Real-time laboratory surveillance of Dengue antigen (NS1) - Best proposed early warning and response system for Dengue in Sri Lanka? - Results from a pilot study

Abstract

Introduction: During the recent past, dengue fever and associated complications have been the most important concern for health policy makers of Sri Lanka. The current notification system has considerable inevitable delays in preventive measures. Objectives: Implementing a laboratory-based real-time antigen(NS1) surveillance system for notification coupled with a rapid preventive response within the Colombo district as a pilot project and compare the notifications with existing national surveillance systems. Methods: An online notification platform was established with a centralized database. Seven main laboratories of the private sector linked with the notification system, where they can create new notifications at the central database, whenever the NS1 test detected as positive. Relevant Medical Officers of Health should update action implemented to complete the response process. A dashboard was designed to visualize each notification and its status with a predefined color code. Results: Patients from 14 Medical Officer of Health (MOH) areas out of 15 were captured. The immediate preventive response was recorded from the field preventive staff for 90% of the reportings. All most all attended patients have given health advice on awareness, prevention, and source reduction through premise inspection by trained field staff with 24hrs of notification. Conclusions: Salient features of the novel system are notification of antigen-positive patients, the rapidity of notification(real-time) and response, user-friendliness, access to multiple stakeholders simultaneously without data duplication, early involvement of the field staff, the ability to trace the cases using checklists and a color-coding system from a dashboard.