This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features!
Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

NIH NLM Logo
Log in
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 May 16:15:214.
doi: 10.1186/s12879-015-0946-4.

Developing a community-led SMS reporting tool for the rapid assessment of lymphatic filariasis morbidity burden: case studies from Malawi and Ghana

Affiliations

Developing a community-led SMS reporting tool for the rapid assessment of lymphatic filariasis morbidity burden: case studies from Malawi and Ghana

Michelle C Stanton et al. BMC Infect Dis. .

Abstract

Background: Lymphoedema and hydrocoele are the two most common clinical manifestations of lymphatic filariasis (LF). In order to effectively target morbidity management strategies, more information is rapidly needed on morbidity burden across all endemic countries. The purpose of this study was to develop and test an SMS tool (MeasureSMS) which enables trained community-based health workers to report basic information on all cases they identified.

Methods: The tool was trialled in Chikwawa district, Malawi and Ahanta West district, Ghana in 2014. Salaried health surveillance assistants (HSAs) identified and reported cases in Malawi whereas volunteer community health workers (CHWs) were used in Ghana. Health workers were trained in recognising lymphoedema and hydrocoeles and submitting individual case data using MeasureSMS, after which they undertook a LF morbidity survey. After the reporting period, a random sample of reported cases was visited by a physician to verify the health workers' diagnoses. The proportion of correctly diagnosed cases i.e. the positive predictive value (PPV) was then calculated.

Results: HSAs in Malawi successfully reported 256 unique cases by SMS from 107 communities (166 hydrocoele, 88 lymphoedema, 2 with both), resulting in an estimated adult prevalence of 17.7 per 10,000 and 33.0 per 10,000 for lymphoedema and hydrocoele respectively. In Ghana, despite being less experienced in using SMS, CHWs successfully reported 360 unique cases by SMS from 33 communities (169 hydrocoele, 185 lymphoedema, 6 with both), resulting in an estimated adult prevalence of 76.9 per 10,000 and 70.5 per 10,000 adults for lymphoedema and hydrocoele respectively. The verification exercise resulted in a PPV for lymphoedema and hydrocoele diagnosis of 90 % (n = 42, 95 % CI 76.5 - 96.9) and 92 % (n = 49, 95 % CI 79.5 - 97.4) in Malawi and 94 % (n = 34, 95 % CI 78.9 %-99.0 %) and 47 % (n = 59, 35.1 %-61.7 %) in Ghana, indicating that non-invasive methods for diagnosing hydrocoeles needed to be further emphasised.

Conclusions: The study concludes that given the appropriate education and tools, community-based health workers are exceptionally well-placed to participate in quantifying LF morbidity burden, and other NTDs with observable symptoms. This concept has the potential to enable national programmes to more effectively monitor their community impact in an efficient, timely and cost-effective way.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Lymphoedema severity staging used in the LF morbidity case identification study. Adapted from [27]
Fig. 2
Fig. 2
Sequence diagram MeasureSMS tool. The health worker sends their SMS record in the prescribed format to a local Android Smartphone on which the MeasureSMS app is installed. The app validates the SMS i.e. checks for formatting errors and sends a response SMS to the health worker indicating whether or not the SMS was correctly formatted. On connecting to the internet either via WiFi or the local 3G network, the smartphone sends the SMS message data to a UK-based cloud server on which it is then stored. The study team, including the members of the LF Programme can then access this stored data via a password protected web browser
Fig. 3
Fig. 3
SMS experience by age and sex of participating health workers in Malawi (a) and Ghana (b)

References

    1. World Health Organization . Lymphatic Filariasis: Managing Morbidity and Preventing Disability. Geneva: World Health Organization; 2013.
    1. Smith EL, Mkwanda SZ, Martindale S, Kelly-Hope LA, Stanton MC. Lymphatic filariasis morbidity mapping: a comprehensive examination of lymphoedema burden in Chikwawa district, Malawi. Trans R Soc Trop Med Hyg. 2014;108:751–8. doi: 10.1093/trstmh/tru150. - DOI - PubMed
    1. Atkinson J-A, Vallely A, Fitzgerald L, Whittaker M, Tanner M. The architecture and effect of participation: a systematic review of community participation for communicable disease control and elimination. Implications for malaria elimination. Malar J. 2011;10:225. doi: 10.1186/1475-2875年10月22日5. - DOI - PMC - PubMed
    1. Katabarwa MN, Richards FO. Community-directed health (CDH) workers enhance the performance and sustainability of CDH programmes: experience from ivermectin distribution in Uganda. Ann Trop Med Parasitol. 2001;95:275–86. doi: 10.1080/00034980120072260. - DOI - PubMed
    1. Homeida M, Braide E, Elhassan E, Amazigo UV, Liese B, Benton B, et al. APOC’s strategy of community-directed treatment with ivermectin (CDTI) and its potential for providing additional health services to the poorest populations. Ann Trop Med Parasitol. 2002;96:93–104. doi: 10.1179/000349802125000673. - DOI - PubMed
Full text links
BioMed Central full text link BioMed Central Free PMC article
Cite

AltStyle によって変換されたページ (->オリジナル) /