Grant Amount: US$ 24,877

Keywords: HEALTH, FREE AND OPEN SOURCE, GEOGRAPHIC INFORMATION SYSTEM, INDONESIA

Geographic coverage: Indonesia

Objectives

The objectives of this project are to improve the detection and management of Dengue Haemorrhagic Fever (DHF) cases and help control dengue transmission in the community.

Research context

DHF is the leading cause of hospitalization and death among children in Indonesia and in other endemic areas in the developing world. The ability to prevent and manage DHF outbreaks is often limited by poor disease detection, surveillance and management systems and a corresponding lack of coordination among community-based control efforts. This action research project aims to involve the local government, community members and health care personnel in the development of an integrated, web-based Geographic Information System (GIS) on DHF outbreaks. The system is expected to improve the detection and management of DHF cases in the community and become a model for DHF control in other endemic areas. It may also be applied to other communicable diseases.

Target beneficiaries

The direct beneficiaries of the project are communities who live in urban and suburban areas, where the incidence of DHF is highest. The health sector can use data from the system to plan, mobilize resources, advocate and implement coordinated DHF control efforts.

Outputs

The project aims to integrate DHF surveillance and control activities among health care personnel and public health administrators through a web-based geographic information and decision support system, so that hospitals, community health centres and health offices are able to monitor the incidence and time-space clustering of DHF cases and fatalities. To achieve this, the project will: 

• Develop guidelines for the mobilization of resources to minimize DHF morbidity and mortality, especially in the form of web-based interactive programs;
• Enhance learning on the successes and failures of DHF case management and control in the community; and
• Report on the effectiveness of the web-based DHF surveillance system published on the website and in a peer-reviewed journal.

Research results and outcomes

At the time of writing formal reports from this project were not available. The project however has communicated the following progress. The intended project site was originally only one district (Sleman). After initial project socialization, the administrators of nearby Yogyakarta Municipality, which shares contiguous DHF risk areas, also requested to participate in the project. As the Yogyakarta Municipal Government were willing to pay field workers to monitor Aedes larvae in the community, no additional resources from the ICT R&D Grants Programme were required for this project expansion. At the time of writing the government had committed to funding the project for an additional year.

The networked surveillance system is a tool to utilize data that is systematically collected, processed and presented in an electronic virtual map. The map can be used to inform strategies to control the spread of DHF. The surveillance system has covered the project areas and was used to generate spatial clusters of DHF cases. The information on the location and increase in number of cases is monitored by two local health officials who inform hospitals admitting DHF cases, allowing them to improve early diagnosis and case management. The incidence of cases in Sleman District from 2003 to 2005 has been 552, 732 and 316 respectively. Up until May 2006, there have been 176 cases.

The project is now mapping vector densities (percentage of houses with Aedes larvae) in Yogyakarta Municipality. After this is complete the DHF control programme will focus on preventing dengue transmission in two highly endemic villages, Caturtunggal and Condongcatur. Ovitrap will be used to monitor vector density in the two villages, and then the project will map the results for surveillance purposes.

The project is collaborating with social scientists to develop ways to use evidence generated by the mapping system to influence policy-making and lead to community behaviour changes campaigns that can help control DHF outbreaks. Social scientists in the Department of Public Health, Faculty of Medicine at Gadjah Mada University are conducting research on behaviour change relating to dengue vector elimination and intend to publish key messages and summary of their findings on the project website (under construction).

The project developed training modules on GIS for disease surveillance. Health staff responsible for infectious disease control in South Kalimantan, East Java and Yogyakarta provinces has attended the training. Four seminar papers in Indonesian have been produced and two articles were submitted to the American Journal of Tropical Medicine and Hygiene and Tropical Medicine and International Health.

Duration

Start Date: January 2005
End Date: September 2006
Total Duration: 21 Months

Contact information

Prof. Dr. Hari Kusnanto
Centre for Health Informatics and Learning
Department of Public Health, Faculty of Medicine, Gadjah Mada University
Sekip Utara, Yogyakarta 55281, Indonesia
Telephone/Fax: +62 274 549 432
Email: harikusnanto@yahoo.com

Website: http://map.depkes.go.id