TY - JOUR AU - Olson, Daniel AU - Lamb, Molly AU - Lopez, Maria Renee AU - Colborn, Kathryn AU - Paniagua-Avila, Alejandra AU - Zacarias, Alma AU - Zambrano-Perilla, Ricardo AU - Rodríguez-Castro, Sergio Ricardo AU - Cordon-Rosales, Celia AU - Asturias，埃德温·穆PY - 2017 DA - 2017/11/09 TI -手机的性能App-Based参与急性发热性疾病和急性胃肠炎症状监测系统在农村危地马拉乔- J地中海互联网Res SP - e368六世- 19 - 11 KW -手机KW - app KW -参与式KW -症状监测KW -诺瓦克病毒KW -登革热KW -急性发热性疾病KW -腹泻KW -危地马拉AB -背景:随着移动电话在资源有限的环境中越来越多的可用性，它可能为参与式综合征监测提供一个重要的工具，其中用户直接将症状数据提供给一个集中的数据库。目的:我们研究了一个基于手机应用程序的参与式综合征监测系统的性能，该系统收集综合征数据(急性发热性疾病和急性胃肠炎)，以检测生活在危地马拉资源匮乏和农村地区的一组儿童的登革热病毒和诺如病毒。方法:随机抽取家庭，提供手机，并要求使用症状日记应用程序(Vigilant-e)提交每周报告。报告急性发热疾病或急性胃肠炎的参与者使用决策树算法回答了额外的问题，随后由研究护士到家中进行第二次访谈，如果确认为急性发热疾病，则收集登革热病毒样本，如果确认为急性胃肠炎，则收集诺如病毒样本。我们使用Vigilant-e应用程序分析了与综合征数据自我报告减少相关的风险因素，并评估了改善自我报告的策略。我们还评估了自我报告和护士在家访期间收集的数据之间的一致性。结果:2015年4月至2016年6月，207个家庭的469名儿童提供了471人年的观察。平均每周症状报告率为78%(范围58%-89%)。 Households with a poor (<70%) weekly reporting rate using the Vigilant-e app during the first 25 weeks of observation (n=57) had a greater number of children (mean 2.8, SD 1.5 vs mean 2.5, SD 1.3; risk ratio [RR] 1.2, 95% CI 1.1-1.4), were less likely to have used mobile phones for text messaging at study enrollment (61%, 35/57 vs 76.7%, 115/150; RR 0.6, 95% CI 0.4-0.9), and were less likely to access care at the local public clinic (35%, 20/57 vs 67.3%, 101/150; RR 0.4, 95% CI 0.2-0.6). Parents of female enrolled participants were more likely to have low response rate (57.1%, 84/147 vs 43.8%, 141/322; RR 1.4, 95% CI 1.1-1.9). Several external factors (cellular tower collapse, contentious elections) were associated with periods of decreased reporting. Poor response rate (<70%) was associated with lower case reporting of acute gastroenteritis, norovirus-associated acute gastroenteritis, acute febrile illness, and dengue virus-associated acute febrile illness (P<.001). Parent-reported syndromic data on the Vigilant-e app demonstrated agreement with nurse-collected data for fever (kappa=.57, P<.001), vomiting (kappa=.63, P<.001), and diarrhea (kappa=.61, P<.001), with decreased agreement as the time interval between parental report and nurse home visit increased (<1 day: kappa=.65-.70; ≥2 days: kappa=.08-.29). Conclusions: In a resource-limited area of rural Guatemala, a mobile phone app-based participatory syndromic surveillance system demonstrated a high reporting rate and good agreement between parental reported data and nurse-reported data during home visits. Several household-level and external factors were associated with decreased syndromic reporting. Poor reporting rate was associated with decreased syndromic and pathogen-specific case ascertainment. SN - 1438-8871 UR - //www.mybigtv.com/2017/11/e368/ UR - https://doi.org/10.2196/jmir.8041 UR - http://www.ncbi.nlm.nih.gov/pubmed/29122738 DO - 10.2196/jmir.8041 ID - info:doi/10.2196/jmir.8041 ER -