- A smartphone-based mHealth surveillance project in Tanzania is earning kudos for its success in containing a deadly disease – and it could be a model for similar population health efforts in the U.S. and elsewhere.
The program, launched in 2011 by the University of Glasgow, enables hundreds of frontline health workers in the southern part of the country to report on rabies cases via their smartphone. Their information is combined with reports from veterinarians, who are tracking and treating rabies cases among their populations, and environmental scientists who are looking at how the disease is allowed to spread, to create a comprehensive database that can be accessed in real time on mobile devices.
Smartphones are an ideal mHealth platform for the program because most health and veterinary services in the country have unreliable Internet access and power, though all have reliable phone coverage. They also replace the traditional method of pen-and-paper reporting, and all data is stored in a central database that can be accessed via mobile device or computer by healthcare providers and government officials.
“It is historically really difficult to measure what’s going on in terms of rabies in Tanzania,” Dr. Kate Sampson, the lead author for the study, told Scientist Live. “The records there are very incomplete and hard to access. Our system was designed to track all rabies incidences in the southern part of the country in real time. The system had to be easy to for vets and health workers to use, even though most users are only familiar with very basic mobile phones.”
“Bringing the vets together with the medics, for a disease like rabies, is absolutely essential,” she added, noting the one in five people bitten by an animal develop rabies, for which there is no cure and for which there is a high fatality rate. “The results show people generally like it, it works, and it’s the same price, if not cheaper, than paper systems.”
“Ninety-five percent of deaths from rabies occur in Asia and Africa,” Dr. Mike Turner, head of infection and immunobiology for the Wellcome Trust, which co-funded the project with the UBS Optimus Foundation, told Scientist Live. “Poor diagnosis, inadequate monitoring, and a lack of coordination when an outbreak has been identified all result in people not receiving life-saving vaccinations. There is very limited data on rabies outbreaks in these areas, so it’s impossible to know the full scale of the problem.”
The program could be used as a model for similar rabies eradication efforts in the U.S., as well as population health projects targeting anything from sexually transmitted diseases to tuberculosis or hepatitis outbreaks. It might even find its way into programs like the Centers for Medicare & Medicaid Services’ five-year, $157 million Accountable Health Communities Model, unveiled this past January to push population health management out to larger populations.
Indeed, as recently as 2013, the Robert Wood Johnson Foundation and Trust for America’s Health reported that roughly one-third of the country’s healthcare ecosystem was unprepared to handle a serious disease outbreak, due to incomplete data collection methods or underfunded population health resources.
“There are many different diseases – including rabies – which require medics, vets or environmental scientists all working together to control and hopefully eradicate them,” Hampson said. “Bridging those sectors sounds easy, but it has not proved to be in the past. Sharing tools, information and infrastructure, and then piecing it altogether, is essential, and that’s what this mHealth system has done.”