The Cholera Phone: Diarrheal Disease Surveillance by Mobile Phone in Bangladesh

Leela Sengupta Carstensen Department of Public Health University of Copenhagen, Copenhagen Center for Disaster Research, Section of Global Health, Copenhagen, Denmark;
Copenhagen Centre for Disaster Research, University of Copenhagen, Copenhagen, Denmark;

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Charlotte Crim Tamason Department of Public Health University of Copenhagen, Copenhagen Center for Disaster Research, Section of Global Health, Copenhagen, Denmark;
Copenhagen Centre for Disaster Research, University of Copenhagen, Copenhagen, Denmark;

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Rebeca Sultana Department of Public Health University of Copenhagen, Copenhagen Center for Disaster Research, Section of Global Health, Copenhagen, Denmark;
Infectious Diseases Division, icddr,b, Dhaka, Bangladesh;

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Suhella Mohan Tulsiani Department of Public Health University of Copenhagen, Copenhagen Center for Disaster Research, Section of Global Health, Copenhagen, Denmark;
Copenhagen Centre for Disaster Research, University of Copenhagen, Copenhagen, Denmark;

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Matthew David Phelps Department of Public Health University of Copenhagen, Copenhagen Center for Disaster Research, Section of Global Health, Copenhagen, Denmark;
Copenhagen Centre for Disaster Research, University of Copenhagen, Copenhagen, Denmark;

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Emily Suzanne Gurley Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

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Peter Kjær Mackie Jensen Department of Public Health University of Copenhagen, Copenhagen Center for Disaster Research, Section of Global Health, Copenhagen, Denmark;
Copenhagen Centre for Disaster Research, University of Copenhagen, Copenhagen, Denmark;

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DOI:
https://doi.org/10.4269/ajtmh.18-0546
Volume/Issue:
Volume 100: Issue 3
Page(s):
510–516
Restricted access
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Existing methodologies to record diarrheal disease incidence in households have limitations due to a high-episode recall error outside a 48-hour window. Our objective was to use mobile phones for reporting diarrheal episodes in households to provide real-time incidence data with minimum resource consumption and low recall error. From June 2014 to June 2015, we enrolled 417 low-income households in Dhaka, Bangladesh, and asked them to report diarrheal episodes to a call center. A team of data collectors then visited persons reporting the episode to collect data. In addition, each month, the team conducted in-home surveys on diarrhea incidence for a preceding 48-hour period. The mobile phone surveillance reported an incidence of 0.16 cases per person-year (95% CI: 0.13–0.19), with 117 reported diarrhea cases, and the routine in-home survey detected an incidence of 0.33 cases per person-year (95% CI: 0.18–0.60), the incidence rate ratio was 2.11 (95% CI: 1.08–3.78). During focus group discussions, participants reported a lack in motivation to report diarrhea by phone because of the absence of provision of intervening treatment following reporting. Mobile phone technology can provide a unique tool for real-time disease reporting. The phone surveillance in this study reported a lower incidence of diarrhea than an in-home survey, possibly because of the absence of intervention and, therefore, a perceived lack of incentive to report. However, this study reports the untapped potential of mobile phones in monitoring infectious disease incidence in a low-income setting.

Author Notes

Address correspondence to Peter Kjær Mackie Jensen, Department of Public Health, COPE-Copenhagen Center for Disaster Research, Oester Farimagsgade 5a, Bldg. 22, Copenhagen 1535, Denmark. E-mail: mackie@sund.ku.dk

Financial support: This research study was funded by the Danish Ministry of Foreign Affairs (MFA)—Consultative Research Committee For Development Research (FFU) grant 12-040KU, icddr,b acknowledges with gratitude the commitment of the Danish Ministry of Foreign Affairs (MFA)—Consultative Research Committee For Development Research (FFU) to its research efforts. icddr,b is also grateful to the Governments of Bangladesh, Canada, Sweden, and the United Kingdom for providing unrestricted support.

Authors’ addresses: Leela Sengupta Carstensen, Charlotte Crim Tamason, Suhella Mohan Tulsiani, and Matthew David Phelps, Department of Public Health University of Copenhagen, Section of Global Health, Copenhagen, Denmark, E-mails: leela@sund.ku.dk, cctamason@gmail.com, suhella.tulsiani@gmail.com, and ma.phelps@gmail.com. Rebeca Sultana, Infectious Diseases Division, icddr,b, Dhaka, Bangladessh, E-mail: rebeca@icddrb.org. Emily Suzanne Gurley, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mail: egurley1@jhu.edu. Peter Kjær Mackie Jensen, Department of Public Health University of Copenhagen, Copenhagen Center for Disaster Research, Section of Global Health, Copenhagen, Denmark, E-mail: mackie@sund.ku.dk.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2019
Received:
05 Jul 2018
|
Accepted:
13 Nov 2018
|
Published Online:
28 Jan 2019
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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