Daniel W. Martin, MSPH, is an Epidemiologist, and Michelle L. Sloan, MA, is a Health Scientist; both in the Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA. Brigette L. Gleason, MD, is Surveillance and Program Lead; Ansumana Kamara is a Public Health Specialist; and Tushar Singh, MD, PhD, is Country Director; all in the CDC Sierra Leone Country Office, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Freetown, Sierra Leone. Les de Wit, MIntDev, is Information Systems Manager, Global Health Informatics, and Nelson Clemens, MBA, is eIDSR Project Coordinator, Disease Surveillance Systems; both with eHealth Africa, Freetown, Sierra Leone. Mohamed Alex Vandi, MD, is Director of Health Security and Emergencies, Ministry of Health and Sanitation, Freetown, Sierra Leone. David K. Kargbo is with the Ministry of Health and Sanitation, Freetown, Sierra Leone. Charles Njuguna, PhD, is Health Security and Emergency Cluster Lead, and Stephen Sesay is Data Manager/GIS Analyst; both with the World Health Organization, Freetown, Sierra Leone. The views expressed are the authors' own and do not necessarily represent the views of the Centers for Disease Control and Prevention, the US government, or the World Health Organization.
Health Secur. 2020 Jan;18(S1):S72-S80. doi: 10.1089/hs.2019.0081.
The Global Health Security Agenda aims to improve countries' ability to prevent, detect, and respond to infectious disease threats by building or strengthening core capacities required by the International Health Regulations (2005). One of those capacities is the development of surveillance systems to rapidly detect and respond to occurrences of diseases with epidemic potential. Since 2015, the US Centers for Disease Control and Prevention (CDC) has worked with partners in Sierra Leone to assist the Ministry of Health and Sanitation in developing an Integrated Disease Surveillance and Response (IDSR) system. Beginning in 2016, CDC, in collaboration with the World Health Organization and eHealth Africa, has supported the ministry in the development of Android device mobile data entry at the health facility for electronic IDSR (eIDSR), also known as health facility-based eIDSR. Health facility-based eIDSR was introduced via a pilot program in 1 district, and national rollout began in 2018. With more than 1,100 health facilities now reporting, the Sierra Leone eIDSR system is substantially larger than most mobile-device health (mHealth) projects found in the literature. Several technical innovations contributed to the success of health facility-based eIDSR in Sierra Leone. Among them were data compression and dual-mode (internet and text) message transmission to mitigate connectivity issues, user interface design tailored to local needs, and a continuous-feedback process to iteratively detect user or system issues and remediate challenges identified. The resultant system achieved high user acceptance and demonstrated the feasibility of an mHealth-based surveillance system implemented on a national scale.
全球卫生安全议程旨在通过建设或加强《国际卫生条例（2005）》所要求的核心能力，提高各国预防、发现和应对传染病威胁的能力。这些能力之一是发展监测系统，以便迅速发现和应对具有流行潜力的疾病的发生。自 2015 年以来，美国疾病控制与预防中心（CDC）与塞拉利昂的合作伙伴合作，协助卫生部和公共卫生署制定综合疾病监测和应对（IDSR）系统。自 2016 年以来，CDC 与世界卫生组织和电子卫生非洲合作，支持该部开发用于电子 IDSR（eIDSR）的卫生机构移动数据输入的 Android 设备，也称为基于卫生机构的 eIDSR。基于卫生机构的 eIDSR 通过一个试点项目在一个地区推出，2018 年开始在全国范围内推广。现在有超过 1100 个卫生机构报告，塞拉利昂的 eIDSR 系统比文献中大多数移动医疗（mHealth）项目都要大。几项技术创新促成了塞拉利昂基于卫生机构的 eIDSR 的成功。其中包括数据压缩和双模（互联网和短信）消息传输，以减轻连接问题、根据当地需求定制的用户界面设计，以及一个持续反馈过程，以迭代地检测用户或系统问题，并解决确定的挑战。由此产生的系统实现了高用户接受度，并证明了在全国范围内实施基于移动医疗的监测系统的可行性。
