Isah Mohammed Bello - Academia.edu (original) (raw)

Papers by Isah Mohammed Bello

Frontiers in Digital Health, 2022

The mobile phone global positioning system (GPS) is used to reconnaissance a mobile phone user's ... more The mobile phone global positioning system (GPS) is used to reconnaissance a mobile phone user's location, e.g., at work, home, shops, etc. Such information can be used to feed data gathering expeditions, the actual position of the interviewer/surveyor using the mobile phone inert settings of location mode via GPS, WIFI, and Mobile networks. Mobile devices are becoming progressively erudite and now integrate diverse and robust sensors. The new generation of smartphones is multi-laden with sensors, including GPS sensors. The study describes and evaluates a data-gathering process used by the World Health Organization (WHO–Nigeria, EPI Program) that uses phone-based in-built GPS sensors to identify the position of users while they undergo supportive supervision. This form of spatial data is collected intrinsically using the Open Data Kit (ODK) GPS interface, which interlaces with the mobile phone GPS sensor to fetch the geo-coordinates during the process. It represents a step in bu...

Vaccines

Mozambique introduced monovalent rotavirus vaccine (Rotarix®) in September 2015. We evaluated the... more Mozambique introduced monovalent rotavirus vaccine (Rotarix®) in September 2015. We evaluated the effectiveness of Rotarix® under conditions of routine use in Mozambican children hospitalized with acute gastroenteritis (AGE). A test negative case-control analysis was performed on data collected during 2017–2019 from children <5 years old, admitted with AGE in seven sentinel hospital sites in Mozambique. Adjusted VE was calculated for ≥1 dose of vaccine vs. zero doses using unconditional logistic regression, where VE = (1 − aOR) × 100%. VE estimates were stratified by age group, AGE severity, malnutrition, and genotype. Among 689 children eligible for analysis, 23.7% were rotavirus positive (cases) and 76.3% were negative (controls). The adjusted VE of ≥1 dose in children aged 6–11 months was 52.0% (95% CI, −11, 79), and −24.0% (95% CI, −459, 62) among children aged 12–23 months. Estimated VE was lower in stunted than non-stunted children (14% (95% CI, −138, 66) vs. 59% (95% CI, −...

BMC Public Health

Background: Nigeria is the only country in Africa that is yet to be certified as polio free. Surv... more Background: Nigeria is the only country in Africa that is yet to be certified as polio free. Surveillance for acute flaccid paralysis (AFP) is the foundation of the polio eradication initiative since it provides information to alert both health managers and clinician that timely actions should be initiated to interrupt transmission of the polio virus. The strategy also provides evidence for the absence of wild poliovirus. This evaluation was performed to assess key quality indicators defined by the polio eradication program and thus to identify gaps to allow planning for corrective measures to achieve a polio-free situation in Bauchi state and in Nigeria at large. We conducted a crosssectional descriptive study which involved a desk review of documents to authenticate the correctness and completeness of data, and a review of documented evidence for the quality of AFP surveillance. We interviewed Local Government Authority (LGA) surveillance officers and clinicians from focal and non-focal sites, along with caregivers of children with AFP and community leaders. The data were entered and analyzed in a Microsoft Excel spreadsheet. Methods: We conducted a cross-sectional study of the AFP surveillance and documentation in eighteen of the twenty Local Government Areas (LGAs) of Bauchi State. We assessed the knowledge of the clinician at focal and non-focal sites on case definition of AFP, the number and method of stool specimen collection to investigate a case and types of training received for AFP surveillance. We verified AFP case investigations for the last three years: The caregivers (mothers) were interviewed to authenticate the reported information of AFP cases, the method used for stool specimen collection and feedbacks. Community leaders' knowledge on AFP surveillance was also assessed. Data was entered and analyzed in excel spread sheet.

Background The Auto-Visual AFP Detection and Reporting (AVADAR) digital health intervention progr... more Background The Auto-Visual AFP Detection and Reporting (AVADAR) digital health intervention programme is a programme that was introduced to Africa in 2016. The programme adopts the use of the AVADAR SMS – based smartphone application (app) in community-based AFP surveillance activities in order to enhance the detection and reporting of AFP (polio) cases and improve AFP surveillance quality. As at 2020, the AVADAR application is being used in 11 African countries. The need to conduct regular and relevant evaluations of the AVADAR programme is very essential towards improving polio eradication programme performance and effectiveness in Africa. Hence, this study aimed to review and evaluate the quality of the AFP cases reported through the AVADAR intervention and as well evaluate the documentation process of AVADAR alerts and investigations, and the assimilation of AFP cases found via AVADAR into the national databases. Methods This study reviewed and evaluated the quality of AVADAR-in...

