Protocol for the crowdsourced image-based morbidity hotspot surveillance for neglected tropical diseases (CIMS-NTDs).

INTRODUCTION: Efficient NTDs elimination strategies require effective surveillance and targeted interventions. Traditional methods are costly and time-consuming, often failing to cover entire populations in case of movement restrictions. To address these challenges, a morbidity image-based surveillance system is being developed. This innovative approach which leverages the smartphone technology aims at simultaneous surveillance of multiple NTDs, enhancing cost-efficiency, reliability, and community involvement, particularly in areas with movement constraints. Moreover, it holds promise for post-elimination surveillance. METHODOLOGY: The pilot of this method will be conducted across three states in southern Nigeria. It will target people affected by Neglected Tropical Diseases and members of their communities. The new surveillance method will be introduced to target communities in the selected states through community stakeholder's advocacy meetings and awareness campaigns. The pilot which is set to span eighteen months, entails sensitizing NTDs-affected individuals and community members using signposts, posters, and handbills, to capture photos of NTDs manifestations upon notice using smartphones. These images, along with pertinent demographic information, will be transmitted to a dedicated server through WhatsApp or Telegram accounts. The received images will be reviewed and organized at backend and then forwarded to a panel of experts for identification and annotation to specific NTDs. Data generated, along with geocoordinate information, will be used to create NTDs morbidity hotspot maps using ArcGIS. Accompanying metadata will be used to generate geographic and demographic distributions of various NTDs identified. To protect privacy, people will be encouraged to send manifestation photos of the affected body part only without any identifiable features. EVALUATION PROTOCOL: NTDs prevalence data obtained using conventional surveillance methods from both the pilot and selected control states during the pilot period will be compared with data from the CIMS-NTDs method to determine its effectiveness. EXPECTED RESULTS AND CONCLUSION: It is expected that an effective, privacy-conscious, population inclusive new method for NTDs surveillance, with the potential to yield real-time data for the identification of morbidity hotspots and distribution patterns of NTDs will be established. The results will provide insights into the effectiveness of the new surveillance method in comparison to traditional approaches, potentially advancing NTDs elimination strategies.

Knowledge of school teachers and the associating factors in the effective delivery of the school health programme in Nigeria.

Introduction: the important position that teachers occupy in school settings make them indispensable in the effective delivery of the School Health Programme (SHP). This study assessed the SHP knowledge of primary school teachers and the perception of their roles in the successful delivery of the programme in Ondo State, Nigeria. Methods: this was a cross-sectional descriptive study. A multi-stage sampling technique was used to select 400 teachers from 42 primary schools, from the study population. A semi-structured self-administered questionnaire was used to collect data. Each respondent´s aggregate score was classified as being poor knowledge, if it was < 50% of the maximum obtainable score and good knowledge, if it was equal or more than 50% of the maximum obtainable score. Results: the majority of the teachers (76%) demonstrated poor knowledge of the programme. Yet, a good number of them, believe they have a part to play in the implementation of the SHP. Academic qualification was found to be statistically associated with SHP knowledge (p < 0.01). Length of time in teaching service (p= 0.035; OR=1.033; 95%CI = 1.002- 1.065) was found to be a predictor of adequate SHP knowledge. Conclusion: the SHP knowledge of the teachers was found to be inadequate. Although, most of the teachers agreed that they had roles to play in the SHP delivery, a sizeable number of them could not state what those roles entailed. It is recommended, therefore, that government and all stakeholders in education and health sectors should conduct trainings on SHP, focusing on teachers´ roles in the school community.