Contact tracing, is an essential step in breaking the chain of disease transmission and ending an outbreak. There is need to explore digital tools and skills which will enhance the collection and management of epidemiologic, clinical, and laboratory information for every case. This data is crucial for developing outbreak counter measures. In the context of ebola virus disease (EVD), developing a Geographical Information System (GIS) and remote sensing platform for contacting tracing and monitoring of cases will aid field workers visualize outbreak spread between people as well as provide automated tools that speed contact tracing and spatial data analysis. With a disease as often fatal as Ebola, quickly identifying and following up with those who may have been exposed is key to saving lives and containing the outbreak . This paper gives a preliminary non-technical insight on how GIS and remote sensing can be integrated into existing methodologies to mitigate the challenges in contact tracing and monitoring of Ebola virus diseases cases in any given geographical location. Invariably, this can also be used to design appropriate tools for monitoring outbreaks of viral hemorrhagic fevers such as Ebola, Marburg, Rift Valley, Lassa, and Crimean-Congo hemorrhagic fevers.

1. Integrating GIS & Remote Sensing Technology in Contact Tracing of Ebola virus disease Cases in Nigeria.
Presented by
ANUMBA JOSEPH UCHE
Scientific Officer
Federal Ministry of Health,
National Arbovirus and Vectors Research Centre-Enugu, Nigeria.

2. Integrating GIS & Remote Sensing Technology In Contact Tracing Of Ebola Virus Disease Cases In Nigeria.
Anumba Joseph Uche
Scientific Officer,
National Arbovirus and Vectors Research Centre,
Enugu-Nigeria.

3. •To understand the concept of Contact Tracing in the context of epidemiology and disease surveillance
•To understand the fundamentals of Geographic Information System (GIS) and Remote Sensing.
•Garner knowledge on how to apply/integrate ICT, GIS and Remote sensing in mitigating the spread of Ebola Virus Disease (EVD)

4. The identification of an Ebola virus case must take into account both the clinical manifestations as well as the travel history and exposure history reported by the patient.

5. Different points of detection of possible EVD cases.
Detection at point of origin
During embarking/ boarding
During flight
During transit between flight or other transport
At destination

6. Timeline of the Ebola Disease outbreak
A timeline of the outbreak follows, using data reported by the Centers for Disease Control and Prevention and the World Health Organization.
 The table also includes suspected cases that have yet to be confirmed for the virus.
WHO Disease Outbreak News

7. *The total number of cases is subject to change due to on- going reclassification, retrospective investigation, and availability of laboratory results. * Data reported in the Disease Outbreak News are based on official information reported by Ministries of Health.

8. Ask Your Self…
What is Contact Tracing?
What does contact tracing entail?
As a public health personnel, what are the required tools and skills?
Why do we need these skills?

9. A contact is any person without any disease signs and symptoms but had physical contact with a case (alive or dead) or the body fluids of a case within the last three weeks. This can be least one of the following ways:
Having slept in the same household with a case
Has had direct physical contact with the case (dead or alive) during the illness
Has had direct physical contact with the (dead) case at the funeral
Has touched his/her blood or body fluids during the illness
Has touched his/her clothes or linens
Has been breastfed by the patient (baby)

10. An individual with clinical and epidemiology history compatible with EVD is identified
Unexplained deaths of travellers, with clinical and epidemiological history compatible with EVD
Identification of contacts and monitoring for 21 days (after the last known exposure to EVD) should be initiated.

11. When an individuals with clinical and epidemiology history compatible with EVD is identified or if there are unexplained deaths of travellers, with clinical and epidemiological history compatible with EVD, (even though laboratory diagnosis is pending), Identification of contacts and monitoring for 21 days (after the last known exposure to EVD) should be initiated.
▪ [Ref: Word Health Organization; Ebola Virus Disease, Implications of introduction in the Americas- 13th August 2014]

12. Contact tracing must be made according to the Risk assessment guidelines for diseases transmitted on aircraft (RAGIDA) protocol;
which indicates contact tracing of all those passengers seated in an adjacent seat to the patient in all directions -on the side, in front or behind, including across an aisle- , as well as the crew on board.
If the cleaning of the aircraft is performed by unprotected personnel, they should be considered as contacts.