The Pan African Medical Journal, 2021

Introduction the new coronavirus (COVID-19) that emerged from Wuhan, Hubei Province of China in D... more Introduction the new coronavirus (COVID-19) that emerged from Wuhan, Hubei Province of China in December 2019, causing severe acute respiratory syndrome (SARS) has fast spread across the entire globe, with most countries struggling to slow and reduce the spread of the virus through rapid screening, testing, isolation, case management, contact tracing, implementing social distancing and lockdowns. This has been shown to be a major factor in countries that have been successful in containing COVID-19 transmission. Early detection of cases is important, and the use of geospatial technology can support to detect and easily identify potential hotspots that will require timely response. The use of spatial analysis with geographic information systems (GIS) had proved to be effective in providing timely and effective solutions in supporting epidemic response and pandemics over the years. It has developed and evolved rapidly with a complete technological tool for representing data, model cons...

Pan African Medical Journal

The use of online Integrated Supportive Supervision (ISS) is aimed to improve the quality of serv... more The use of online Integrated Supportive Supervision (ISS) is aimed to improve the quality of services provided by front line health workers. This work is aimed to document the effects of ISS on the performance of health workers in Zambia using selected key surveillance and immunization process indicators. ISS data on WHO ODK server of all Integrated Supportive Supervisory (ISS) visits that were conducted in Zambia between 1st January 2018 to 30th September 2018 were analysed to determine the Percentage point difference between the first and the most recent ISS visits in order to determine whether an observed gap during first ISS visit had persisted during the most recent ISS visit. Our study demonstrated that ISS has remarkable percentage point increase between the first and the most recent ISS visits on availability of an updated monitoring chart, health workers knowledge of AFP case definition and AFP case files. However, there exist variations in the frequency of ISS visits acros...

Journal of immunological sciences, 2021

Mobile phone data collection tools are increasingly becoming very usable collecting, collating an... more Mobile phone data collection tools are increasingly becoming very usable collecting, collating and analysing data in the health sector. In this paper, we documented the experiences with mobile phone data collection, collation and analysis in 5 countries of the East and Southern African, using Open Data Kit (ODK), where questionnaires were designed and coded on an XML form, uploaded and data collected using Android-Based mobile phones, with a web-based system to monitor data in real-time during EPI comprehensive review. The ODK interface supports in real-time monitoring of the flow of data, detection of missing or incomplete data, coordinate location of all locations visited, embedded charts for basic analysis. It also minimized data quality errors at entry level with the use of validation codes and constraint developed into the checklist. These benefits, combined with the improvement that mobile phones offer over paper-based in terms of timeliness, data loss, collation, and real-tim...

The Pan African Medical Journal, 2021

Introduction the coronavirus disease (COVID-19) global pandemic has caused serious disruption to ... more Introduction the coronavirus disease (COVID-19) global pandemic has caused serious disruption to almost all aspect of human endeavor forcing countries to implement unprecedented public health measures aimed at mitigating its effects, such as total lockdown (inter and intra), travel bans, quarantine, social distancing in an effort to contain the spread of the virus. Supportive supervision is a functional component of the immunization systems that allows identification of existing gaps, provides an opportunity for onsite training, and document real-time findings for improvement of the program. The control measures of COVID-19 pandemic have also resulted in limitation of operations of the immunization system including supportive supervision. This has limited many aspects of supportive supervision for surveillance and routine immunization monitoring system in the East and Southern African countries. The aim of this study is to identify the effects of COVID-19 on Integrated Supportive Su...

Clinical Infectious Diseases

Background Rotavirus is the leading cause of acute gastroenteritis (AGE) among children worldwide... more Background Rotavirus is the leading cause of acute gastroenteritis (AGE) among children worldwide. Prior to rotavirus vaccine introduction, over one third of AGE hospitalizations in Africa were due to rotavirus. We describe the impact of rotavirus vaccines using data from the African Rotavirus Surveillance Network (ARSN). Methods For descriptive analysis, we included all sites reporting to ARSN for any length of time between 2008 and 2018. For vaccine impact analysis, continuous surveillance throughout the year was required to minimize potential bias due to enrollment of partial seasons and sites had to report a minimum of 100 AGE cases per year. We report the proportion of rotavirus AGE cases by year relative to vaccine introduction, and the relative reduction in the proportion of rotavirus AGE cases reported following vaccine introduction. Results From 2008 to 2018, 97 366 prospectively enrolled hospitalized children <5 years of age met the case definition for AGE, and 34.1% te...

