A Mobile App and Dashboard for Early Detection of Infectious Disease Outbreaks: Development Study

BackgroundOutbreaks of infectious diseases pose great risks, including hospitalization and death, to public health. Therefore, improving the management of outbreaks is important for preventing widespread infection and mitigating associated risks. Mobile health technology provides new capabilities that can help better capture, monitor, and manage infectious diseases, including the ability to quickly identify potential outbreaks.ObjectiveThis study aims to develop a new infectious disease surveillance (IDS) system comprising a mobile app for accurate data capturing and dashboard for better health care planning and decision making.MethodsWe developed the IDS system using a 2-pronged approach: a literature review on available and similar disease surveillance systems to understand the fundamental requirements and face-to-face interviews to collect specific user requirements from the local public health unit team at the Nepean Hospital, Nepean Blue Mountains Local Health District, New South Wales, Australia.ResultsWe identified 3 fundamental requirements when designing an electronic IDS system, which are the ability to capture and report outbreak data accurately, completely, and in a timely fashion. We then developed our IDS system based on the workflow, scope, and specific requirements of the public health unit team. We also produced detailed design and requirement guidelines. In our system, the outbreak data are captured and sent from anywhere using a mobile device or a desktop PC (web interface). The data are processed using a client-server architecture and, therefore, can be analyzed in real time. Our dashboard is designed to provide a daily, weekly, monthly, and historical summary of outbreak information, which can be potentially used to develop a future intervention plan. Specific information about certain outbreaks can also be visualized interactively to understand the unique characteristics of emerging infectious diseases.ConclusionsWe demonstrated the design and development of our IDS system. We suggest that the use of a mobile app and dashboard will simplify the overall data collection, reporting, and analysis processes, thereby improving the public health responses and providing accurate registration of outbreak information. Accurate data reporting and collection are a major step forward in creating a better intervention plan for future outbreaks of infectious diseases.     

云南省边境地区症状监测预警系统的开发与实践

目的 利用信息化技术,在云南省边境地区建立持续动态症状监测预警系统,并探讨其有效性和及时性,以提升边境地区传染病防控能力。方法 选择3个边境县,以全覆盖的方式,于2016年1月至2018年2月持续监测医疗机构14个症状及6个症候群,收集小学每天学生缺勤信息和边境口岸入境人员发热信息,构建基于手机和电脑平台的症状监测预警系统。结果 采用EARS-3C和Kulldorff时空扫描的预警模型,发现皮疹、流感样症状和小学缺勤等多个监测信号源对手足口病、流感和水痘等常见传染病预警有较高的灵敏度和特异度（可提前1~5 d预警）。系统简便易用,安全性和可行性较强,以交互式图表及可视化地图的方式展示,相关人员能够随时掌握监测数据情况和预警信号的变化,及时采取处置措施。结论 该系统科学有效、操作方便,能实时发现边境地区常见传染病的暴发或聚集事件,实现及时采取有效干预措施,减少本地及跨境传染病暴发的风险,具有实际应用价值。     

Promoting early achievement in low-income preschoolers in the United States with educational apps

ABSTRACT

The present study examined the potential of educational apps for mobile devices as a home-based learning tool to promote preliteracy and emergent math development among preschool-aged children. A randomized controlled trial was conducted with 22 preschoolers from low-income families and their primary caregivers. Children demonstrated substantively significant gains in preliteracy and emergent math skills after 3 months of educational app use at home, compared with a control group who used wholesome entertainment apps over the same period. Parent-rated academic interest also significantly increased for the experimental group compared to the control group. The educational apps were well-received and used as directed. Apps were most often used with a parent or sibling. Given the prevalence of mobile devices – even in the lowest income communities – and the low cost of apps, educational apps may be a promising avenue of intervention to address early achievement gaps.     

