title: Short message service sentinel surveillance of influenza-like illness in Madagascar, 2008-2012.
abstract: OBJECTIVE
  The revision of the International Health Regulations (IHR) and the threat of influenza pandemics and other disease outbreaks with a major impact on developing countries have prompted bolstered surveillance capacity, particularly in low-resource settings.
  
  
  METHODS
  Surveillance tools with well-timed, validated data are necessary to strengthen disease surveillance. In 2007 Madagascar implemented a sentinel surveillance system for influenza-like illness (ILI) based on data collected from sentinel general practitioners.
  
  
  METHODS
  Before 2007, Madagascar's disease surveillance was based on the passive collection and reporting of data aggregated weekly or monthly. The system did not allow for the early identification of outbreaks or unexpected increases in disease incidence.
  
  
  RESULTS
  An innovative case reporting system based on the use of cell phones was launched in March 2007. Encrypted short message service, which costs less than 2 United States dollars per month per health centre, is now being used by sentinel general practitioners for the daily reporting of cases of fever and ILI seen in their practices. To validate the daily data, practitioners also report epidemiological and clinical data (e.g. new febrile patient's sex, age, visit date, symptoms) weekly to the epidemiologists on the research team using special patient forms.
  
  
  CONCLUSIONS
  Madagascar's sentinel ILI surveillance system represents the country's first nationwide "real-time" surveillance system. It has proved the feasibility of improving disease surveillance capacity through innovative systems despite resource constraints. This type of syndromic surveillance can detect unexpected increases in the incidence of ILI and other syndromic illnesses.
authors.affiliation: Unité d'Epidémiologie, Institut Pasteur de Madagascar, Antananarivo, Madagascar.
authors.forename: Soatiana
authors.initials: S
authors.lastname: Rajatonirina
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Heraud
authors.forename: Laurence
authors.initials: L
authors.lastname: Randrianasolo
authors.forename: Arnaud
authors.initials: A
authors.lastname: Orelle
authors.forename: Norosoa Harline
authors.initials: NH
authors.lastname: Razanajatovo
authors.forename: Yolande Nirina
authors.initials: YN
authors.lastname: Raoelina
authors.forename: Lisette
authors.initials: L
authors.lastname: Ravolomanana
authors.forename: Fanjasoa
authors.initials: F
authors.lastname: Rakotomanana
authors.forename: Robinson
authors.initials: R
authors.lastname: Ramanjato
authors.forename: Armand Eugène
authors.initials: AE
authors.lastname: Randrianarivo-Solofoniaina
authors.forename: Vincent
authors.initials: V
authors.lastname: Richard
mesh_terms: D002648:Child; D016001:Confidence Intervals; D003625:Data Collection; D003906:Developing Countries; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000175:diagnosis / Q000453:epidemiology*; D008270:Madagascar / Q000453:epidemiology; D008297:Male; D058873:Pandemics / Q000517:prevention & control*; D015980:Public Health Practice; D018570:Risk Assessment; D018571:Sentinel Surveillance; D060145:Text Messaging / Q000295:instrumentation*
chemical_list: D007252:Influenza Vaccines