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Outcomes of the Deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) System for Strengthening Polio Surveillance in Africa From 2017 to 2018: Evaluation Study

BACKGROUND: As we move toward a polio-free world, the challenge for the polio program is to create an unrelenting focus on smaller areas where the virus is still present, where children are being repeatedly missed, where immunity levels are low, and where surveillance is weak. OBJECTIVE: This articl...

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Autores principales: Ticha, Johnson Muluh, Akpan, Godwin Ubong, Paige, Lara MF, Senouci, Kamel, Stein, Andrew, Briand, Patrick, Tuma, Jude, Oyaole, Daniel Rasheed, Ngofa, Reuben, Maleghemi, Sylvester, Touray, Kebba, Salihu, Abdullahi Ahmed, Diallo, Mamadou, Tegegne, Sisay Gashu, Bello, Isah Mohammed, Idris, Umar Kabo, Maduka, Omosivie, Manengu, Casimir, Shuaib, Faisal, Galway, Michael, Mkanda, Pascal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744265/
https://www.ncbi.nlm.nih.gov/pubmed/33263550
http://dx.doi.org/10.2196/18950
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author Ticha, Johnson Muluh
Akpan, Godwin Ubong
Paige, Lara MF
Senouci, Kamel
Stein, Andrew
Briand, Patrick
Tuma, Jude
Oyaole, Daniel Rasheed
Ngofa, Reuben
Maleghemi, Sylvester
Touray, Kebba
Salihu, Abdullahi Ahmed
Diallo, Mamadou
Tegegne, Sisay Gashu
Bello, Isah Mohammed
Idris, Umar Kabo
Maduka, Omosivie
Manengu, Casimir
Shuaib, Faisal
Galway, Michael
Mkanda, Pascal
author_facet Ticha, Johnson Muluh
Akpan, Godwin Ubong
Paige, Lara MF
Senouci, Kamel
Stein, Andrew
Briand, Patrick
Tuma, Jude
Oyaole, Daniel Rasheed
Ngofa, Reuben
Maleghemi, Sylvester
Touray, Kebba
Salihu, Abdullahi Ahmed
Diallo, Mamadou
Tegegne, Sisay Gashu
Bello, Isah Mohammed
Idris, Umar Kabo
Maduka, Omosivie
Manengu, Casimir
Shuaib, Faisal
Galway, Michael
Mkanda, Pascal
author_sort Ticha, Johnson Muluh
collection PubMed
description BACKGROUND: As we move toward a polio-free world, the challenge for the polio program is to create an unrelenting focus on smaller areas where the virus is still present, where children are being repeatedly missed, where immunity levels are low, and where surveillance is weak. OBJECTIVE: This article aimed to describe a possible solution to address weak surveillance systems and document the outcomes of the deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) project. METHODS: This intervention was implemented in 99 targeted high-risk districts with concerns for silent polio circulation from eight countries in Africa between August 1, 2017, and July 31, 2018. A total of 6954 persons (5390 community informants and 1564 health workers) were trained and equipped with a smartphone on which the AVADAR app was configured to allow community informants to send alerts on suspected acute flaccid paralysis (AFP) and allow health worker to use electronic checklists for investigation of such alerts. The AVADAR and Open Data Kit ONA servers were at the center of the entire process. A dashboard system and coordination teams for monitoring and supervision were put in place at all levels. RESULTS: Overall, 96.44% (24,142/25,032) of potential AFP case alerts were investigated by surveillance personnel, yielding 1414 true AFP cases. This number (n=1414) reported through AVADAR was higher than the 238 AFP cases expected during the study period in the AVADAR districts and the 491 true AFP cases reported by the traditional surveillance system. A total of 203 out of the 1414 true AFP cases reported were from special population settings, such as refugee camps and insecure areas. There was an improvement in reporting in silent health areas in all the countries using the AVADAR system. Finally, there were 23,473 reports for other diseases, such as measles, diarrhea, and cerebrospinal meningitis, using the AVADAR platform. CONCLUSIONS: This article demonstrates the added value of AVADAR to rapidly improve surveillance sensitivity. AVADAR is capable of supporting countries to improve surveillance sensitivity within a short interval before and beyond polio-free certification.