Field-based evaluation of malaria outbreak detection and response in Mudzi and Goromonzi districts,Zimbabwe – 2017

ABSTRACT

National-level evaluations may fail to identify capacity improvements for detecting and responding to outbreaks which begin and are first detected at the local level. In response to this issue, we conducted a field-based assessment of the malaria outbreak surveillance system in Mashonaland East, Zimbabwe. We visited eleven clinics in Mudzi and Goromonzi districts. Twenty-one interviews were conducted with key informants from the provincial (n?=?2), district (n?=?7), and clinic (n?=?12) levels. Interviews focused on surveillance system activities, preparedness, data quality, timeliness, stability, and usefulness. Main themes were captured utilising standard qualitative data analysis techniques. While the surveillance system detects malaria outbreaks at all levels, we identified several gaps. Clinics experience barriers to timely and reliable reporting of outbreaks to the district level and staff cross-training. Stability of resources, including transportation (33% of informants, n?=?7) and staff capacity (48% of informants, n?=?10), presented barriers. Strengthening these surveillance barriers may improve staff readiness to detect malaria outbreaks, resulting in timelier outbreak response and a reduction in malaria outbreaks, cases, and deaths. By focusing at the local level, our assessment approach provides a framework for identifying and addressing gaps that may be overlooked when utilising tools that evaluate surveillance capacity at the national level.     

Quality and Presence of Behaviour Change Techniques in Mobile Apps for the Mediterranean Diet: A Content Analysis of Android Google Play and Apple App Store Apps

Smartphone apps might represent an opportunity to promote adherence to the Mediterranean diet (MedDiet). This study aimed to evaluate the quality of commercially available apps for the MedDiet and the presence of behavioural change techniques (BCTs) used by these apps. A systematic search was conducted on the Apple App and Google Play stores in November 2021. Apps were included if they provided information on the MedDiet or if their objective was to promote a healthy lifestyle through adherence to the MedDiet. Eligible apps were independently evaluated by two reviewers with regard to their quality (engagement, functionality, aesthetics and information quality) using the 5-point Mobile App Rating Scale (MARS; with higher scores indicating higher quality), and the presence of BCTs using an established 26-item BCT taxonomy. Of the 55 analysed apps, 52 (94.5%) were free, 50 (90.9%) provided recipe ideas, 29 (52.7%) provided meal plans, and 22 (40%) provided information on the health benefits of the MedDiet. The overall quality mean MARS score was 2.84 (standard deviation (SD) = 0.42), with functionality being the highest scored MARS domain (mean = 3.58, SD = 0.44) and engagement the lowest (mean = 2.29, SD = 0.61). The average number of BCTs in the analysed apps was 2.3 (SD = 1.4; range: 0–6 per app). The number of BCTs was positively correlated with app information quality (r_rho = 0.269, p = 0.047), overall MARS score (r_rho = 0.267, p = 0.049), app subjective quality (r_rho = 0.326, p = 0.015) and app-specific quality (r_rho = 0.351, p = 0.009). These findings suggest that currently available apps might provide information on the MedDiet, but the incorporation of more BCTs is warranted to maximise the potential for behaviour change towards the MedDiet.     

Mobile medical and health apps: state of the art,concerns, regulatory control and certification

This paper examines the state of the art in mobile clinical and health-related apps. A 2012 estimate puts the number of health-related apps at no fewer than 40,000, as healthcare professionals and consumers continue to express concerns about the quality of many apps, calling for some form of app regulatory control or certification to be put in place. We describe the range of apps on offer as of 2013, and then present a brief survey of evaluation studies of medical and health-related apps that have been conducted to date, covering a range of clinical disciplines and topics. Our survey includes studies that highlighted risks, negative issues and worrying deficiencies in existing apps. We discuss the concept of ‘apps as a medical device’ and the relevant regulatory controls that apply in USA and Europe, offering examples of apps that have been formally approved using these mechanisms. We describe the online Health Apps Library run by the National Health Service in England and the calls for a vetted medical and health app store. We discuss the ingredients for successful apps beyond the rather narrow definition of ‘apps as a medical device’. These ingredients cover app content quality, usability, the need to match apps to consumers’ general and health literacy levels, device connectivity standards (for apps that connect to glucometers, blood pressure monitors, etc.), as well as app security and user privacy. ‘Happtique Health App Certification Program’ (HACP), a voluntary app certification scheme, successfully captures most of these desiderata, but is solely focused on apps targeting the US market. HACP, while very welcome, is in ways reminiscent of the early days of the Web, when many “similar” quality benchmarking tools and codes of conduct for information publishers were proposed to appraise and rate online medical and health information. It is probably impossible to rate and police every app on offer today, much like in those early days of the Web, when people quickly realised the same regarding informational Web pages. The best first line of defence was, is, and will always be to educate consumers regarding the potentially harmful content of (some) apps.     

