Assessment of complications and outcome in Plasmodium vivax, falciparum and their mixed infections

Abstract

Background: A paperbased notification system is used for reporting key infectious diseases from primary health care to sub district level. The use of a smart phone for data submission to a central server was piloted in a rural area to improve timeliness. Follow up within 48hours of a malaria diagnosis is required as part of the elimination strategy. Methods & Materials: A designated nurse reported from three clinics in Mpumalanga Province, South Africa from October 2012 to May 2013: weekly data on three infectious disease syndromes; patient-level data on positive malaria cases; and patient-level data for acute febrile illness. The nurse entered data from the paperbased forms to a smart phone and submitted those for further dissemination. A text message was sent to the malaria coordinator for confirmed malaria cases. A qualitative and quantitative evaluation regarding the acceptability, technical feasibility and timeliness of the reporting was performed. Results from themalaria component are reported here. Results: The network connection was sufficient, as the data could be collected offline, stored on the phone and sent by bulk later if connectionwas temporarily unavailable. In total, 23malaria forms were submitted from the three clinics. We compared time from diagnosis to follow up of malaria cases from our clinics with other clinics in the area. The median number of days for follow up was 2 for our clinics. 65% were followed up within 48hours. For 57 other clinics 36%of 236 caseswere followed upwithin 48hours, themedian number of dayswas 4. For the same time period a year earlier (without cell phone reporting) 5% were followed up within 48hours from our clinics (median 13.5 days) compared to 13% and 6 days from the other clinics. Conclusion: The use of cell phone significantly improved the timeliness of data transmission, was acceptable to users and technically feasible in this rural area. For malaria reporting, time to follow up improved compared to other clinics and to the previous year because of the sms alerts. Althoughmalaria case numbers were small, consideration should be given to larger scale usewithin the malaria programme.