ABSTRACT
INTRODUCTION: Argus is an open source electronic solution to facilitate the reporting and management of public health surveillance data. Its components include an Android-phone application, used by healthcare facilities to report results via SMS; and a central server located at the Ministry of Health, displaying aggregated results on a web platform for intermediate and central levels. This study describes the results of the use of Argus in two regions of Togo. METHODS: Argus was used in 148 healthcare facilities from May 2016 to July 2018, expanding to 185 healthcare facilities from July 2018. Data from week 21 of 2016 to week 12 of 2019 was extracted from the Argus database and analysed. An assessment mission took place in August 2016 to collect users' satisfaction, to estimate the concordance of the received data with the collected data, and to estimate the time required to report data with Argus. RESULTS: Overall completeness of data reporting was 76%, with 80% of reports from a given week being received before Tuesday 9PM. Concordance of data received from Argus and standard paper forms was 99.7%. Median time needed to send a report using Argus was 4 minutes. Overall completeness of data review at district, regional, and central levels were 89%, 68%, and 35% respectively. Implementation cost of Argus was 23 760 USD for 148 facilities. CONCLUSIONS: The use of Argus in Togo enabled healthcare facilities to send weekly reports and alerts through SMS in a user-friendly, reliable and timely manner. Reengagement of surveillance officers at all levels, especially at the central level, enabled a dramatic increase in completeness and timeliness of data report and data review.
Subject(s)
Internet , Public Health Surveillance/methods , Text Messaging , Cell Phone , Data Collection , Health Care Costs , Humans , Outcome Assessment, Health Care , Pilot Projects , Research Design , Surveys and Questionnaires , Togo , Web BrowserABSTRACT
Water, sanitation, and hygiene (WASH) services in healthcare facilities are essential to ensure quality health care and to facilitate infection, prevention, and control practices. They are critical to responding to outbreaks and preventing healthcare-associated infections and, therefore, critical to global health security. Many healthcare facilities in low- and middle-income settings have limited WASH services. One tool to address this issue is the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) Water and Sanitation for Health Facility Improvement Tool, or "WASH FIT." WASH FIT is a continuous improvement tool based on key WHO environmental health and infection, prevention, and control standards. While using WASH FIT, internal teams regularly perform self-assessments at their facilities, using up to 65 WASH indicators to develop and implement an improvement plan. The Ministry of Health and Social Protection (MSPS) in Togo, with support from WHO and the US Centers for Disease Control and Prevention (CDC), piloted this tool in 3 healthcare facilities. The pilot included facility assessments at 3 time points and in-depth interviews and document review 7 months after initiating WASH FIT. Facilities made improvements without significant external financial or material support. On average, pilot facilities improved from 18% of total indicators meeting standards at baseline to 44% after 7 months. Examples included improved drinking water supply, medical waste segregation, and increased soap at handwashing stations. Participants reported improvements in staff and patient satisfaction, hand hygiene, and occupational safety. Findings suggest that WASH FIT, coupled with training and supervision, may help facilities improve WASH services and practices, thus contributing to global health security. Based on these findings, the Togolese MSPS plans to scale up nationwide. Les services d'eau, d'assainissement, et d'hygiène (WASH) dans les établissements de santé sont essentiels pour assurer des soins de qualité et faciliter les pratiques de prévention et contrôle des infections. Ils sont essentiels pour répondre aux épidémies et prévenir les infections associées aux soins de santé, et donc à la sécurité sanitaire mondiale. De nombreux pays à revenu faible ou intermédiaire ont des services WASH limités dans les établissements de soins. Un outil récemment publié pour remédier cette situation est l'outil WASH FIT [Water and Sanitation for Health Facility Improvement Tool] de l'Organisation mondiale de la Santé (OMS) et le Fonds des Nations Unies (UNICEF) pour l'amélioration de l'eau et l'assainissement dans les formations sanitaires. WASH FIT est un outil d'amélioration continue basé sur les normes de l'OMS en matière de santé environnementale et de prévention et contrôle des infections. Lors de l'utilisation de WASH FIT, les équipes internes effectuent régulièrement des auto-évaluations dans leurs installations en utilisant jusqu'à 65 indicateurs pour élaborer et mettre en Åuvre leur plan d'amélioration. Le ministère de la Santé et de la Protection Sociale (MSPS) du Togo, avec le soutien de l'OMS et les Centres pour le contrôle et la prévention des maladies (CDC), a fait un pilotage de cet outil dans 3 centres de santé. Ce pilotage comprenait 3 évaluations dans chaque formation sanitaire, des interviews approfondies, et une revue documentaire, 7 mois après l'initiation du WASH FIT. Les formations sanitaires ont réalisé des progrès, sans aide financière ou matérielle extérieure. En moyenne, les formations sanitaires sont passées de 18% des indicateurs atteignant les standards au départ, à 44% après 7 mois. Les exemples incluent l'approvisionnement en eau potable, le tri des déchets médicaux, et le savon aux points de lavage des mains. Les participants ont signalé des améliorations dans la satisfaction du personnel et des patients, l'hygiène des mains, et la sécurité au travail. Les résultats indiquent que WASH FIT, associé à la formation et à la supervision, pourrait être un outil pour aider les formations sanitaires à améliorer les services et pratiques WASH, contribuant ainsi à la sécurité sanitaire mondiale. Sur la base de ces résultats, le MSPS prévoit une extension à l'échelle nationale.
Subject(s)
Drinking Water/standards , Health Facilities/standards , Infection Control , Quality Improvement , Sanitation/standards , Female , Global Health , Health Personnel , Humans , Hygiene , Infection Control/methods , Infection Control/standards , Male , Pilot Projects , Security Measures , TogoABSTRACT
BACKGROUND: Lassa fever belongs to the group of potentially fatal hemorrhagic fevers, never reported in Togo. The aim of this paper is to report the first two cases of Lassa fever infection in Togo. CASE PRESENTATION: The two first Lassa fever cases occurred in two expatriate's health professionals working in Togo for more than two years. The symptoms appeared among two health professionals of a clinic located in Oti district in the north of the country. The absence of clinical improvement after antimalarial treatment and the worsening of clinical symptoms led to the medical evacuation. The delayed diagnosis of the first case led to a fatal outcome. The second case recovered under ribavirin treatment. CONCLUSION: The emergence of this hemorrhagic fever confirms the existence of Lassa fever virus in Togo. After a period of intensive Ebola virus transmission from 2013 to 2015, this is an additional call for the establishment and enhancement of infection prevention and control measures in the health care setting in West Africa.
