Daily zero-reporting for suspect Ebola using short message service (SMS) in Guinea-Bissau

Area of Science:

• Public Health
• Epidemiology
• Health Informatics

Background:

• Intensified surveillance is crucial for Ebola elimination and preventing reemergence in West Africa.
• Zero-reporting from high-risk districts is a key surveillance strategy.
• The Surveillance Training for Ebola Preparedness (STEP) program aimed to enhance response capabilities.

Purpose of the Study:

• To pilot and assess the feasibility of using Short Message Service (SMS) texting for daily reporting of Ebola cases under investigation (CUI).
• To evaluate the effectiveness of SMS reporting within an emergency-response training context in Guinea-Bissau.

Main Methods:

• A prospective cohort pilot study was conducted from January 24 to March 24, 2015.
• Fourteen surveillance officers received training and cell phones for daily SMS reporting of CUI.
• Data was transmitted via SMS to a smartphone application and uploaded to a cloud platform.

Main Results:

• An average daily reporting rate of 85% was achieved across two training groups.
• The median reporting rate among 14 reporters was 85% (range 36%-100%).
• No cases meeting the definition for an Ebola CUI were reported during the 60-day pilot period.

Conclusions:

• Real-time, SMS-based daily zero-reporting is a feasible, rapid, and simple strategy for low-resource settings.
• High compliance was attributed to SMS familiarity and heightened awareness from the STEP training.
• This model offers potential for rapid scale-up of alert systems in public health emergencies.