Building Electronic Disease Surveillance Capacity in the Peruvian Navy with SAGES

ObjectiveTo introduce SMS-based data collection into the Peruvian Navy’s public health surveillance system for increased reporting rates and timeliness, particularly from remote areas, as well as improve capabilities for analysis of surveillance data by decision makers.IntroductionIn the past 15 years, public health surveillance has undergone a revolution driven by advances in information technology (IT) with vast improvements in the collection, analysis, visualization, and reporting of health data. Mobile technologies and open source software have played a key role in advancing surveillance techniques, particularly in resource-limited settings. Johns Hopkins University Applied Physics Laboratory (JHU/APL) is an internationally recognized leader in the area of electronic disease surveillance. In addition to the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) used by several state and local jurisdictions and the CDC in the U.S., JHU/APL has also developed the Suite for Automated Global Electronic bioSurveillance (SAGES). SAGES is a collection of modular, open-source software tools designed to meet the challenges of electronic disease surveillance in resource-limited settings.JHU/APL is working with the Peruvian Navy health system to improve their electronic disease surveillance capabilities. The Peruvian Navy currently uses a SAGES-based system called Alerta DISAMAR that was implemented several years ago in an effort supported by the Armed Forces Health Surveillance Branch, and in collaboration with the Naval Medical Research Unit No. 6 (NAMRU-6). The system uses both web-based and IVR-based (interactive voice response) data collection from several Navy health facilities in Peru. For the present effort, JHU/APL is implementing a new SMS-based data collection capability for the Peruvian Navy.MethodsJHU/APL is engaged with the Peruvian Navy Health System to upgrade the existing SAGES-based Alerta DISAMAR surveillance system which relies on remote data collection using IVR (interactive voice recording) technology, with a SAGES-based system that uses SMS (short message service) text messages for remote data collection. Based on Peruvian Navy requirements, JHU/APL created mobile data entry forms for Android smartphones using the SAGES mCollect application. SAGES mCollect is built using Open Data Kit open source tools along with added features such as 128-bit encryption and quality checks.The JHU/APL team engages c