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. 2019 Sep 18;19(1):810.
doi: 10.1186/s12879-019-4354-z.

Use of a mobile application for Ebola contact tracing and monitoring in northern Sierra Leone: a proof-of-concept study

Lisa O Danquah  1   2 , Nadia Hasham  3   4 , Matthew MacFarlane  4 , Fatu E Conteh  4 , Fatoma Momoh  4 , Andrew A Tedesco  4 , Amara Jambai  5 , David A Ross  3 , Helen A Weiss  3
Affiliations

Use of a mobile application for Ebola contact tracing and monitoring in northern Sierra Leone: a proof-of-concept study

Lisa O Danquah et al. BMC Infect Dis. .

Abstract

Background: The 2014-2016 Ebola epidemic in West Africa was the largest Ebola epidemic to date. Contact tracing was a core surveillance activity. Challenges with paper-based contact tracing systems include incomplete identification of contacts, delays in communication and response, loss of contact lists, inadequate data collection and transcription errors. The aim of this study was to design and evaluate an electronic system for tracing contacts of Ebola cases in Port Loko District, Sierra Leone, and to compare this with the existing paper-based system. The electronic system featured data capture using a smartphone application, linked to an alert system to notify the District Ebola Response Centre of symptomatic contacts.

Methods: The intervention was a customised three-tier smartphone application developed using Dimagi's CommCare platform known as the Ebola Contact Tracing application (ECT app). Eligible study participants were all 26 Contact Tracing Coordinators (CTCs) and 86 Contact Tracers (CTs) working in the 11 Chiefdoms of Port Loko District during the study period (April-August 2015). Case detection was from 13th April to 17th July 2015. The CTCs and their CTs were provided with smartphones installed with the ECT app which was used to conduct contact tracing activities. Completeness and timeliness of contact tracing using the app were compared with data from April 13th-June 7th 2015, when the standard paper-based system was used.

Results: For 25 laboratory-confirmed cases for whom paper-based contact tracing was conducted, data for only 39% of 408 contacts were returned to the District, and data were often incomplete. For 16 cases for whom app-based contact tracing was conducted, 63% of 556 contacts were recorded as having been visited on the app, and the median recorded duration from case confirmation to first contact visit was 70 h.

Conclusion: There were considerable challenges to conducting high-quality contact tracing in this setting using either the paper-based or the app-based system. However, the study demonstrated that it was possible to implement mobile health (mHealth) in this emergency setting. The app had the benefits of improved data completeness, storage and accuracy, but the challenges of using an app in this setting and epidemic context were substantial.

Keywords: Contact tracing; Ebola; Sierra Leone; mHealth.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Design of the Ebola Contact Tracing smartphone app study. Key. * The surveillance team goes back to the house of the suspected case to obtain an updated list of contacts following laboratory confirmation. ** District Health Management Team. # Viral Hemorrhagic Fever. † Contact Tracing Coordinators visit the DHMT six days a week (Monday to Saturday). $ Ebola Contact Tracing
See this image and copyright information in PMC

References

    1. 2014 Ebola Outbreak in West Africa - Case Counts [http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/case-counts.html. Accessed 5 May 2016].
    1. World Health Organization. Contact tracing during an outbreak of Ebola virus disease. Geneva: WHO; 2014.
    1. World Health Organization. Surveillance strategy during Phase 3 of the Ebola response. Geneva: WHO; 2015.
    1. Faye O, Boëlle P-Y, Heleze E, Faye O, Loucoubar C, Magassouba NF, Soropogui B, Keita S, Gakou T, Bah EHI, et al. Chains of transmission and control of Ebola virus disease in Conakry, Guinea, in 2014: an observational study. Lancet Infect Dis. 2015;15(3):320–326. doi: 10.1016/S1473-3099(14)71075-8. - DOI - PMC - PubMed
    1. McNamara LA, Schafer IJ, Nolen LD, Gorina Y, Redd JT, Lo T, Ervin E, Henao O, Dahl BA, Morgan O, et al. Ebola Surveillance -Guinea, Liberia and Sierra Leone. MMWR Suppl. 2016;65(Suppl-3):35–43. doi: 10.15585/mmwr.su6503a6. - DOI - PubMed