深圳市2005～2006年传染病暴发疫情监测分析

目的对深圳市2005～2006年暴发疫情监测系统的运行结果进行流行病学分析,分析两年监测结果的异同。方法对法定传染病疫情及常见的非法定传染病疫情报告建立主动监测网络直报系统,应用描述性流行病学方法,从深圳市暴发疫情监测系统导出2005及2006年的监测数据Excel报表,利用SPSS13.0进行统计分析。结果深圳市2006年聚集性病例及暴发疫情共报告204起,总病例数2423例,分别较2005年上升89%和51%。2006年暴发疫情仍以流感、水痘、流行性腮腺炎为代表的呼吸道传染病为主;暴发疫情多集中发生在中小学和幼儿园等集体单位;2006年传染病暴发疫情的高峰在春季;与2005年暴发疫情大多类似但略有区别。结论深圳市2006年传染病暴发疫情较2005年有明显增加,但流行特征类似。依托各级疾控机构和医疗机构建立的暴发疫情网络直报系统是行之有效的,它能与国家疾病监测信息报告管理系统互为补充。     

Stakeholders’ Views on Mobile Applications to Deliver Infant and Toddler Feeding Education to Latina Mothers of Low Socioeconomic Status

Infant- and toddler-feeding (ITF) practices are critical to long-term health and chronic disease prevention. Using mobile applications (apps) to promote desirable ITF practices shows promise for overcoming challenges of in-person education. However, the viability of ITF apps for Latina mothers of low-socioeconomic status (SES) remains unclear. The objective of this study was to characterize stakeholders’ views on Latina mothers’ capability, motivation, and barriers to using ITF apps. New York City-based health professionals who frequently engage with Latina mothers of low SES completed in-depth interviews. Directed content analysis was used to identify themes through theoretical and inductive codes. Participants included dietitians, nutrition educators, and physicians (n = 17). The following themes were identified: (1) Most Latina mothers of low-SES are tech-savvy (i.e., high capability and experience using smartphones and apps); (2) Apps are an appealing way to deliver ITF education; (3) There are challenges to using apps that must be carefully considered for ITF education development. Overall, ITF apps are a viable option as skills and use appear high among Latina mothers. Key considerations for app development include targeted app promotion; detailed instructions for obtaining and using app; more visuals, less text for low literacy and multiple dialects; making key features available offline.     

TRACnet: A National Phone-based and Web-based Tool for the Timely Integrated Disease Surveillance and Response in Rwanda

Objective

(1) To describe the implementation of the electronic system for integrated disease surveillance in Rwanda. (2) To present the sensitivity and specificity of the electronic reporting system to detect potential outbreaks

Introduction

In Rwanda, communicable diseases are the mostly predominant representing 90% of all reported medical consultations in health centers. The country has often faced epidemics including emerging and re-emerging infectious diseases. To enhance its preparedness to identify and respond to outbreaks and prevent epidemics, the Government of Rwanda has developed and deployed an electronic Integrated Disease Surveillance and Response (eIDSR) working with Voxiva with funding from the U.S. Centers for Disease Control and Prevention(CDC).

