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. 2022 Nov 12:4:100339.
doi: 10.1016/j.puhip.2022.100339. eCollection 2022 Dec.

Protocol to implement a syndromic surveillance survey of COVID-19 in Malawi

Thulani Maphosa  1 , Godfrey Woelk  2 , Brittney N Baack  3 , Evelyn Kim  3 , Rhoderick Machekano  2 , Annie Chauma Mwale  4 , Thokozani Kalua  5 , Suzgo Zimba  1 , Rachel Kanyenda Chamanga  1 , Alice Maida  3 , Andrew Auld  3 , Andrew S Azman  6 , Maria Oziemkowska  2 , Joram Sunguti  1 , Cathy Golowa  1 , Lester Kapanda  1 , Harrid Nkhoma  1 , Veena Sampathkumar  1 , Allan Ahimbisibwe  1 , Louiser Kalitera  1 , Elton Masina  1 , Rumours Lumala  1 , Kwashie Kudiabor  1 , Zuze Joaki  1 , Cephas Muchuchuti  6 , Tadala H Mengezi  5 , Rose Nyirenda  5 , Laura Guay  2
Affiliations

Protocol to implement a syndromic surveillance survey of COVID-19 in Malawi

Thulani Maphosa et al. Public Health Pract (Oxf). .

Abstract

Introduction: Malawi experienced two waves of COVID-19 between April 2020 and February 2021. A High negative impact of COVID-19 was experienced in the second wave, with increased hospital admissions that overwhelmed the healthcare system. This paper describes a protocol to implement a telephone-based syndromic surveillance system to assist public health leaders in the guidance, implementation, and evaluation of programs and policies for COVID-19 prevention and control in Malawi.

Study design: This is a serial cross-sectional telephonic-based national survey focusing on the general population and People living with HIV and AIDS.

Methods: We will conduct a serial cross-sectional telephone survey to assess self-reported recent and current experience of influenza-like illness (ILI)/COVID-19-like-illness (CLI), household deaths, access to routine health services, and knowledge related to COVID-19. Structured questionnaires will be administered to two populations: 1) the general population and 2) people living with HIV (PLHIV) on antiretroviral therapy (ART) at EGPAF-supported health facilities. Electronic data collection forms using secure tablets will be used based on randomly selected mobile numbers from electronic medical records (EMR) for PLHIV. We will use random digit dialing (RDD) for the general population to generate phone numbers to dial respondents. The technique uses computer-generated random numbers, using the 10-digit basic structure of mobile phone numbers for the two existing mobile phone companies in Malawi. Interviews will be conducted only with respondents that will verbally consent. A near real-time online dashboard will be developed to help visualize the data and share results with key policymakers.

Conclusion: The designed syndromic surveillance system is low-cost and feasible to implement under COVID-19 restrictions, with no physical contact with respondents and limited movement of the study teams and communities. The system will allow estimation proportions of those reporting ILI/CLI among the general population and PLHIV on ART and monitor trends over time to detect locations with possible COVID-19 transmission. Reported household deaths in Malawi, access to health services, and COVID-19 knowledge will be monitored to assess the burden and impact on communities in Malawi.

Keywords: COVID-19; Influenza-like illness; Malawi; People living with HIV; Syndromic surveillance.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Central Call Center System for calling respondents.
Fig. 2
Fig. 2
Informatics Infrastructure for survey data flow.
See this image and copyright information in PMC

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