JMIR Public Health and Surveillance

Background As we move toward a polio-free world, the challenge for the polio program is to create... more 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...

UNSTRUCTURED The growth of the novel coronavirus 2019 (COVID-19) pandemic in Africa is an urgent ... more UNSTRUCTURED The growth of the novel coronavirus 2019 (COVID-19) pandemic in Africa is an urgent public health crisis. Estimated models project over 150,000 deaths and 4,600,000 hospitalizations in the first year of disease in the absence of adequate interventions. Electronic contact tracing, therefore, offers a critical role in decreasing COVID-19 transmission; yet if not conducted properly can rapidly become a bottleneck for synchronized data collection, case detection, and case management. While the continent is currently reporting relatively low COVID-19 cases, digitized contact tracing mechanisms are necessary for standardizing real-time reporting of new chains of infection to quickly reverse growing trends and halt the pandemic.This article aims to describe a COVID-19 contact tracing and health facility surveillancesmart phone app with real-time visualization platform which was developed by the AFRO GIS centre, in collaboration with the WHO EPR team, through the expertise and ...

BACKGROUND As the world moves towards a polio free world, the challenge for the Polio Programme n... more BACKGROUND As the world moves towards a polio free world, the challenge for the Polio Programme now is to create an unrelenting focus on the 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 describes one possible solution to address weak surveillance systems and documents the outcomes of the deployment of the Auto-Visual AFP Detection and Reporting (AVADAR) project. METHODS This intervention was implemented in 99 targeted high-risk districts with concerns for silent polio circulation, in eight countries in Africa between 1st August 2017 and 31st July 2018. A total of 6954 persons; 5390 community informants and 1564 health workers were trained and equipped with a smart phone on which the AVADAR application was configured to facilitate Community Informants (CI) sending alerts on suspected AFP and health workers’ use of electronic checklists for investigation ...

BACKGROUND Acute Flaccid Paralysis (AFP) surveillance is the bedrock of polio case detection. The... more BACKGROUND Acute Flaccid Paralysis (AFP) surveillance is the bedrock of polio case detection. The Auto Visual AFP Detection and Reporting (AVADAR) is a digital health intervention designed as a supplemental community surveillance system. OBJECTIVE This paper describes the design and implementation process that made AVADAR a successful disease surveillance strategy at the community level. METHODS This paper outlines the methods for the design and implementation of the AVADAR application. It explains the co-design of the application, the implementation of a helpdesk support structure, the process involved in trouble shooting the application, the benefits of utilizing a closed user group for telecommunication requirements, and the use of a consented video. We also describe how these features combined led to user acceptance testing using black box methodology. RESULTS A total of 198 community informants across two provinces, four districts and 32 settlements were interviewed about appli...

BMC Public Health

Background: Nigeria is the only country in Africa that is yet to be certified as polio free. Surv... more Background: Nigeria is the only country in Africa that is yet to be certified as polio free. Surveillance for acute flaccid paralysis (AFP) is the foundation of the polio eradication initiative since it provides information to alert both health managers and clinician that timely actions should be initiated to interrupt transmission of the polio virus. The strategy also provides evidence for the absence of wild poliovirus. This evaluation was performed to assess key quality indicators defined by the polio eradication program and thus to identify gaps to allow planning for corrective measures to achieve a polio-free situation in Bauchi state and in Nigeria at large. We conducted a crosssectional descriptive study which involved a desk review of documents to authenticate the correctness and completeness of data, and a review of documented evidence for the quality of AFP surveillance. We interviewed Local Government Authority (LGA) surveillance officers and clinicians from focal and non-focal sites, along with caregivers of children with AFP and community leaders. The data were entered and analyzed in a Microsoft Excel spreadsheet. Methods: We conducted a cross-sectional study of the AFP surveillance and documentation in eighteen of the twenty Local Government Areas (LGAs) of Bauchi State. We assessed the knowledge of the clinician at focal and non-focal sites on case definition of AFP, the number and method of stool specimen collection to investigate a case and types of training received for AFP surveillance. We verified AFP case investigations for the last three years: The caregivers (mothers) were interviewed to authenticate the reported information of AFP cases, the method used for stool specimen collection and feedbacks. Community leaders' knowledge on AFP surveillance was also assessed. Data was entered and analyzed in excel spread sheet.

