Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Dec 5, 2023
Date Accepted: Aug 20, 2024
Influenza-like illness symptoms as reported by a population-based participatory surveillance system in Lesotho, July 2020- July 2021
ABSTRACT
Background:
Participatory surveillance – a public population at risk reporting symptoms using technology – can supplement existing surveillance systems. In Lesotho, a landlocked country of 2 million people in Southern Africa, the laboratory and case-based COVID-19 surveillance systems were complemented by a participatory surveillance system called “LeCellPHIA” (Lesotho Cell phone Population-based HIV Impact Assessment Survey).
Objective:
This report describes person, place, and time of ILI in Lesotho from July 15, 2020 to July 15, 2021.
Methods:
LeCellPHIA was built from the 2020 Lesotho Population-Based HIV Impact Assessment (LePHIA2020) survey. LePHIA2020 was a cross-sectional nationally representative household survey that assessed the prevalence of key human immunodeficiency virus (HIV) related health indicators. LeCellPHIA employed interviewers to call participants to enquire weekly about influenza-like illness (ILI) among a nationally representative sample of LePHIA 2020 participants.
Results:
The LeCellPHIA ILI participatory surveillance system captured 122,985 weekly reports of symptomology in Lesotho from July 2020- 2021. Influenza-like illness trends from LeCellPHIA mirror COVID-19 testing data trends; with an epidemic peak in mid- to late- January 2021. Overall, report of any ILI symptoms (fever, dry cough, shortness of breath) were reported at an average weekly rate of 879 per 100,000 at risk (95% Confidence Interval (CI): 782- 988). ILI was highest among men aged 60 and older (1,124 per 100,000; 95% CI 836 - 1512). The overall response rate for the year of data collection was 75%. Weekly data were shared with the National COVID-19 Secretariat and other stakeholders to monitor ILI trends, identify and respond to increases in report of ILI, and inform policies and practices designed to reduce COVID-19 transmission in Lesotho.
Conclusions:
LeCellPHIA, an innovative and cost-effective system, could be replicated in countries where phone ownership is high but internet use is not yet high enough for a web or app-based system.
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