve surveillance sensitivity. AVADAR is capable of supporting countries to improve surveillance sensitivity within a short interval before and beyond polio-free certification.


Assuntos
Hipotonia Muscular/diagnóstico , Poliomielite/prevenção & controle , Vigilância da População/métodos , África/epidemiologia , Estudos de Avaliação como Assunto , Humanos , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Hipotonia Muscular/epidemiologia , Poliomielite/epidemiologia , Avaliação de Programas e Projetos de Saúde/métodos
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