Category Archives: Surveillance

Creating a Data Warehouse to Support COVID-19 Surveillance in Mauritius

The Digital Initiatives Group at I-TECH (DIGI) worked closely with the Mauritius Ministry of Health and Wellness (MOHW) to implement a national laboratory information system (LIMS) using OpenELIS and expanded it to create a national-level data warehouse.

The data warehouse captures all the information that has been input into OpenELIS by the two reference labs and all ten regional flu clinics and creates real-time, easy-to-read data dashboards. These dashboards are used by the MOHW staff and public health officials to track national COVID-19 cases numbers and trace ongoing and potential outbreaks of COVID-19 and other infectious diseases.

DIGI continues to support MOHW with LIMS training, LIMS maintenance, and national laboratory strengthening.

Implementing a National Laboratory Information System in Mauritius

Since 2020, the Digital Initiative Group at I-TECH (DIGI)  has worked closely with the Mauritius Ministry of Health and Wellness (MOHW) to deploy a national laboratory information management system (LIMS) using the OpenELIS platform. The LIMS connects the national reference laboratory to regional laboratories and flu clinics around the country to quickly process COVID-19 tests, as well as send results notifications to patients via text message or email.

The OpenELIS system, while implemented to support COVID-19 surveillance, was also designed to be able to support most routine lab workflows, including HIV viral load testing and other other infectious diseases (e.g., HIV, Ebola, Zika, Chikungunya), which ensures MOHW can quickly trace, respond to, and manage cases.

DIGI continues to support MOHW with LIMS training, LIMS maintenance, and national laboratory strengthening.

Optimizing the COVID-19 Testing Process at the Airport in Mauritius

As a measure to help stop the spread of COVID-19, the Government of Mauritius began requiring that all arriving passengers submit to COVID-19 health screenings upon arrival in Mauritius. To rapidly process the influx of tests and quickly notify passengers of their results, the Digital Initiatives Group at I-TECH (DIGI) worked closely with the Mauritius Ministry of Health and Wellness (MOHW) to digitize the COVID-19 screening declaration form for all passengers arriving to the Mauritius International Airport and supported MOHW in opening a COVID-19 reference laboratory at the airport to rapidly process the tests and send notifications of COVID-19 tests passengers.

The airport laboratory is connected to the National Reference Laboratory via OpenELIS, which allows all the data captured on the digital form, such as passenger information and COVID-19 screenings/test results, to assist public health officials from all over Mauritius to carry out surveillance and contact tracing efforts.

Since opening in December 2020, the airport reference laboratory has returned over 250,000 tests and continues to process thousands of tests to passengers and citizens of Mauritius daily.

Birth Defects Surveillance in Malawi

Malawi is one of first countries in Southeast Africa to respond to the World Health Organization’s call for robust birth surveillance systems. Routine surveillance is essential for public health monitoring of pregnancy outcomes and birth defects, especially in high-HIV burden settings where women living with HIV initiate the use of antiretroviral therapy before or during pregnancy.

Since 2016, the International Training and Education Center for Health, in collaboration with the Centers for Disease Control and Prevention, has supported the implementation of an active hospital-based birth surveillance system at four high-volume facilities in Malawi. To date, a total of 165,608 of births have been assessed. A subset of women are also enrolled in an ongoing nested case control study to assess associations between external birth defects and maternal exposures such as prior health conditions, medications, and environmental and lifestyle factors.

Anticipated use of these data include:

  • Establish a baseline prevalence of external birth defects in Malawi
  • Evaluate the impact of introducing new drugs for the management of HIV (e.g., dolutegravir) on the prevalence of external birth defects
  • Advocate for investment in programs and interventions to reduce the occurrence of birth defects and adverse pregnancy outcomes.

National COVID-19 Emergency Response in Malawi

In collaboration with the Malawi Ministry of Health (MOH) and Centers for the Disease Control and Prevention (CDC), I-TECH has supported the national COVID-19 response in Malawi since March 2020. Technical assistance has focused on laboratory capacity, supporting quality COVID-19 surveillance and data management, and implementing a COVID-19 population-based survey with oversight from the Public Health Institute of Malawi (PHIM), under MOH.

In June 2020, I-TECH seconded a Technical Advisor (TA) to PHIM to support COVID-19 activities. The I-TECH TA acts as secretariat for the national Public Health Emergency Operations Center (PHEOC), supporting the coordination of the multi-sectoral COVID-19 response, developing and revising strategies and procedures, facilitating communication, and ensuring access to and sharing of COVID-19 data and information between partners.

I-TECH has also assisted with data management and reporting at the district level, as well as with contact tracing and adherence to infection prevention and control measures.

I-TECH has been able to leverage use of its platform for HIV laboratory activities to provide critical lab support for COVID-19 activities and provide key support to the National Health Reference Laboratory, focusing on building or increasing laboratory capacity including with genomic sequencing, maintaining quality assurance, and improving communication and coordination among laboratory stakeholders.

The I-TECH Team also coordinated a population-based survey to evaluate the extent of spread of COVID-19 in five high-burden districts in Malawi.

I-TECH Presents Posters at IAS 2021 Conference on HIV Science

The International AIDS Society (IAS) virtually hosted the 11th Conference on HIV Science on 18-21 July 2021. The conference also included a “local partner hub” in Berlin, the original host city, for local experts to gather in person. This biennial conference brings together top HIV researchers, experts, and scientists for presentations and discussions on the latest advances in HIV research and practice.

Representatives from the International Training and Education Center for Health (I-TECH) virtually presented the following posters:

Representatives from I-TECH’s partner network organizations and the Centers for Disease Control and Prevention (CDC) also presented data from I-TECH-supported programs in Malawi, India, and Zimbabwe.

HIV Recency Surveillance in Malawi

The International Training and Education Center for Health (I-TECH), in collaboration with the Malawian Ministry of Health (MOH) and the Centers for Disease Control and Prevention, began implementing recent HIV infection surveillance in April 2019. The project aims to establish a surveillance system among persons newly diagnosed with HIV infection by integrating point-of-care testing for recent infection into routine HIV testing services (HTS). A rapid test for recent infection is given to consenting clients 13-years-and-older who screen HIV positive within routine HTS across participating health facilities. Between April 2019-2020, I-TECH and MOH activated 485 testing points at 155 facilities in Malawi. All 155 facilities implemented recent HIV infection surveillance and reported data. The project has reached 11 of 28 districts to date.

These data allow the detection and characterization of recent HIV infection among newly diagnosed individuals and identify geographic areas associated with recent HIV-1 infection to inform geographic prioritization of HIV prevention and treatment strategies. The project has demonstrated high uptake and allowed characterization of recent infections according to socio-demographic and geographic factors. PEPFAR implementers in Malawi will collaborate with MOH to further investigate the reasons for high recent infection prevalence in identified clusters. Based on the findings of these responses, Malawi may focus on interventions such as youth-focused programs that aim to limit HIV acquisition and transmission among young people.