Methods

The eIDSR is built on Rwanda’s existing national phone and web-based HIV-reporting system, “TRACnet” that has been operating nationwide since 2004. Data is collected for 23 communicable diseases under surveillance in Rwanda categorized into immediately and weekly reportable. If a lab test is required, the sample is taken and sent to laboratory for testing. Immediate, Weekly, Lab request and lab results forms are completed before submitting data in the system. Data is entered using phone or web based application and is stored in the central database.

Results

The design of eIDSR module was completed in November 2011. As of September 2012, 252 out of 457 health facilities in Rwanda have been trained and are using the electronic system (over 50% of coverage); the national roll out is still going on with complete coverage planned for December 2012. The system sends SMS reminders for due and overdue reports. The timeliness and completeness of reporting are 98% and 100% respectively. Notifications are sent to the concerned personnel when the threshold for outbreak detection is reached. When lab results are available and entered in the system, the results are automatically communicated to the health centers originating samples. Data is automatically summarized in predefined tables, graphs, dashboards and maps.As of September 3rd, 2012, a total of 5813 reports including 1325 immediate reports and 4488 weekly reports were submitted electronically. Out of 1325 immediate reports submitted, 406 potential outbreaks were detected and immediately notified and 7 of them were confirmed for cholera, rubella, Influenza-like illness (H1N1), measles and food poisoning. From these data, the eIDSR system shows a sensitivity of 100% and a specificity of 70% for outbreak detection. The early notification of probable outbreaks stimulated the early investigations and the quick response to outbreaks within the country and across the borders.

Conclusions

The electronic disease surveillance system has improved timeliness and completeness of reporting and extremely supports early detection and notification of outbreaks for timely response. This system should be a model for the East African region as it has demonstrated advantages in the cross-border disease surveillance.     

Use of workplace health promotion apps: Analysis of employee log data

ObjectiveStudies have shown that mobile applications (apps) can effectively support lifestyle-related health. Hence, apps are started to be used in workplaces with the expectation that they can promote the well-being of employees. However, no technological advance can make a difference if it is not utilised. This study investigated the usage of a health app in a workplace through analysing log data.MethodsThe average frequency of using the app by employees at a German IT company was assessed by analysing three months’ worth of log data together with 197 employees’ responses to a questionnaire. The app offered its users the results of an objective health screening, personalised information and assigned challenges. Correlations between the app usage frequency and various factors were established. The factors were gender, age, previous experience with apps, personal innovativeness towards new information technologies, health status and perceived app credibility.ResultsThe app usage frequency was relatively high due to the inclusion of the health screening results; however, it appeared to be impacted by only some of the considered factors.ConclusionDemographic and personal factors of the target group should be considered when developing health apps. The inclusion of appropriate functionalities and their personalisation can ensure a high uptake of health apps in workplaces.     

German Mobile Apps for Patients with Psoriatic Arthritis: Systematic App Search and Content Analysis

BackgroundPsoriatic arthritis (PsA) is a chronic musculoskeletal disease. Functional limitations result in significant patient burden. The use of smartphone apps to complement medical treatments could increase patients’ adherence resulting in better clinical outcome and consequently increased quality of life.ObjectiveThis study aimed to assess and compare currently available smartphone apps for PsA patients using a standardized rating scale.MethodsWe conducted a systematic screening of apps for PsA patients in German App Stores and selected apps meeting inclusion criteria: availability in both app stores, German or English language, relevant for patients with psoriatic arthritis, not developed for congress use or clinical studies, no fee-based apps. Three reviewers evaluated apps using the Mobile Application Rating Scale (MARS). Analysis included technical features and mean scores as well as interrater agreement and linear regression. The best-rated app was then rated by PsA patients.ResultsAmong 232 screened apps, 8 met all inclusion criteria. The app “Rheuma-Auszeit” scored highest with a healthcare provider MARS rating of 4.4 and a patient userMARS rating of 3.7. Subjective quality was lower for all apps. App store star ratings and MARS ratings were not significantly correlated (P=0.34). No app was Conformité Européenne (CE) certified and no underlying clinical studies were found.ConclusionsApp quality was heterogenous and generally low. Star ratings – the only accessible tool for patients – does not suffice to identify high-quality apps. We suggest involving patients in development of apps. Since patients and physicians have different perceptions of app quality, we recommend a joint development and evaluation process.     