Frontiers in Digital Health, 2022

The mobile phone global positioning system (GPS) is used to reconnaissance a mobile phone user's ... more The mobile phone global positioning system (GPS) is used to reconnaissance a mobile phone user's location, e.g., at work, home, shops, etc. Such information can be used to feed data gathering expeditions, the actual position of the interviewer/surveyor using the mobile phone inert settings of location mode via GPS, WIFI, and Mobile networks. Mobile devices are becoming progressively erudite and now integrate diverse and robust sensors. The new generation of smartphones is multi-laden with sensors, including GPS sensors. The study describes and evaluates a data-gathering process used by the World Health Organization (WHO–Nigeria, EPI Program) that uses phone-based in-built GPS sensors to identify the position of users while they undergo supportive supervision. This form of spatial data is collected intrinsically using the Open Data Kit (ODK) GPS interface, which interlaces with the mobile phone GPS sensor to fetch the geo-coordinates during the process. It represents a step in bu...

Vaccines

Mozambique introduced monovalent rotavirus vaccine (Rotarix®) in September 2015. We evaluated the... more Mozambique introduced monovalent rotavirus vaccine (Rotarix®) in September 2015. We evaluated the effectiveness of Rotarix® under conditions of routine use in Mozambican children hospitalized with acute gastroenteritis (AGE). A test negative case-control analysis was performed on data collected during 2017–2019 from children <5 years old, admitted with AGE in seven sentinel hospital sites in Mozambique. Adjusted VE was calculated for ≥1 dose of vaccine vs. zero doses using unconditional logistic regression, where VE = (1 − aOR) × 100%. VE estimates were stratified by age group, AGE severity, malnutrition, and genotype. Among 689 children eligible for analysis, 23.7% were rotavirus positive (cases) and 76.3% were negative (controls). The adjusted VE of ≥1 dose in children aged 6–11 months was 52.0% (95% CI, −11, 79), and −24.0% (95% CI, −459, 62) among children aged 12–23 months. Estimated VE was lower in stunted than non-stunted children (14% (95% CI, −138, 66) vs. 59% (95% CI, −...

BMC Public Health

Background: Nigeria is the only country in Africa that is yet to be certified as polio free. Surv... more Background: Nigeria is the only country in Africa that is yet to be certified as polio free. Surveillance for acute flaccid paralysis (AFP) is the foundation of the polio eradication initiative since it provides information to alert both health managers and clinician that timely actions should be initiated to interrupt transmission of the polio virus. The strategy also provides evidence for the absence of wild poliovirus. This evaluation was performed to assess key quality indicators defined by the polio eradication program and thus to identify gaps to allow planning for corrective measures to achieve a polio-free situation in Bauchi state and in Nigeria at large. We conducted a crosssectional descriptive study which involved a desk review of documents to authenticate the correctness and completeness of data, and a review of documented evidence for the quality of AFP surveillance. We interviewed Local Government Authority (LGA) surveillance officers and clinicians from focal and non-focal sites, along with caregivers of children with AFP and community leaders. The data were entered and analyzed in a Microsoft Excel spreadsheet. Methods: We conducted a cross-sectional study of the AFP surveillance and documentation in eighteen of the twenty Local Government Areas (LGAs) of Bauchi State. We assessed the knowledge of the clinician at focal and non-focal sites on case definition of AFP, the number and method of stool specimen collection to investigate a case and types of training received for AFP surveillance. We verified AFP case investigations for the last three years: The caregivers (mothers) were interviewed to authenticate the reported information of AFP cases, the method used for stool specimen collection and feedbacks. Community leaders' knowledge on AFP surveillance was also assessed. Data was entered and analyzed in excel spread sheet.

Background The Auto-Visual AFP Detection and Reporting (AVADAR) digital health intervention progr... more Background The Auto-Visual AFP Detection and Reporting (AVADAR) digital health intervention programme is a programme that was introduced to Africa in 2016. The programme adopts the use of the AVADAR SMS – based smartphone application (app) in community-based AFP surveillance activities in order to enhance the detection and reporting of AFP (polio) cases and improve AFP surveillance quality. As at 2020, the AVADAR application is being used in 11 African countries. The need to conduct regular and relevant evaluations of the AVADAR programme is very essential towards improving polio eradication programme performance and effectiveness in Africa. Hence, this study aimed to review and evaluate the quality of the AFP cases reported through the AVADAR intervention and as well evaluate the documentation process of AVADAR alerts and investigations, and the assimilation of AFP cases found via AVADAR into the national databases. Methods This study reviewed and evaluated the quality of AVADAR-in...

