Abstract
BackgroundAs South Africa strives to achieve malaria elimination by 2018 (zero local cases) the country needs to strengthen its disease surveillance system by reducing the timeliness from case diagnosis to notification of key stakeholders in the malaria programme. This study evaluated the feasibility of a 24-h mobile reporting system, designed for speeding up malaria notifications, from primary healthcare facilities to district, provincial, and national malaria programmes in South Africa.MethodsA prospective descriptive study utilizing primary data collected from structured interviews with healthcare workers in public healthcare facilities was used to compare two reporting systems (24-h mobile reporting system and the paper-based reporting system) in malaria endemic provinces (Limpopo, Mpumalanga and KwaZulu-Natal). Data on completeness of reporting, simplicity, user acceptability and technical limitations were analysed. A Wilcoxon signed-rank test was used to compare the time difference between the two reporting systems.ResultsThere were 1819 cases of malaria reported through the paper-based system, and 63.2% (1149) of those cases were also reported through the 24-h mobile reporting system. Out of the 272 healthcare workers who were interviewed, 40% (108) had seen malaria patients and reported a case through the 24-h mobile reporting system. The median time for cases to be reported through the 24-h mobile reporting system was significantly shorter at < 1 day (range < 1 to 31 days) compared to the paper-based system at 3 days (range 2 to > 39 days) (p < 0.001). It was found that 26% (28) were able to use the system and send reports within 2 min, 94% (256) were willing to continue to use the system. Of the 108 healthcare workers who reported a case, 18.5% (20) experienced network challenges.ConclusionsThe 24-h mobile reporting system is user friendly and trained healthcare workers are willing to use the system, despite network limitations. The 24-h mobile reporting system reduces the time required for diagnosed cases to be notified by the health care facility to district, provincial and national levels. The 24-h mobile reporting system is a feasible option for malaria notification in South Africa and will assist with early detection of malaria outbreaks.
Highlights
As South Africa strives to achieve malaria elimination by 2018 the country needs to strengthen its disease surveillance system by reducing the timeliness from case diagnosis to notification of key stakeholders in the malaria programme
Of the 298 healthcare facilities that were recruited into the study, 58% (n = 172) reported malaria cases through the 24-h mobile reporting system and 64% (n = 190) reported cases through the paper-based system (Table 1)
There were 1819 cases of malaria reported through the paper-based system, and 63.2% (1149) of those cases were reported through the 24-h mobile reporting system (Fig. 4)
Summary
As South Africa strives to achieve malaria elimination by 2018 (zero local cases) the country needs to strengthen its disease surveillance system by reducing the timeliness from case diagnosis to notification of key stakeholders in the malaria programme. Transitioning the programme from a pre-elimination to an elimination phase (0 cases/1000 population at risk) will require among others strengthening of the surveillance system, ensuring that cases are reported within 24 h of diagnosis, and optimizing data collection and reporting through the use of new technological methods [1,2,3]. Current case reporting practices in South Africa vary by province, district, and facility; in all instances the process is manual [1, 5]. The paper-based notification form and the EP6 form are submitted to the central office, and data is later entered as an electronic record by data capturers (Fig. 1) [3]
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