Selecting the Technology

Coconut Surveillance mobile software for case response workers runs on low cost Android smart phones or tablets. Coconut Surveillance analytics software for program managers is a responsive web application can be used on desktop, laptop, tablet computers, and smart phones, though larger displays are better for detailed reports. The Coconut Surveillance database can be hosted in the cloud or installed locally on your own server. 

Connecting a Case Notification System

Coconut Surveillance can be adapted to use existing case notification systems, such as Rapid Pro or Frontline SMS, or can use its own interactive SMS system. It has already been adapted to use three different external case notification systems, including MEEDS Unstructured Supplementary Service Data (USSD), Telerivet, and Medic Mobile.

Setting Notification and Response Targets

Case notification response targets in Zanzibar include the time from diagnosis to case notification (24 hours), and the time from case notification received to completed follow-up (48 hours). The "1-3-7" system, initiated in China and now used by several other countries in the region, sets three case targets: case reporting within 1 day, case investigation within 3 days, and focus investigation and action within 7 days. Coconut Surveillance supports up to three case notification and response targets for monitoring. These can be configured via the Coconut Surveillance user interface.

Synchronizing Case Data

Mobile users can work offline, and then synchronize case data when they have an internet connection. Coconut Surveillance can synchronize case data over mobile phone networks, Wi-Fi networks, and portable, battery-powered Wi-Fi routers. Coconut Surveillance synchronization is optimized to minimize transmission without losing the advantages of case-level data synchronization.

Estimating Transmission Risk

Coconut Surveillance can guide mobile users through reactive and active surveillance protocols based on the estimated risk of transmission in the case area. It can be adapted to use transmission risk estimates from external sources, and to feed case data into external transmission risk models. 

Setting Epidemic Thresholds

Coconut Surveillance supports multiple epidemic alarm and alert thresholds based on the number of new cases reported within a selected area (e.g. facility, village, district) and time period (days). Epidemic alarm and alert thresholds can be configured via the Coconut Surveillance user interface.

Analyzing Case Data

The Coconut Surveillance analytics software includes a set of reports, graphs, and maps, that enable program managers to monitor case reporting and follow up in real time to the individual case level. De-identified case data can be exported easily in comma separated value (CSV) format for analysis in other tools, such as Microsoft Excel.

Connecting with Other Systems

Coconut Surveillance can be adapted to retrieve case notifications from existing systems. It can also be adapted to retrieve data from existing aggregate weekly case reporting systems. This makes it possible to easily compare the numbers cases reported by these systems with the numbers of cases reported to Coconut Surveillance.

Coconut Surveillance can import an organizational structure (e.g. region, district, facility) from DHIS 2. This saves significant time and ensures that malaria indicator data transmitted to DHIS 2 will align with the organizational structure in DHIS 2. Coconut Surveillance can export malaria data element metadata to DHIS 2, and can transmit aggregate malaria indicator values directly to DHIS 2.

Of course there are many other important issues that need to be considered. These include the numbers and capabilities of the intended users, their anticipated case loads, training for clinicians and mobile users, transportation, electrical power sources, and internet connectivity for synchronizing data. You may also want to consider whether to host your own local Coconut Surveillance database, use your own cloud hosting service, or work with RTI to host your database. It is also important to consider whether mobile devices need to be provided to mobile users, what types of mobile devices, and how they will be managed.

Other Considerations