The Pan African Medical Journal, 2021

Introduction the new coronavirus (COVID-19) that emerged from Wuhan, Hubei Province of China in D... more Introduction the new coronavirus (COVID-19) that emerged from Wuhan, Hubei Province of China in December 2019, causing severe acute respiratory syndrome (SARS) has fast spread across the entire globe, with most countries struggling to slow and reduce the spread of the virus through rapid screening, testing, isolation, case management, contact tracing, implementing social distancing and lockdowns. This has been shown to be a major factor in countries that have been successful in containing COVID-19 transmission. Early detection of cases is important, and the use of geospatial technology can support to detect and easily identify potential hotspots that will require timely response. The use of spatial analysis with geographic information systems (GIS) had proved to be effective in providing timely and effective solutions in supporting epidemic response and pandemics over the years. It has developed and evolved rapidly with a complete technological tool for representing data, model cons...

Pan African Medical Journal

The use of online Integrated Supportive Supervision (ISS) is aimed to improve the quality of serv... more The use of online Integrated Supportive Supervision (ISS) is aimed to improve the quality of services provided by front line health workers. This work is aimed to document the effects of ISS on the performance of health workers in Zambia using selected key surveillance and immunization process indicators. ISS data on WHO ODK server of all Integrated Supportive Supervisory (ISS) visits that were conducted in Zambia between 1st January 2018 to 30th September 2018 were analysed to determine the Percentage point difference between the first and the most recent ISS visits in order to determine whether an observed gap during first ISS visit had persisted during the most recent ISS visit. Our study demonstrated that ISS has remarkable percentage point increase between the first and the most recent ISS visits on availability of an updated monitoring chart, health workers knowledge of AFP case definition and AFP case files. However, there exist variations in the frequency of ISS visits acros...

Journal of immunological sciences, 2021

Mobile phone data collection tools are increasingly becoming very usable collecting, collating an... more Mobile phone data collection tools are increasingly becoming very usable collecting, collating and analysing data in the health sector. In this paper, we documented the experiences with mobile phone data collection, collation and analysis in 5 countries of the East and Southern African, using Open Data Kit (ODK), where questionnaires were designed and coded on an XML form, uploaded and data collected using Android-Based mobile phones, with a web-based system to monitor data in real-time during EPI comprehensive review. The ODK interface supports in real-time monitoring of the flow of data, detection of missing or incomplete data, coordinate location of all locations visited, embedded charts for basic analysis. It also minimized data quality errors at entry level with the use of validation codes and constraint developed into the checklist. These benefits, combined with the improvement that mobile phones offer over paper-based in terms of timeliness, data loss, collation, and real-tim...

The Pan African Medical Journal, 2021

Introduction the coronavirus disease (COVID-19) global pandemic has caused serious disruption to ... more Introduction the coronavirus disease (COVID-19) global pandemic has caused serious disruption to almost all aspect of human endeavor forcing countries to implement unprecedented public health measures aimed at mitigating its effects, such as total lockdown (inter and intra), travel bans, quarantine, social distancing in an effort to contain the spread of the virus. Supportive supervision is a functional component of the immunization systems that allows identification of existing gaps, provides an opportunity for onsite training, and document real-time findings for improvement of the program. The control measures of COVID-19 pandemic have also resulted in limitation of operations of the immunization system including supportive supervision. This has limited many aspects of supportive supervision for surveillance and routine immunization monitoring system in the East and Southern African countries. The aim of this study is to identify the effects of COVID-19 on Integrated Supportive Su...

Clinical Infectious Diseases

Background Rotavirus is the leading cause of acute gastroenteritis (AGE) among children worldwide... more Background Rotavirus is the leading cause of acute gastroenteritis (AGE) among children worldwide. Prior to rotavirus vaccine introduction, over one third of AGE hospitalizations in Africa were due to rotavirus. We describe the impact of rotavirus vaccines using data from the African Rotavirus Surveillance Network (ARSN). Methods For descriptive analysis, we included all sites reporting to ARSN for any length of time between 2008 and 2018. For vaccine impact analysis, continuous surveillance throughout the year was required to minimize potential bias due to enrollment of partial seasons and sites had to report a minimum of 100 AGE cases per year. We report the proportion of rotavirus AGE cases by year relative to vaccine introduction, and the relative reduction in the proportion of rotavirus AGE cases reported following vaccine introduction. Results From 2008 to 2018, 97 366 prospectively enrolled hospitalized children <5 years of age met the case definition for AGE, and 34.1% te...

