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Table 4 Description of the SMS-reinforced IDSR strategy. Table describing characteristics of the reinforced IDSR strategy in southern Madagascar including objectives, indicators, data source, collection, transfer and use

From: Evaluation of the reinforced integrated disease surveillance and response strategy using short message service data transmission in two southern regions of Madagascar, 2014–15

Characteristic Description
PH importance of diseases/ syndromes under surveillance Diseases under surveillance constitute the biggest part of basic healthcare consultations such as Acute Respiratory Infections (ARI), malaria, diarrhoea
Available interventions 23/35 of the diseases and syndromes under surveillance have a defined response foreseen in the national health action plan
IDSR objectives Follow the trend of endemic and/or epidemic diseases and syndromes
Detect cases of highly epidemic diseases or diseases subject to elimination or eradication programmes as well as unexpected events in a timely manner
Provide IHR data to the WHO
Performance indicators used Weekly number of cases and deaths by disease, syndrome or event, and by HS
Proportional morbidity: Number of consultations by disease, syndrome or event/ Number of total consultations
Completeness: Number of reports received/Number of expected surveillance reports
Timeliness: Number of reports received within 48 h after the week in question/Number of expected surveillance reports
Information collected Number of cases and deaths for three groups of diseases/syndromes/ events
 • Endemic and potential epidemic diseases: Acute Respiratory Infections (ARI), diarrhoeal diseases, malnutrition, malaria, tuberculosis, Human Immunodeficiency Virus (HIV), Sexually Transmitted Infections (STI), maternal deaths
 • Highly epidemic diseases: cholera, bacterial dysentery, meningitis, plague, yellow fever, viral haemorrhagic fever, chikungunya, dengue-like syndrome (DLS), rabies, foodborne outbreaks, severe acute respiratory syndrome (SARS), avian influenza, Rift Valley fever, chickenpox, West Nile virus
 • Diseases subject to eradication or elimination programmes: poliomyelitis & acute flaccid paralysis (AFP), leprosy, measles, neonatal tetanus, filariasis, malaria
Data source HS patient consultation register
Data collection, entry and transfer Compilation of weekly number of total consultations, and cases and deaths per disease/ syndrome or event (including zero reporting) before sending them per SMS to the DHO. At the DHO, the surveillance focal point enters the data into an Excel spreadsheet.
Database set-up One observation (line) per week and per district
Data analysis and thresholds Weekly analyses based on defined thresholds, for example:
 • Disease for which one case = epidemic, such as meningitis, acute flaccid paralysis, neonatal tetanus, measles, SARI, avian influenza, cholera, plague, haemorrhagic fever, human rabies
 • Malaria: doubling of cases over three consecutive weeks
 • Brutal increase in comparison with other diseases/ syndromes
 • Completeness and timeliness of data transfer
Communication No routine communication of analysis results to stakeholders (2016)
Use of data and analyses results Weekly monitoring of performance indicators (completeness, timeliness), investigation of and response to potential identified or notified signals
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