Dashboards to Support Nigeria COVID-19 Serosurveillance Study
In the fall of 2020, Ciheb conducted the first phase of a COVID-19 population-based serosurveillance study (COVID-19 Household Seroprevalance Survey) in the Nigerian states of Enugu, Nasarawa, and Gombe to assess the prevalence of COVID-19 in the country.
Due to the complexity and scale of the project, the 201 Team — a health informatics consortium within Ciheb that offers full stack web development services — was brought in to support the Ciheb Head Office and Ciheb Nigeria team. The 201 Team created a data collection tool for the serosurveillance study known as the Computer-Assisted Personal Interview (CAPI). Within CAPI, the 201 Team devised multiple software solutions to help coordinate and synthesize data including a CAPI Mobile Application, Lab Systems Application, and Lab Dashboard.
Data flow diagram from lab data (click to enlarge)
The procedures for the survey included:
- Community mobilization efforts and mapping out randomly selected households to survey.
- The data collection survey team comprised of one team lead, two testers, and one driver and tracker. Serologic blood samples were collected to test antibody levels and nasal swabs to test current infection rates. Participants received a questionnaire and were also offered free malaria testing.
- State epidemiologists disseminated COVID-19 positive tests, and the survey team followed up with households where at least one positive participant was found.
- The survey team conducted participant quarantine and household testing and sometimes provided malaria drugs.
Dashboard showing the mapping and listing enumeration areas
201 Team Solutions
CAPI Mobile Application: The 201 Team developed this app using CSPro. On this mobile app, team leads collect and upload questionnaire data onto tablets, which get synced to the server. Testers can also collect lab data onto tablets, which get synced to the server.
Lab Systems Application: The 201 Team developed this app using .NET Core and the Microsoft SQL Server database. Data of samples are converted into aliquots, stored, and results sent to teams. Samples with barcodes are tracked from receipt of sample to storage at lab.
Dashboard showing the monitoring dashboard CAPI feeds data into
Real Time Dashboards: The 201 Team also developed the dashboards using .NET Core and the Microsoft SQL Server database. A mapping and listing dashboard included a GIS map of all the households included in the survey. CSPro file processors running in the background reads the files sent to the central server and stores the content to the database. Follow-up file generation procedures are also running in the background. A survey dashboard includes the COVID-19 response rate, malaria positivity rate, and age disaggregation. Results are linked to participant ID, so participants with COVID-positive tests can be notified.
Mapping and listing dashboard
Impact
The 201 Team followed an agile software development approach, whereby the team added enhancements, fixed bugs, and addressed user requests as they arose on an ongoing basis. The team ran into issues linking some samples, but that was addressed with system updates. The 201 Team also improved manual data collection to semi-automatic collection.
Progress was measured through daily reports with monitoring trackers. Each of the three states had its own plan. The development team used a sprint list and daily check-in meeting as well.
One of the key lessons from the development of these applications and dashboards is that in order to achieve success in projects on a short timeline, stakeholder engagement is essential.
The CAPI application was developed to have a modular structure, which is primarily controlled by dictionaries, so it is possible for the 201 Team to scale and modify it to suit other country programs if needed elsewhere.