JMIR Public Health and Surveillance

Background As we move toward a polio-free world, the challenge for the polio program is to create... more 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...

UNSTRUCTURED The growth of the novel coronavirus 2019 (COVID-19) pandemic in Africa is an urgent ... more UNSTRUCTURED The growth of the novel coronavirus 2019 (COVID-19) pandemic in Africa is an urgent public health crisis. Estimated models project over 150,000 deaths and 4,600,000 hospitalizations in the first year of disease in the absence of adequate interventions. Electronic contact tracing, therefore, offers a critical role in decreasing COVID-19 transmission; yet if not conducted properly can rapidly become a bottleneck for synchronized data collection, case detection, and case management. While the continent is currently reporting relatively low COVID-19 cases, digitized contact tracing mechanisms are necessary for standardizing real-time reporting of new chains of infection to quickly reverse growing trends and halt the pandemic.This article aims to describe a COVID-19 contact tracing and health facility surveillancesmart phone app with real-time visualization platform which was developed by the AFRO GIS centre, in collaboration with the WHO EPR team, through the expertise and ...

BACKGROUND As the world moves towards a polio free world, the challenge for the Polio Programme n... more BACKGROUND As the world moves towards a polio free world, the challenge for the Polio Programme now is to create an unrelenting focus on the 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 describes one possible solution to address weak surveillance systems and documents the outcomes of the deployment of the Auto-Visual AFP Detection and Reporting (AVADAR) project. METHODS This intervention was implemented in 99 targeted high-risk districts with concerns for silent polio circulation, in eight countries in Africa between 1st August 2017 and 31st July 2018. A total of 6954 persons; 5390 community informants and 1564 health workers were trained and equipped with a smart phone on which the AVADAR application was configured to facilitate Community Informants (CI) sending alerts on suspected AFP and health workers’ use of electronic checklists for investigation ...

BACKGROUND Acute Flaccid Paralysis (AFP) surveillance is the bedrock of polio case detection. The... more BACKGROUND Acute Flaccid Paralysis (AFP) surveillance is the bedrock of polio case detection. The Auto Visual AFP Detection and Reporting (AVADAR) is a digital health intervention designed as a supplemental community surveillance system. OBJECTIVE This paper describes the design and implementation process that made AVADAR a successful disease surveillance strategy at the community level. METHODS This paper outlines the methods for the design and implementation of the AVADAR application. It explains the co-design of the application, the implementation of a helpdesk support structure, the process involved in trouble shooting the application, the benefits of utilizing a closed user group for telecommunication requirements, and the use of a consented video. We also describe how these features combined led to user acceptance testing using black box methodology. RESULTS A total of 198 community informants across two provinces, four districts and 32 settlements were interviewed about appli...

BMC Public Health

Background: Nigeria is the only country in Africa that is yet to be certified as polio free. Surv... more Background: Nigeria is the only country in Africa that is yet to be certified as polio free. Surveillance for acute flaccid paralysis (AFP) is the foundation of the polio eradication initiative since it provides information to alert both health managers and clinician that timely actions should be initiated to interrupt transmission of the polio virus. The strategy also provides evidence for the absence of wild poliovirus. This evaluation was performed to assess key quality indicators defined by the polio eradication program and thus to identify gaps to allow planning for corrective measures to achieve a polio-free situation in Bauchi state and in Nigeria at large. We conducted a crosssectional descriptive study which involved a desk review of documents to authenticate the correctness and completeness of data, and a review of documented evidence for the quality of AFP surveillance. We interviewed Local Government Authority (LGA) surveillance officers and clinicians from focal and non-focal sites, along with caregivers of children with AFP and community leaders. The data were entered and analyzed in a Microsoft Excel spreadsheet. Methods: We conducted a cross-sectional study of the AFP surveillance and documentation in eighteen of the twenty Local Government Areas (LGAs) of Bauchi State. We assessed the knowledge of the clinician at focal and non-focal sites on case definition of AFP, the number and method of stool specimen collection to investigate a case and types of training received for AFP surveillance. We verified AFP case investigations for the last three years: The caregivers (mothers) were interviewed to authenticate the reported information of AFP cases, the method used for stool specimen collection and feedbacks. Community leaders' knowledge on AFP surveillance was also assessed. Data was entered and analyzed in excel spread sheet.