Sokoine University of Agriculture The UBS Rabies Surveillance Project

Aims To generate and disseminate real-time data on disease incidence, prevention and control Increase surveillance capacity through: – A mobile phone-based surveillance system Improve PEP supply, availability & administration Improve reporting (timeliness and completeness) Aid monitoring of control efforts Improve intersectoral sharing of information – Rapid diagnostic testing Improve detection of rabies

Rabies Elimination Demonstration Project, Southeast Tanzania 4 Regions4 Regions 24 districts24 districts 6.5 million people6.5 million people >200,000 dogs>200,000 dogs

Veterinary SectorMedical Sector CENTRAL MINISTRIES DISTRICTS server AT RISK POPULATION Individually owned & shared low cost phones e.g. Nokia 1000 CLINCS: Java-enabled configured phones local communities Bite-victim report & PEP use PEP procurement & supply Outbreak investigation Vaccination Campaign planning & reports SMS reply with PEP info INTERNET: Data interface INTERNET: Data interface Program evaluation Sample submissions Outbreak alerts VET OFFICES: International reporting Vaccine procurement & supply INTERNET: Data interface Laboratory Sector lab results & resupplies

Why mobile phones? Accessible everywhere (even the most remote, marginalized areas), familiar, easy to use and immediate! Improves frontline health care and decreases costs Potential to improve feedback & inter-sectoral communication

Potential to overcome issues of paper-based surveillance

Development of the mobile phone-based system

Using the system: Users select software Users Login and choose data entry form Enter data according to prompted questions then submit data

Using the system:

Training provided to use mobile phone system

MEDICAL SECTOR Health workers trained to report animal bite victims & PEP use Continued support to use the mobile phone system Assistance with transition to ID administration of PEP Trailed the use of SMS reminders to improve PEP compliance Data used to manage vaccine stock, to automate reminders for patients and to evaluate control efforts

Trained field officers to report dog vaccination campaigns (all Gates districts) Conducted large-scale coverage surveys (HHs & transects) VETERINARY SECTOR

Sample collection Sampling kits and follow up provided to field officers

Laboratory diagnosis Trained technicians in standard diagnostic techniques Serviced laboratory equipment (CDC visit - Nov 2009) Provided laboratory supplies

FLUORESCENT ANTIBODY TEST DIRECT RAPID IMMUNOHISTOCHEMICAL TEST LATERAL FLOW KIT Trialed rapid diagnostic technologies

Livestock officer feedback from 1601 campaigns submitted to database!

PEP shortages and human deaths highlighted Few shortages Doses Frequent shortages Doses Major shortages in Nachingwea District Hospital (when deaths occurred)

Sample submission and reporting of animal rabies cases increased –Mobile phone reports (588) and sample submissions (79) improved –Samples submitted from most districts 79 samples submitted from districts Most in Morogoro rural, Nachingwea, Morogoro urban and Mkuranga

Data available: