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 andassociated complications have been the most importantconcern for health policy makers of Sri Lanka. The currentnotification system has considerable inevitable delaysin preventive measures.Objectives: Implementing a laboratory-based real-timeantigen(NS1) surveillance system for notification coupledwith a rapid preventive response within the Colombodistrict as a pilot project and compare the notificationswith existing national surveillance systems.Methods: An online notification platform was establishedwith a centralized database. Seven main laboratories ofthe private sector linked with the notification system,where they can create new notifications at the centraldatabase, whenever the NS1 test detected as positive.Relevant Medical Officers of Health should update actionimplemented to complete the response process. Adashboard was designed to visualize each notificationand its status with a predefined color code.Results: Patients from 14 Medical Officer of Health (MOH)areas out of 15 were captured. The immediate preventiveresponse was recorded from the field preventive staff for90% of the reportings. Almost all attended patients havegiven health advice on awareness, prevention, andsource reduction through premise inspection by trainedfield staff with 24hrs of notification.Conclusions: Salient features of the novel system arenotification of antigen-positive patients, the rapidity ofnotification(real-time) and response, user-friendliness,access to multiple stakeholders simultaneously withoutdata duplication, early involvement of the field staff, theability to trace the cases using checklists and a color-coding system from a dashboard.