Geosocial Networking Smartphone App Use and High-Risk Sexual Behaviors Among Men Who Have Sex With Men Attending University in China: Cross-sectional Study

BackgroundGay apps are smartphone-based geosocial networking apps where many men who have sex with men (MSM) socialize and seek sex partners. Existing studies showed that gay app use is associated with greater odds of high-risk sexual behaviors and potentially more HIV infections. However, little is known about this behavior among young MSM.ObjectiveWe conducted this study to understand gay app use and its influencing factors among MSM attending university in China.MethodsFrom January to March 2019, participants were recruited from 4 regions with large populations of college students in China: Chongqing, Guangdong, Shandong, and Tianjin. The eligibility criteria were MSM aged 16 years or older, self-identified as a university student, and being HIV negative. A self-administered online structured questionnaire was used to collect data on sociodemographic information, sexual behaviors, gay app use, substance use, and HIV testing history. We performed multivariable log-binomial regression to assess correlates of seeking sex partners via gay apps.ResultsA total of 447 MSM attending university with an average age of 20.4 (SD 1.5) years were recruited. Almost all participants (439/447, 98.2%) reported gay app use at some point in their life, and 240/439 (53.7%) reported ever seeking sex partners via gay apps. Blued (428/439, 97.5%) was the most popular gay app. Higher proportions of sexual risk behaviors (including seeking sex partners via apps [P<.001], engaging in group sex [P<.001], having multiple sex partners [P<.001], unawareness of sex partners’ HIV status [P<.001], and using recreational drugs during sex [P<.02]) were positively associated with the increase in the frequency of gay app use. In multivariable analysis, participants who used gay apps to seek sex partners might be more likely to have multiple sex partners in the past 3 months (adjusted prevalence ratio [APR] 1.53, 95% CI 1.33-1.76; P<.001), engage in group sex in the past 3 months (APR 1.55, 95% CI 1.35-1.78; P<.001), and have sex partners with unknown or positive HIV status (APR 1.72, 95% CI 1.46-2.01; P<.001).ConclusionsSeeking sex partners via gay apps may associate with the increased high-risk sexual behaviors among MSM attending university. The causality between seeking sex partners via gay apps and increased high-risk sexual behaviors should be further investigated so as to inform potential policies for HIV prevention.Trial RegistrationChinese Clinical Trial Registry ChiCTR1900020645; http://www.chictr.org.cn/showprojen.aspx?proj=34741     

A Framework for Detecting and Classifying Outbreaks of Gastrointestinal Disease

Objective

To develop a methodological framework for detecting and classifying outbreaks of gastrointestinal disease on the island of Montreal, with the goal of improving early outbreak detection using simulated surveillance data.

Introduction

Outbreaks of waterborne gastrointestinal disease occur routinely in North America, resulting in considerable morbidity, mortality, and cost (Hrudey, Payment et al. 2003). Outbreak detection methods generally attempt to identify anomalies in time, but do not identify the type or source of an outbreak. We seek to develop a framework for both detection and classification of outbreaks using information in both space and time. Outbreak detection can be improved by using simulated outbreak data to build, validate, and evaluate models that aim to improve accuracy and timeliness of outbreak detection.

Methods

To generate outbreak data, we used a previously validated microsimulation model depicting waterborne outbreaks of gastrointestinal disease (Okhmatovskaia et al. 2010). The model is parameterized based on outbreak characteristics such as concentration and duration of contamination, and calibrated to produce realistic outbreak data (e.g., emergency department visits from GI-illness, laboratory reporting to public health) in space and time. We are interested in identifying unique space-time signatures in the data that would allow not only detection, but also classification based on outbreak type. For example, to be able to detect and classify an outbreak as due to a water plant failure versus an food-borne illness based on unique space-time patterns, even though symptoms and temporal outbreak patterns may be similar. For the detection step, we use a hidden Markov model (HMM) that accounts for spatial information through a spatially correlated random effect with an exponential decay. HMMs have been used previously in disease mapping (Green 2002) but not widely in space-time disease outbreak detection. For the classification step, we use a supervised clustering algorithm to classify the outbreak by source (e.g., water plant location) and type (e.g., disease).

