Detecting

It’s Wednesday, and feeling awful, Siti and her mom decide to head to the doctor. It’s at Charawe heath facility that Siti first will learn that she has malaria. 

From the health facility, Siti receives artemisinin-based combination therapy, the recommended treatment for P. falciparum malaria. She is instructed to take the medicine for three days.

What happened next is really incredible.

Notifying

At the Charawe health facility, Siti’s clinical and diagnostic record is entered into the Malaria Case Notification (MCN) System, developed by the U.S. Agency for International Development’s Tanzania Vector Control Scale-up Project. All public and and private healthcare facilities in Zanzibar use this system.

Through MCN, notifications of all reported malaria cases are sent to District Malaria Surveillance Officers (DMSO) of the Zanzibar Malaria Elimination Program.

Each officer is equipped with with a motorbike, mobile phone, and a tablet equipped with a wireless internet connection. These tools allow them to respond to each new malaria case in record time.

Responding

Shabani Khamis is one of 20 District Malaria Surveillance Officers serving Zanzibar’s 10 health districts.

Instantly, Shabani receives a notification that a new malaria case has been identified in Central District, where he serves. Shabani will be the first to respond to Siti’s malaria case.

Shabani receives the new case information in Coconut Surveillance on his tablet. On his motorbike, Shabani rides off with a backpack containing medical supplies.

At the Facility

First, Shabani visits the Charawe health facility, where he verifies the reported case and gathers additional information.

He enters the information collected into the Coconut Surveillance System on his tablet.

At the health facility, a medical provider will give Shabani additional patient information for Siti, including a phone number and address where he can reach her.

Making a House Call

Shabani finds Siti and her mom at their home. First, he checks in with Siti to see how she is feeling and to make sure she is taking her prescribed medicine. 
Then he begins testing all members of the household - as long as they are home- for malaria infection using rapid diagnostic strip tests. 

Malaria is transmitted from one infected family member to another as mosquito vectors commonly feed on multiple people within a household. By detecting and treating cases early, Shabani ensures that the disease transmission stops with Siti.

Stopping Transmission

Pricking the finger of Siti’s mother, Shabani draws a small drop of blood and places it on the rapid diagnostic strip test. He also takes her temperature.

If any household members test positive for malaria, Shabani will give them medication on the spot.

Through TVCSP, secondary malaria cases are being detected and treated in record time, often within 48 hours and before clinical symptoms are even presented.

It’s state-of-the-art disease surveillance and it’s helping Zanzibar in the fight against malaria.

Assessing the Household

Shabani then assesses the household and its surroundings for any environmental and household factors that may be conducive to malaria transmission. He drains any standing water and checks for the presence of window screens and when the household was last sprayed with residual insecticide.

Before he leaves, Shabani makes sure that Siti’s family has enough long-lasting insecticide-treated bednets to protect the entire family from mosquitoes and malaria.

He pauses outside the house to record the geo-location and wirelessly sends the data collected during his household visit through the Coconut Surveillance System, the data being stored in a cloud-based server for further analysis and reporting.

Translating Data Into Action

Back at the office, the Ministry of Health’s Zanzibar Malaria Elimination Program is able to access data for Siti and her household as well as any new malaria case data in all of Zanzibar, along with the GPS locations for each.

Coconut Surveillance provides unprecedented data for reacting quickly to new infections and halting local transmission in its tracks. It also makes it possible to monitor the results of new interventions, such as voluntary screening at border entry points, automated risk-based community alerts, and new personal protection technologies

Coconut Surveillance is helping Zanzibar sustain the remarkable gains it has made in controlling malaria by helping to respond quickly to newly reported cases and informing intervention efforts.

For Siti and her family, it’s making all the difference.