Use of weekly mobile phone call-unit to screen pregnant women and their newborns for acute respiratory and gastrointestinal illness symptoms in rural Bangladesh

Abstract

Background/Aims Acute respiratory and gastrointestinal illnesses are major contributors to morbidity and mortality worldwide, particularly in vulnerable populations of pregnant women and infants. It is critical to understand the burden of these illnesses in low-resource settings where infectious, nutritional, and immunotoxicological risk factors overlap and access to medical care may be limited.Methods We established a birth cohort (NCT03930017) at the JiVitA Maternal and Child Health and Nutrition Research Project site in rural Bangladesh enrolling pregnant women during gestational weeks 13-16. In collaboration with the Government of Bangladesh Institute of Epidemiology, Disease Control and Research (IEDCR), we established a mobile phone-based research support system call-center to ascertain acute respiratory and gastrointestinal symptoms in the cohort of pregnant women and their newborns at weekly intervals from study enrollment to 3-months postpartum. Further, if a participant reported acute respiratory illness or influenza-like illness (ILI) symptoms a confirmatory nasal swab specimen was collected, and real time qPCR analysis and subtyping was conducted for influenza types A and B.Results From October 2018 to January 2020, IEDCR completed 24,915 weekly mobile phone call-based interviews with 765 mothers (94% completion rate) and 11,230 weekly call-based interviews with caretakers who described morbidity for 638 infants (93% completion rate). Incident cases of ILI were recorded at a rate of 3.2 per 100 interviews among mothers and 7.7 per 100 interviews for infants. We also observed 1.6 and 1.8 incident cases of diarrhea per 100 interviews among mothers and infants, respectively. 850 nasal swabs were collected for confirmatory RT-qPCR analysis.Conclusions A mobile phone call-unit was established and produced high degree of data completeness in a pregnancy and birth cohort in rural Bangladesh. These longitudinal acute respiratory and gastrointestinal morbidity symptom data can support future planned analyses of associations with biomarkers of co-infections, micronutrient deficiency, and immunotoxicant exposure.