Results

Preliminary results for the detection step show that the HMM can distinguish accurately between regions in an outbreak state versus those in a normal state at each time period. Ongoing work for the detection step includes further evaluation of the HMM accuracy as a function of outbreak characteristics. For the classification step, we are evaluating the suitability of different supervised clustering algorithms for identifying the type of outbreak from the HMM results.

Conclusions

If outbreaks are detected rapidly, interventions, such as boil-water advisories, are available to quickly and effectively limit the human and economic impacts. Traditional public health surveillance systems, however, frequently fail to detect waterborne disease outbreaks. Every disease outbreak has unique characteristics; simulation is the best method to estimate the capacity of syndromic surveillance to more efficiently detect different types of enteric disease outbreaks based on a variety of parameters. Outbreak detection can be improved with advances in data availability, such as syndromic surveillance data that will increase timeliness of detection, and space-time information to allow for simultaneous detection and classification of outbreaks by important characteristics (type of outbreak, source of outbreak).     

Understanding digital contact tracing app continuance: Insights from India

ObjectivesDigital contact tracing (DCT) was touted as an effective alternative to lockdown and other restrictive measures in controlling the spread of the COVID-19 pandemic. Despite considerable investments in research and development, the usage of DCT apps was found to be phenomenally low across the world. In this context, the current study investigates the factors influencing citizens’ continuance intentions to use the DCT app.MethodsA theoretical framework was developed by extending the Expectation-confirmation model (ECM) of Information system continuance with Technology trust theory and a contextual factor perceived security and privacy to predict citizens’ continuance intentions to use the DCT app. The model was empirically tested using data from a field survey of 206 actual users of a DCT app implemented in India.ResultsThe findings reveal that user satisfaction, trust in government, and trust in technology are significant predictors of citizens’ continuance intention. The model demonstrates high explanatory power by explaining 57.8% of the variance of continuance intention. It also validates the role of perceived security and privacy and trust in technology in determining user satisfaction.ConclusionThe study makes a theoretical contribution by extending the ECM framework to predict DCT app continuance behavior. The insights from the study could be helpful for developers and policymakers in crafting strategies to improve the usage of DCT apps during future disease outbreaks.     

Medical students’ attitudes and wishes towards extending an educational general practice app to be suitable for practice: A cross-sectional survey from Leipzig,Germany

Background: In medical education and practice, smartphone apps are increasingly becoming popular. In general practice, apps could play an important future role in supporting medical education and practice.

Objectives: To explore medical students’ perceptions regarding the potential of a general practice app for training and subsequent work as a physician.

Methods: Cross-sectional survey among Leipzig fourth-year medical students who were provided with an app prototype for a mandatory general practice course.

Results: Response rate was 99.3% (n?=?305/307); 59.0% were female and mean age was 24.5 years. Students certified that the app had a higher potential than textbooks in both education (57.4% vs. 18.0%) and practice (47.1% vs. 22.8%). Students’ most desired possible app extensions when anticipating its use for subsequent work as a physician were looking up information for diagnostics, therapy and prediction (85.1%), access to electronic patient files (48.1%), communication and networking (44.3%), organization of medical training (42.9%) and online monitoring of patients (38.1%). Students experienced with medical smartphone apps were more interested in app extensions. Consideration to use the app to support the opening of their own practice was significantly associated with higher interest in accessing electronic patient files, networking with colleagues and telemedicine.

Conclusion: Fourth year medical students from Leipzig see a high potential in smartphone apps for education and practice and are interested in further using the technology after undergraduate education.     

