title: Using mobile phone text messaging for malaria surveillance in rural Kenya.
abstract: BACKGROUND
  Effective surveillance systems are required to track malaria testing and treatment practices. A 26-week study "SMS for Life" was piloted in five rural districts of Kenya to examine whether SMS reported surveillance data could ensure real-time visibility of accurate data and their use by district managers to impact on malaria case-management.
  
  
  METHODS
  Health workers from 87 public health facilities used their personal mobile phones to send a weekly structured SMS text message reporting the counts of four basic surveillance data elements to a web-based system accessed by district managers. Longitudinal monitoring of SMS reported data through the web-based system and two rounds of cross-sectional health facility surveys were done to validate accuracy of data.
  
  
  RESULTS
  Mean response rates were 96% with 87% of facilities reporting on time. Fifty-eight per cent of surveillance data parameters were accurately reported. Overall mean testing rates were 37% with minor weekly variations ranging from 32 to 45%. Overall test positivity rate was 24% (weekly range: 17-37%). Ratio of anti-malarial treatments to test positive cases was 1.7:1 (weekly range: 1.3:1-2.2:1). District specific trends showed fluctuating patterns in testing rates without notable improvement over time but the ratio of anti-malarial treatments to test positive cases improved over short periods of time in three out of five districts.
  
  
  CONCLUSIONS
  The study demonstrated the feasibility of using simple mobile phone text messages to transmit timely surveillance data from peripheral health facilities to higher levels. However, accuracy of data reported was suboptimal. Future work should focus on improving quality of SMS reported surveillance data.
authors.affiliation: Malaria Public Health Department, KEMRI-Wellcome Trust - University of Oxford Collaborative Programme, Nairobi, Kenya. sgithinji@kemri-wellcome.org.
authors.forename: Sophie
authors.initials: S
authors.lastname: Githinji
authors.forename: Samwel
authors.initials: S
authors.lastname: Kigen
authors.forename: Dorothy
authors.initials: D
authors.lastname: Memusi
authors.forename: Andrew
authors.initials: A
authors.lastname: Nyandigisi
authors.forename: Andrew
authors.initials: A
authors.lastname: Wamari
authors.forename: Alex
authors.initials: A
authors.lastname: Muturi
authors.forename: George
authors.initials: G
authors.lastname: Jagoe
authors.forename: René
authors.initials: R
authors.lastname: Ziegler
authors.forename: Robert W
authors.initials: RW
authors.lastname: Snow
authors.forename: Dejan
authors.initials: D
authors.lastname: Zurovac
mesh_terms: D040421:Cell Phone / Q000706:statistics & numerical data; D062665:Epidemiological Monitoring; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D007630:Kenya / Q000453:epidemiology; D008288:Malaria / Q000453:epidemiology*; D012424:Rural Population; D060145:Text Messaging / Q000706:statistics & numerical data