13. Contact tracing is an integral component of active surveillance during Ebola virus disease (EVD) outbreak.
It is defined as the identification and follow up of persons who may have come into contact with an infected person.
Early detection and prompt isolation of new EVD cases is requisite for interrupting secondary transmission of Ebola virus in any community.

14. Immediate evacuation of potentially infectious individuals who have signs and symptoms of the disease from the community prevents high-risk exposures during home-based care, other social activities, and subsequent customary burial procedures.
.

15. During EVD outbreak, all potential contacts to suspected, probable and confirmed cases should be systematically identified and put under observation for 21 days (the maximum incubation period of the Ebola virus) from the last day of contact.
This is the most effective outbreak containment measures that must be implemented prudently.

16. Contact Identification
Contact listing
Contact follow up
CT
* There ought to be tools for efficient information management of these elements.

17. •Detect Outbreak to initiate timely & effective control
Disease Transmission Status
•Prioritize the area (Temporal & Geographic distribution) for disease control measures.
Prioritization
•Monitor the impact of control interventions
Disease Control Sustainability

18. During the current EVD outbreak in Guinea, Liberia, and Sierra Leone, conducting contact tracing posed serious challenges;
in parts, due to the wide geographical expanse of the EVD outbreak, insufficient resources (human, financial and logistics), and to some extent, limited access to affected communities.
The procedures for setting up functional contact tracing systems were also not well articulated; inadvertently many stakeholders conducted contact tracing differently.

19. SURVEILLANCE
EBOLA VIRUS DISEASE
CONTROL
An integral component of active surveillance during Ebola virus disease (EVD) outbreak is Contact Tracing. Early detection and prompt isolation of new EVD cases is requisite for interrupting secondary transmission of Ebola virus in the community.

20. - Ebola contact listing form
Contact Follow up form
Reporting forms for the field team
Ebola Virus Disease
Surveillance.
Monitoring and follow up of people in contact with cases remain difficult and for people living in remote areas, it ca be difficult accessing them

24. Mitigating the challenges in Contact Tracing.

25. Misinformation and Misdirection of surveillance officers.
Remote location and inability to access cases.
Communication lag among volunteers and public health professionals.
Asynchronous data collation and reporting methodology.
Limited expertise & training of personnel.

26. EVD Surveillance
&
Molecular Diagnosis
•Contemporary EVD Surveillance tools & Activities
•Specimen Collection
•PCR molecular diagnosis& Analysis
Information Communication Technology (ICT)
•Case Contact Database
•Data Storage & Analysis
•Information communication / transmission
Geo informatics [Decision Support System]
•EVD Surveillance & Monitoring (spatial & geographical distribution)
•Simulation of EVD Control activities
•Develop EVD case Management Strategies & Decision support systems
INTEGRATED SURVEILLANCE & CONTROL MECHANISM AGAINST EVD

27. Data
Activities, projects, research.
People
Hardware
PCs, input & output devices, smart phones, tabs.
Software
Procedures
Feedback, reporting, implementation, maintenance.
Information
Individuals, organizations, Institutions.
Mobile Apps, statistical analysis, database .
Internet, Cloud computing, Webinar, Geoinfo.

28. •raw facts and figures
Data
•data is entered by humans (people, organization, institutions etc).
People
•physical components & devices used to aquire, process, store.
Hardware:
•the name given to computer programs usually installed I most hardware.
Software
•data that is converted to give it a meaning.
Information:
•a series of actions conducted in a certain order to make sure the system runs smoothly.
Procedures:

29. Cloud computing, or something within the cloud, is an expression used to describe a variety of computing concepts that involve a large number of computers connected through a real-time communication networks.
In an epidemiological context, Cloud computing is used as an innovative concept to mitigate the problem of communication lag in disease surveillance, monitoring, control, research activities, documentation and data transfer among field epidemiologist and professionals across the world.

