Dengue SMS Surveillance Project in the Philippines

Rationale:  Dengue fever poses a significant health threat in the Republic of the Philippines (RP).  Current hospital-based surveillance is highly valid, but poorly suited for rapid identification of dengue ‘hot spots’ because of the delay associated with laboratory confirmation.   A more rapid, but less specific, surveillance method will be implemented and compared to the standard sentinel surveillance system.

Objective:  The objective of this pilot study is to implement and evaluate a simple dengue surveillance protocol using Short Message Service (SMS) text messages to send daily, person-based dengue surveillance data from local health clinics (BHCs) to the city health office (CHO) in Cebu City, RP.

Methods/Conclusions:  Beginning 1 June 2009,BHCs in Cebu City, RP will identify all patients who meet the RP clinical case definition for dengue fever (age >6 mos, fever in the last 7 days and any two of the following symptoms: headache, pain behind the eyes, rash, muscle or joint pain, anorexia, nausea, vomiting, abdominal pain, nose bleed or coffee-colored stool.)  Family and address codes, age, sex, date of onset and presenting signs/symptoms will be recorded for each patient meeting the case definition.  Each day, the BHC doctor will send this information to the CHO in a single SMS text message.  The first line of the SMS message will contain the date and clinic name.  Each subsequent line will contain the required data for a single case.  The SMS message will be transferred into an EpiInfo database, and the ESSENCE Desktop Edition application will be used to identify statistically significant increases in reported clinical dengue cases.  The time series for the SMS rapid surveillance system data will be compared with those produced by the RP hospital-based, sentinel dengue surveillance system.  Success of the SMS system will be measured by the agreement between these two time series.