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Combating dengue in Segamat

Dengue is a mosquito borne virus that causes severe illness and even death. Malaysia is dealing with one of the worst dengue outbreaks in the last four years. There are many contributing factors one of which is the El Niño weather effect is one of the most significant. The severity of an outbreak can be mitigated by communities and local authorities working together to take action to reduce mosquito breeding sites and interrupt the transmission with targetted spraying.

Segamat, is a district in the southern Malaysian state of Johor and like other parts of Malaysia has experienced an increase in dengue cases over the last 12 months. The Ministry of Health's (MOH) District Health Office and the State Government's District Office have highlighted the importance of the public's role in identifying areas such as drains and empty land where rubbish is dumped and still water accumulates. These sites can be targetted for cleaning up and spraying. A team of volunteers has engaged to "gotong-royong", conducting community patrols to identify and report potential breeding sites.

One of the challenges facing the District Health Office and the community volunteers has been geo-locating and keeping track of problem sites, and documenting corrective action.

The volunteer teams and the District Health Office currently use instant messaging apps to share information. What is needed, however, is a more comprehensive, centralised, coordinated system to track potential breeding sites, the location of actual dengue cases, and the action taken.

Embedded within the district of Segamat is the Monash University health and demographic surveillance site, called SEACO. Working with a pro-active District Health Office and local community, the SEACO IT development team has created a mobile application that can be used to geo-locate, tag and photograph potential breeding sites as well as the location of dengue cases. Using the app the District Health Office can monitor community reports, view the images and map location of sites, mark them for action, and record the action taken.

The system can also be used in environment surveillance and case detection using dengue cases diagnosed in the health centres and Segamat district hospital.The development team began work on the mobile application late last year and will begin field trials in April 2016 with the District Health Office and teams of community volunteers. The mobile application runs on GPS enabled, Android devices. Time, date, GPS location, the photograph of the breeding site and field notes are gathered via the mobile application and relayed to a server. The District Health Officers can monitor reports in real time. Using the same application, Officers can photograph or note any corrective action and log that on the servers, giving the community volunteers quick feedback about their efforts.

There is also a web interface that give District Health Officers a dynamic map of the district on which they can play a time series of captured images and potential dengue breeding sites. Navigation tools give them a range controls to monitor changes over time, specific locations, or even reports from individual community volunteers.

The SEACO-MOH dengue app is designed to help health officials better manage their resources, conduct targetted fogging in clustered areas where suspected dengue breeding sites are present, and in the future, assist in better planning efforts to reach out to community members on effective ways to reduce transmission.

While the application was built with dengue (and Segamat) in mind, the technology can be readily adapted to other districts in Malaysia, or elsewhere in the world. It could also be extended to help the District Office reach out to the needs of the community from reported road traffic hotspots to damaged public infrastructure, or crime reporting.

Using technology to improve measurement and data capture has been central to SEACO's work and being able to develop the dengue app was a way for us to support the community, the District Health Team and the Distrcit Office. It is the community that empowers SEACO and the collaborations with the government that enables us.