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ESIDA: Epidemiological Surveillance for Infectious Diseases in sub-Saharan Africa

Contact: Juliane Boenecke

The Overall Objective of the ESIDA project is to connect skills, methods and data objects from different research disciplines and information sources in order to explore and design new approaches of data-driven health information and surveillance systems for early detection and control of emerging infectious disease outbreaks in the target region Tanzania. The project builds upon previous networks of German and African partners and aims to strengthen the international cross-disciplinary collaboration in research and education, involving epidemiology, clinical research, biosecurity, public health, health geography, environmental sciences, computer and data sciences.

Description​

In countries with limited capacities of epidemiological surveillance, disease outbreaks often go unnoticed. As a result, early detection and timely response is difficult. This is a challenge that particularly affects resource-restricted regions, such as countries in sub-Saharan Africa.

Here the growing digital infrastructure in sub-Saharan Africa and advances in communication technologies, particularly in the mobile-phone sector, hold considerable potential for improving local monitoring systems that allow for more efficient and timely information exchange. For example, the collection of health data through mobile devices and the use of Open Data as a new dimension of traditional epidemiological surveillance systems open up new avenues for research and development. However, they also require joint efforts of qualified actors across borders and research disciplines.

To achieve this goal, the ESIDA project aims to strengthen interdisciplinary and international collaboration in research and education. The anticipated outcome is the pre-prototype electronic health information and surveillance system ESIDA that aims to strengthen local epidemiological surveillance in Tanzania and help alert local public health actors at an early stage of an outbreak. In the long term, the ESIDA system could be extended to the member states of the East African Community to support efforts of local field diagnostics as part of an existing national laboratory project.

ESIDA overall structure​

The ESIDA project integrates seven modules with specific research foci and objectives:

Module 1: ESIDA Collaboration and Networking (Lead: BNITM and HAW Hamburg)​

The aim of module 1 is to initiate a cross-disciplinary research and education network of German and African partners in order to strengthen epidemiological surveillance of infectious diseases in sub-Saharan Africa. Together with local stakeholders in Tanzania, infectious diseases of public health importance shall be prioritized. The main activities include the overall research coordination, the identification of the strengths, weaknesses, opportunities and threats of the ESIDA network and to build capacities in joint research and teaching.

Module 2: eHealth Strategies in Epidemiological Surveillance (Lead: BNITM)​

Module 2 aims to explore the potentials of digital epidemiological surveillance approaches in sub-Saharan Africa using eHealth solutions. The work focuses on the design and development of a mobile-phone based health information and surveillance system approach in Tanzania, together with local partners from research, telecommunication and health care, which enables automated real-time syndrome surveillance and early identification of diseased cases while providing tailored health information to its users. The concept builds on the results of the BMBF-funded concept and pilot study “eHISS”, which was conducted in Ghana 2013-2015 (BNITM, Kumasi Centre for Collaborative Research, the Ghana School of Public Health, UKE and the National Institute for Public Health and the Environment).

Module 3: Potentials of Open Data Sources in Epidemiological Surveillance (Lead: HAW Hamburg)​

The goal of module 3 is to identify the potentials of Open Data sources (health and non-health information) for digital epidemiological surveillance in sub-Saharan Africa. The epidemiological description of the emerging infectious disease under study and its determinants in Tanzania forms the groundwork of this research. The main activities of this module focus on the summary and critical evaluation of Open Data sources taking into account the environmental, social, political and cultural context of local disease dynamics.

Module 4: ESIDA Data Management (Lead: HAW Hamburg and NM-AIST)​

Module 4 aims to combine and structure various spatiotemporal health and non-health data in a joint server and database system using the information gathered through the mobile-phone-based approach (module 2) and Open Data sources (module 3). The activities form the basis of the technical concept of the ESIDA health information and surveillance system and will further focus on the development of guidelines for the management, privacy and security of electronic health information.

Module 5: Indicator-based Risk Assessment for Early Outbreak Detection (Lead: UHH and UKE)​

Module 5 focuses on the identification and classification of early warning indicators for outbreak detection in Tanzania using the results obtained in module 2-4. The key activities focus on the development of a methodological framework and software concept for data monitoring and analysis to lay out spatiotemporal disease patterns using digital maps. The output will be used to generate and disseminate outbreak alerts targeting public health actors and health policy makers.

Module 6: ESIDA Pilot (Lead: BNITM and NM-AIST)​

In module 6, the four operational sub-systems created in module 2-5 will be combined to design and create the electronic health information and surveillance system ESIDA (pre-prototype level). The main aim is to pilot the ESIDA system concept in the target area Tanzania by looking at its functionality and user acceptance. Additionally, it is envisaged to develop standard operating procedures (SOP) based on the early warning principle of the ESIDA system in order to coordinate local activities of outbreak investigation and laboratory diagnostics. The outcomes are to support and complement the activities and achievements of the project “EAC Mobile Labs” in East Africa.

Module 7: ESIDA Decision Support System (Lead: HAW Hamburg and NM-AIST)​

Alongside module 6, module 7 focuses on the concept development of a decision support approach for early outbreak detection and control in Tanzania using the ESIDA system. Here collaboration with local stakeholders is key. The main activities include the planning and conduction of stakeholder workshops, the identification of health care pathways for effective outbreak management together with local health care providers as well as the development of an ESIDA information and implementation guideline for local stakeholders. The goal is to provide the basis for a possible follow-up pilot phase in collaboration with the East African Community (EAC).