30. CLOUD Computing
+
EVD
Surveillance
Security
Accessible
Affordable
Partnership
Information Syncing
Reliable
Professional
Webinar

32. •GPS technology allows users to determine exactly where they are on the surface of the earth by triangulating data from a series of satellite that orbit the earth. [using a GPS receiver]
GPS
Global Positioning systems
•…the science and art of obtaining information about an object, area, or phenomenon through the analysis of data acquired by a device that is not in contact with the object, area, or phenomenon under investigation.
REMOTE SENSING
•A database is an organized collection of data. The data are typically organized to model relevant aspects of reality in a way that supports processes requiring this information.
DATABASE
• integrates hardware, software, and data for capturing, managing, analysing, and displaying all forms of geographically referenced information.
GIS
Geographic Information System

33. A Geographic Information System (GIS) allows us to view, understand, question, interpret, and visualize data in many ways that reveal relationships, patterns, and trends in the form of maps, globes, reports, and charts.
A GIS is an information system designed to work with data referenced by spatial / geographical coordinates.
In other words, GIS is both a database system with specific capabilities for spatially referenced data as well as a set of operations for working with the data. It may also be considered as a higher order map.

34. GIS technology integrates common database operations such as query and statistical analysis with the unique visualization and geographic analysis benefits offered by maps.
These abilities distinguish GIS from other information systems and make it valuable to a wide range of public and private enterprises for explaining events, predicting outcomes, and planning strategies.

36. Planning of Projects & Activities
Make Better Decisions
Visual Analysis
Improve Organizational Integration

37. Develop online graphic visuals on disease vector activities to assist Vector Control Officers across the geopolitical zones in Nigeria.
Using data generated by the state vector control officers, NAVRC shall develop Geographic Information System (GIS) based maps with animation (video) to bring surveillance results "to life."
The GIS video & maps in vector-borne disease surveillance will aid in refining the science of preventing vector-borne disease outbreaks in Nigeria.

38. GIS & Remote Sensing in Contact Tracing.
• Geoinformatics section shall be responsible to identify whether needed data exists, needs to be collected, or acquired from third parties.
Needs Assessment
•the required spatial data is delivered from the Geoinformatics Section to the relevant EVD control division, in a suitable format and manner
Data Collection
•GIS data is analysed, manipulated, illustrated, plotted and exported. The required spatial analysis is done with the help of the remote sensing and other tools in Geoinfomatics.
Data Analysis
•GIS maps are produced as part of the analysis results. Reporting is again done with the help of the GIS Center or through utilities provided by the Geoinformatics Centre .
Result Reporting

40. NAVRCGIS4ebola; an integrated Geoinformatics tool to support outbreak response activities in terms of case and contact data collection, analysis and production of related reports.
In an effort to streamline management of contacts during infectious disease outbreaks, the World Health Organization developed the Field Information Management System (FIMS) software.

41. Registration of cases and case related data;
Registration of contacts and contacts related data;
Production of daily follow up reports;
Production of predefined summary and detailed reports
Exporting of data to different formats (txt, xls, xml etc.) for further analysis;
Summary case and contact mapping (integrating other mobile apps and GIS softwares);
Visualization of chains of transmission;

42. Ebola Virus: Outbreak Response Preparedness?
How Ready are We?
Any Measures?
Are we upbeat?

44. Precautions for epidemiologists and officers on EVD surveillance

45. By providing digital epidemiological tools to better understand surveillance results, EVD contact tracing personnel and case management professionals in Nigeria can optimize their own surveillance strategies.
Extension personnel can use this system for educating the public and potentially save human lives.

46. The integration of ICT & Geoinformatics in disease surveillance ought to be a fundamental skill for modern epidemiological professionals across the Globe…
Anumba Joseph Uche
http://linkedin.com/in/anumbajoe

47. Fight the Ebola Virus Disease Invasion!

48. Let’s win this Fight against Ebola Virus Disease Invasion!