The Roles of General Health and COVID-19 Proximity in Contact Tracing App Usage: Cross-sectional Survey Study

BackgroundContact tracing apps are considered useful means to monitor SARS-CoV-2 infections during the off-peak stages of the COVID-19 pandemic. Their effectiveness is, however, dependent on the uptake of such COVID-19 apps.ObjectiveWe examined the role of individuals’ general health status in their willingness to use a COVID-19 tracing app as well as the roles of socioeconomic characteristics and COVID-19 proximity.MethodsWe drew data from the WageIndicator Foundation Living and Working in Coronavirus Times survey. The survey collected data on labor market status as well as the potential confounders of the relationship between general health and COVID-19 tracing app usage, such as sociodemographics and regular smartphone usage data. The survey also contained information that allowed us to examine the role of COVID-19 proximity, such as whether an individual has contracted SARS-CoV-2, whether an individual has family members and colleagues with COVID-19, and whether an individual exhibits COVID-19 pandemic–induced depressive and anxiety symptoms. We selected data that were collected in Spain, Italy, Germany, and the Netherlands from individuals aged between 18 and 70 years (N=4504). Logistic regressions were used to measure individuals’ willingness to use a COVID-19 tracing app.ResultsWe found that the influence that socioeconomic factors have on COVID-19 tracing app usage varied dramatically between the four countries, although individuals experiencing forms of not being employed (ie, recent job loss and inactivity) consistently had a lower willingness to use a contact tracing app (effect size: 24.6%) compared to that of employees (effect size: 33.4%; P<.001). Among the selected COVID-19 proximity indicators, having a close family member with SARS-CoV-2 infection was associated with higher contact tracing app usage (effect size: 36.3% vs 27.1%; P<.001). After accounting for these proximity factors and the country-based variations therein, we found that having a poorer general health status was significantly associated with a much higher likelihood of contact tracing app usage; compared to a self-reported “very good” health status (estimated probability of contact tracing app use: 29.6%), the “good” (estimated probability: +4.6%; 95% CI 1.2%-8.1%) and “fair or bad” (estimated probability: +6.3%; 95% CI 2.3%-10.3%) health statuses were associated with a markedly higher willingness to use a COVID-19 tracing app.ConclusionsCurrent public health policies aim to promote the use of smartphone-based contact tracing apps during the off-peak periods of the COVID-19 pandemic. Campaigns that emphasize the health benefits of COVID-19 tracing apps may contribute the most to the uptake of such apps. Public health campaigns that rely on digital platforms would also benefit from seriously considering the country-specific distribution of privacy concerns.     

Polio Eradication Initiative: Contribution to improved communicable diseases surveillance in WHO African region

IntroductionSince the launch of the Global Polio Eradication Initiative (GPEI) in 1988, there has been a tremendous progress in the reduction of cases of poliomyelitis. The world is on the verge of achieving global polio eradication and in May 2013, the 66th World Health Assembly endorsed the Polio Eradication and Endgame Strategic Plan (PEESP) 2013–2018. The plan provides a timeline for the completion of the GPEI by eliminating all paralytic polio due to both wild and vaccine-related polioviruses.MethodsWe reviewed how GPEI supported communicable disease surveillance in seven of the eight countries that were documented as part of World Health Organization African Region best practices documentation. Data from WHO African region was also reviewed to analyze the performance of measles cases based surveillance.ResultsAll 7 countries (100%) which responded had integrated communicable diseases surveillance core functions with AFP surveillance. The difference is on the number of diseases included based on epidemiology of diseases in a particular country. The results showed that the polio eradication infrastructure has supported and improved the implementation of surveillance of other priority communicable diseases under integrated diseases surveillance and response strategy.ConclusionAs we approach polio eradication, polio-eradication initiative staff, financial resources, and infrastructure can be used as one strategy to build IDSR in Africa. As we are now focusing on measles and rubella elimination by the year 2020, other disease-specific programs having similar goals of eradicating and eliminating diseases like malaria, might consider investing in general infectious disease surveillance following the polio example.