April - June 2011ContainmentThe Quarterly Newsletter of the Containment of Artemisinin-Tolerent Malaria Parasites in South...
Surveillance of Day-3 Falciparum MalariaPositives in Real-Time  Malaria Consortium, throughthe Containment Project, is pil...
“FrontlineSMS interfaces with                                                                                             ...
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Surveillance of Day 3 Falciparum Malaria Positives in Real Time


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WHO Publication on using mobile phone and web-based technology to facilitate response to malaria in real-time.

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Surveillance of Day 3 Falciparum Malaria Positives in Real Time

  1. 1. April - June 2011ContainmentThe Quarterly Newsletter of the Containment of Artemisinin-Tolerent Malaria Parasites in South-East Asia Project
  2. 2. Surveillance of Day-3 Falciparum MalariaPositives in Real-Time Malaria Consortium, throughthe Containment Project, is pilot- Location on Google Earthing a Day-3 positive alert systemin western Cambodia’s Ta Sanhdistrict, using mobile phoneand web-based technology tofacilitate response to malariain real-time. CONTAINMENT’sSonny Inbaraj reports. EFFECTIVE containment ofmulti-drug resistant falciparummalaria depends on timely acquisi-tion of information on new cases,their location and frequency. Thisis to plan interventions and focusattention on speci c locations to Source: WHO/Sonny Krishnanprevent an upsurge in transmis-sion. Diagram showing how a text message from the Ta Sanh Health Centre gets disseminated with FrontlineSMS. Response in western Cambodia’sTa Sanh district involves combining skills of VMWs in other villages “Immediately after a villager teststhe process of positive diagnoses in the Containment Project. The positive for falciparum malaria in athrough microscopy of Day 3 posi- VMWs were also trained to carry rapid diagnostic test (RDT), I pre-tives at the Ta Sanh health centre out a three-day directly observed pare the blood slides. Then I givefrom blood slides sent by Village treatment (DOT) of Pf cases with the drugs, which the villager has toMalaria Workers, to an alert system the co-formulated ACT dihydroar- take in front of me,” says Khea.using mobile phone and web-based temisinin - piperaquine.technology to help pinpoint poten- “On Day 2 and Day 3, I’ll go totial outbreaks of malaria and target Chou Khea, a 21-year-old Village the villager’s house and make sureinterventions to foci where parasite Malaria Worker, trained by MCC in that the drugs are again taken inreservoirs are likely to be present. Ta Sanh district’s remote Ou Non- my presence,” she adds. “After 72 oung village tells CONTAINMENT hours from the rst intake of the The proportion of patients who how she carries out DOT. anti-malaria drugs, I’ll be at thestill carry malaria parasites on thethird day of treatment is currentlythe best measure available of slowparasite clearance and can be usedas a warning system for con rma-tion of artemisinin resistance. In Ta Sanh, the Village MalariaWorkers or VMWs play a crucialrole in the early detection andtreatment of the killer falciparummalaria. In September 2010, theContainment Project partnered theUSAID-funded University ResearchCo., LLC (URC) to train these VMWsto prepare blood slides on DaysZero and 3, from those who testedpositive for falciparum malaria. Asimilar partnership was enteredinto with the public health anddevelopment NGO Family Health Photo: WHO/MERGInternational (FHI) to upgrade the A validation of the SMS sent from the Ta Sanh Health Centre, from the database.4 Containment April - June 2011
  3. 3. “FrontlineSMS interfaces with an MS Access database system that was developed to host the SMS data and to provide validation on the data received and to send an automatic reply to the sender con- taining any validation errors found, or to con rm that the data has been accepted,” he adds. In the Access database, a script interfaces with Google Earth and maps out the locations of the Day 3 positives based on the village code. The mapping on Google Earth is essential as it gives a clear visu- alisation of the terrain and helps CNM, WHO and the USAID-funded Cambodia Malaria Prevention and Photo: Malaria Consortium Control Project (MCC) to plan coor-Day 3 positives, in the Access database, mapped in real-time on Google Earth. dinated interventions in terms of case follow-up on Day Zero and Day 3 and carry out epidemiological andvillager’s house again to take his immediately sends out an SMS on entomological investigations.or her blood sample for preparing a mobile phone, using a dedicatedanother blood slide.” number, to a database indicating “All this happens in real-time the village code and the sex of the and alert text messages are sent Chou Khea then takes the Day patient. out simultaneously to the opera-Zero and Day 3 slides, together tional district malaria supervisor,with the used RDT, to the Ta Sanh Malaria Consortium pioneered the provincial health department,Health Centre 30-kilometres away the use of this alert system in Ta CNM and the administrators of thefrom her village. Sanh, with support from Cambodia’s database,” Mellor points out. National Centre for Parasitology, “I usually take a motor-dop Entomology and Malaria Control There are plans to upscale this(motorcycle taxi) to the health (CNM) and the World Health Organ- mobile phone and web-based alertcentre. But most of the motor-dop ization’s Malaria Containment system with InSTEDD, an innova-drivers are reluctant to use the track Project funded by the Bill & Melinda tive humanitarian technology NGO,to health centre in the rainy season Gates Foundation. to map all Day Zero cases. Malariabecause of the slippery mud. Also Consortium and CNM are also inmany of them M a l a r i a direct talks with Mobitel, one ofare scared ofthe wild animals There are plans to up- C o n s o r t i u m ’s Information Sys- Cambodia’s main telecommunica- tion carriers.and land-mines scale this mobile phone tems Managerin the area,” she Steve Mellor “We are in negotiations withtells CONTAIN- and web-based alert explains the use Mobitel for a free number and alsoMENT with system of cellular text free SIM cards to be distributedconcern. “I hope messaging (SMS) to health centre staff and villageto have my own with InSTEDD, an in- as a viable tool to malaria workers,” Mellor reveals.motorcycle soon,so that I’ll be novative humanitarian send alerts and map Day 3 posi- “After all, this is for a public good.”able to transport technology NGO, to tives in real-timethe slides and on Google Earth. Besides plans to map all Day ZeroRDTs faster,” map all Day Zero cases, Malaria Consortium is alsoshe adds with a cases… “We use exploring the possibility of sendingsmile. FrontlineSMS, alert messages in Khmer script. an open-source At the Ta Sanh Health Centre, software, that enables users to “This will be a breakthrough andthe Day 3 slides are examined by a send and receive text messages we hope this will help facilitate amicroscopist and if asexual malaria with groups of people through quick response mechanism fromparasites are seen they are graded mobile phones,” Mellor tells CON- CNM and other partners,” saysas positive. The microscopist TAINMENT. Mellor. April - June 2011 Containment 5