Harnessing Social Media for Public Health: The Dengue Engagement Experience in Sri Lanka

May O. Lwin & Schubert Foo

Centre of Social Media Innovations for Communities (COSMIC)

Wee Kim Wee School of Communication and Information (WKWSCI)

Joint APAN-TEIN Dengue Fever and Public Health Workshop

1 – 6 March 2015, Fukouka, Japan

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COSMIC Centre of Media Innovations for Communities

To empower the next billion people in the community through

social media innovations that improve the way they live, work,

and play

Mo-Buzz To battle global infectious diseases using social media

• Globally – 40% of world’s population at risk from

Dengue

– Nearly 50 to 100 million cases every year

• Asia – Home to 52% of world’s dengue-at-risk

population

• Sri Lanka – More than 70,000 cases since 2009

– More than 47,000 cases reported in 2014

– Close to 15,000 cases from Colombo

Dengue Burden

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Colombo

Preventing Dengue

NO × Vaccination

× Preventive pills

× Specific treatment

(Symptomatic treatment & fluid therapy only)

YES √ Scientific Preventive Methods

Sleeping under mosquito nets

Draining stagnant water

Using mosquito repellents and ointments

Wearing long-sleeves clothes

√ Indigenous Preventive Methods

Burning trash around the house

Growing plants, eg. tulsi

Fumigating house using dhoop

Burning coconut husks

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• Visited India, Indonesia, Laos,

Malaysia, Myanmar, Sri Lanka, and

Vietnam to understand the needs in

the ground

• Conducted massive survey in India,

Singapore, and Vietnam to identify

the current needs in public health

• Administered survey, focus group,

and interviews with public health

inspectors and general public to

identify the gaps in dengue

prevention and attitudes related to

mobile phone usage

In the past 5 years…

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Research Findings

• Traditional methods of conducting

disease surveillance

• Wide interval between disease data

collection and report reaching

authorities

• Challenges in identifying breeding

and recording breeding sites

• Challenges in data collection: getting

public cooperation in providing

details, responding to health

education

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Needs

Assessment

Reactive

Hotspot

Mapping

Circuitous

Surveillance

Outmoded

Health

Education

Based on interviews with policymakers, public health inspectors

and academics

Assessment of Needs

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Interdisciplinary Research Team

Technological

Experts

Topical

Experts

Dynamic

Disease

Mapping

Civic

Engagement

Health

Education

Prof. Schubert FOO

Information Studies

Dr. Newton FERNANDO

Human Computer

Interaction

Vajira RATHNAYAKE

Computer Science

Asst. Prof. Siew Ann CHEONG

Disease Modeling

A/P May O. LWIN

Health & Social Communication

Dr. Santosh VIJAYKUMAR

Behavioral Science

Gentatsu LIM /

Karthikayen JAYASUNDAR

Psychology

Mo-Buzz

Prof. Yin Leng THENG

User-centered Design

Asst. Prof. Astrid ALMKHLAAFY /

Jeffrey HONG

Art Design

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Dynamic

Disease

Mapping

Civic

Engagement

Health

Communication

Drew on insights from: Behavioral science, health communication, computer

science, human computer interaction, information science, mathematics

Mo-Buzz Solution

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One of the first systems

globally to integrate all three

public health functions

Health Authorities Vigilant Citizens

Personal

Networks

General

Public

Hotspot Zones

Citizen Reports

Health Information

Health Alerts

Mo-Buzz

stakeholders

content

social

media

use

to share

Mo-Buzz Approach

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Mo-Buzz Application

For General

Public

For Public Health

Inspectors (PHIs)

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Mo-Buzz

for

Public Health Inspectors

(PHIs)

• Mo-Buzz for Public Health Inspectors (PHIs) was launched in July

2013

• 55 PHIs are using Mo-Buzz app in their tablets for dengue

surveillance

• Received attention from World Health Organization (WHO)

Mo-Buzz for PHIs

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Mo-Buzz for PHIs

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Digital Surveillance

Electronic forms on tablets

Backend database for authorities

Predictive Surveillance

Hotspot maps

Plan for preventive actions

Dynamic Monitoring

Picture or video of breeding sites

Real-time and geo-tagged technologies

Health Communication

Tailored health messages

Interactive educational modules

Digital Surveillance

• Dengue investigation forms digitized and loaded on portable tablet

computers for public health inspectors

• Easy-to-use interface; faster reporting times

• Made accessible as hotspots on mobile devices

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Predictive Modeling

Predictive Hotspots

Map

Mosquito Related Data

(mosquito population & distribution)

Weather Related Data

(temperature, rainfall, & wind

direction)

Dengue Incidence Data

(zip code of suspected and

confirmed cases) Dengue Serotype Data

(zip code of suspected and

confirmed cases)

Human Density Data

(human population and construction

projects)

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Predictive Hotspots Map

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Dynamic Monitoring

• Smartphones to breeding sites & other disease risk factors

• PHIs take pictures/videos of breeding sites using tablets

• Pictures automatically geo-tagged

• Sent to CMC with click of button; ensures quicker response

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Health Communication

• CMC’s health education materials available on tablets

• PHIs use tablets to deliver health education to public: generate

greater attention, more interactivity, more interest

• Future: Targeted health alerts, customized health communication

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Mo-Buzz

for

General Public

• Mo-Buzz for General Public was launched in February 2015

• Attended by Mayor, Municipal Council leaders, Health Ministry officials,

Medical Officers for Health and Public Health Inspectors

• Nearly 125 attendees including potential collaborators from region

Mo-Buzz for General Public

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Mo-Buzz for General Public

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Dynamic Disease Mapping

Hotspot maps

Highlighting danger zones based on real cases

Civic Engagement

Report of breeding sites & symptoms

Crowdsourcing technology

Health Communication

Detailed & graphics-based information

Dynamic component of tailored communication

• To alert general public about dengue

cases in real-time

• Based on real dengue cases recorded by

CMC

• Experts use real-cases to create

geographically- specific dengue clusters

• Mo-Buzz users can see clusters on their

smartphones

• Keeps general public aware about where

an outbreak is occurring

Dynamic Disease Mapping

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• To enable general public to contribute to CMC’s surveillance

efforts using smartphones and/or tablets

• General public take pictures of breeding sites using tablets

• Pictures automatically geo-tagged

• Simple, digitized forms

• Sent to CMC with click of button; ensures quicker response

Civic Engagement

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• To educate general public about dengue spread & prevention

• Education based on simple and intuitive graphics

• Localized education module available in English, Sinhala, Tamil

• Upcoming in the next version: Multimedia-based health

messages; animations; short films

Health Education

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Challenges to Civic Engagement

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Technological constraints (textual): Smartphones vs normal phones

Visual confounders: Image recognition and filtering

Cultural differences: Less likely to report symptoms

A Trans-Sector Collaborative Challenge

• Integration in public health programs:

Cooperation & Collaboration

• Consistent and transparent negotiations

with the relevant stakeholders for data

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• A detailed communication about our system’s capabilities

• A strong assurance about our technological ability to ensure the

confidentiality of data

• Enthusiasm, curiosity and urgency to consider mobile phone-

based innovations

Civic Agencies

Research Institutions

Telecom-munication Companies

Policy-makers

Future of Mo-Buzz

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Potential scaling-up to other districts in Sri Lanka

Potential expansion to other public health issues in Sri Lanka and the region

Influenza prevention system for secondary school children and healthcare workers in Singapore and other countries

Acknowledgement

• This research is supported by the Singapore National Research

Foundation under its International Research Centre @ Singapore

Funding Initiative and administered by the IDM Programme Office

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Q & A

Thank You!

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