Development and On-Field Deployment of a Mobile-Based Application 'MoSQuIT' for Malaria Surveillance in International Border Districts of Northeast India-Challenges and Opportunities.

The conventional paper-based system for malaria surveillance is time-consuming, difficult to track and resource-intensive. Few digital platforms are in use but wide-scale deployment and acceptability remain to be seen. To address this issue, we created a malaria surveillance mobile app that offers real-time data to stakeholders and establishes a centralised data repository. The MoSQuIT app was designed to collect data from the field and was integrated with a web-based platform for data integration and analysis. The MoSQuIT app was deployed on mobile phones of accredited social health activists (ASHA) working in international border villages in the northeast (NE) Indian states of Assam, Tripura and Arunachal Pradesh for 20 months in a phased manner. This paper shares the challenges and opportunities associated with the use of MoSQuIT for malaria surveillance. MoSQuIT employs the same data entry formats as the NVBDCP's malaria surveillance programme. Using this app, a total of 8221 fever cases were recorded, which included 1192 (14.5%) cases of P. falciparum malaria, 280 (3.4%) cases of P. vivax malaria and 52 (0.6%) mixed infection cases. Depending on network availability, GPS coordinates of the fever cases were acquired by the app. The present study demonstrated that mobile-phone-based malaria surveillance facilitates the quick transmission of data from the field to decision makers. Geospatial tagging of cases helped with easy visualisation of the case distribution for the identification of malaria-prone areas and potential outbreaks, especially in hilly and remote regions of Northeast India. However, to achieve the full operational potential of the system, operational challenges have to be overcome.

Fluorescein angiographic features of asymptomatic eyes in central serous chorioretinopathy.

PURPOSE: Analysis of the fundus and fluorescein angiography (FA) features of the asymptomatic eyes in patients of central serous chorioretinopathy (CSC) at initial visit and estimation of the overall magnitude of bilateral pathology. METHODS: Retrospective observational case series that reviewed the medical records and FA features of 229 consecutive patients between January 1999 and December 2001. RESULTS: Seventy-three (31.88%) patients had symptoms in one eye but signs in both the eyes, of which 70 were selected. Bilateral symptomatic CSC was seen in 29 (12.66%). Thus, overall bilateral involvement was found in 102 (44.54%) patients. FA features of asymptomatic eyes were pigment epithelial detachment (32.85%), fluorescein leak (31.42%), window defect (31.42%), depigmented patches (14.29%), drusen-like deposits (12.85%), pigment clumps (4.29%), retinal pigment epithelial atrophy (4.28%), subretinal precipitate (2.85%), and sensory retinal detachment (5.71%). Forty-three (61.43%) had evidence of chronic subclinical CSC, whereas 27(38.57%) had features of clinically healed CSC. CSC developed in the asymptomatic eyes within 3 to 12 months in four of the 24 followed-up patients. CONCLUSION: Considerable number of asymptomatic eyes had features suggestive of healed or chronic subclinical CSC. These eyes are at risk for CSC caused by occurrence of active leak(s) from the same or new site(s).