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spelling pubmed-77442652020-12-18 Outcomes of the Deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) System for Strengthening Polio Surveillance in Africa From 2017 to 2018: Evaluation Study Ticha, Johnson Muluh Akpan, Godwin Ubong Paige, Lara MF Senouci, Kamel Stein, Andrew Briand, Patrick Tuma, Jude Oyaole, Daniel Rasheed Ngofa, Reuben Maleghemi, Sylvester Touray, Kebba Salihu, Abdullahi Ahmed Diallo, Mamadou Tegegne, Sisay Gashu Bello, Isah Mohammed Idris, Umar Kabo Maduka, Omosivie Manengu, Casimir Shuaib, Faisal Galway, Michael Mkanda, Pascal JMIR Public Health Surveill Original Paper BACKGROUND: As we move toward a polio-free world, the challenge for the polio program is to create an unrelenting focus on smaller areas where the virus is still present, where children are being repeatedly missed, where immunity levels are low, and where surveillance is weak. OBJECTIVE: This article aimed to describe a possible solution to address weak surveillance systems and document the outcomes of the deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) project. METHODS: This intervention was implemented in 99 targeted high-risk districts with concerns for silent polio circulation from eight countries in Africa between August 1, 2017, and July 31, 2018. A total of 6954 persons (5390 community informants and 1564 health workers) were trained and equipped with a smartphone on which the AVADAR app was configured to allow community informants to send alerts on suspected acute flaccid paralysis (AFP) and allow health worker to use electronic checklists for investigation of such alerts. The AVADAR and Open Data Kit ONA servers were at the center of the entire process. A dashboard system and coordination teams for monitoring and supervision were put in place at all levels. RESULTS: Overall, 96.44% (24,142/25,032) of potential AFP case alerts were investigated by surveillance personnel, yielding 1414 true AFP cases. This number (n=1414) reported through AVADAR was higher than the 238 AFP cases expected during the study period in the AVADAR districts and the 491 true AFP cases reported by the traditional surveillance system. A total of 203 out of the 1414 true AFP cases reported were from special population settings, such as refugee camps and insecure areas. There was an improvement in reporting in silent health areas in all the countries using the AVADAR system. Finally, there were 23,473 reports for other diseases, such as measles, diarrhea, and cerebrospinal meningitis, using the AVADAR platform. CONCLUSIONS: This article demonstrates the added value of AVADAR to rapidly improve surveillance sensitivity. AVADAR is capable of supporting countries to improve surveillance sensitivity within a short interval before and beyond polio-free certification. JMIR Publications 2020-12-02 /pmc/articles/PMC7744265/ /pubmed/33263550 http://dx.doi.org/10.2196/18950 Text en ©Johnson Muluh Ticha, Godwin Ubong Akpan, Lara MF Paige, Kamel Senouci, Andrew Stein, Patrick Briand, Jude Tuma, Daniel Rasheed Oyaole, Reuben Ngofa, Sylvester Maleghemi, Kebba Touray, Abdullahi Ahmed Salihu, Mamadou Diallo, Sisay Gashu Tegegne, Isah Mohammed Bello, Umar Kabo Idris, Omosivie Maduka, Casimir Manengu, Faisal Shuaib, Michael Galway, Pascal Mkanda. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 02.12.2020. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on http://publichealth.jmir.org, as well as this copyright and license information must be included.
spellingShingle Original Paper
Ticha, Johnson Muluh
Akpan, Godwin Ubong
Paige, Lara MF
Senouci, Kamel
Stein, Andrew
Briand, Patrick
Tuma, Jude
Oyaole, Daniel Rasheed
Ngofa, Reuben
Maleghemi, Sylvester
Touray, Kebba
Salihu, Abdullahi Ahmed
Diallo, Mamadou
Tegegne, Sisay Gashu
Bello, Isah Mohammed
Idris, Umar Kabo
Maduka, Omosivie
Manengu, Casimir
Shuaib, Faisal
Galway, Michael
Mkanda, Pascal
Outcomes of the Deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) System for Strengthening Polio Surveillance in Africa From 2017 to 2018: Evaluation Study
title Outcomes of the Deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) System for Strengthening Polio Surveillance in Africa From 2017 to 2018: Evaluation Study
title_full Outcomes of the Deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) System for Strengthening Polio Surveillance in Africa From 2017 to 2018: Evaluation Study
title_fullStr Outcomes of the Deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) System for Strengthening Polio Surveillance in Africa From 2017 to 2018: Evaluation Study
title_full_unstemmed Outcomes of the Deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) System for Strengthening Polio Surveillance in Africa From 2017 to 2018: Evaluation Study
title_short Outcomes of the Deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) System for Strengthening Polio Surveillance in Africa From 2017 to 2018: Evaluation Study
title_sort outcomes of the deployment of the auto-visual acute flaccid paralysis detection and reporting (avadar) system for strengthening polio surveillance in africa from 2017 to 2018: evaluation study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744265/
https://www.ncbi.nlm.nih.gov/pubmed/33263550
http://dx.doi.org/10.2196/18950
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