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The authors declare that they have no competing interests.
TCC was the technical lead and developer for the OE application, and helped develop EDE. CJH was the technical lead and developer for the EDE application and helped develop later versions of OE. SMB wrote the manuscript, selected figures, and obtained references, based on his work on the ESSENCE project. AMP was the technical lead for telephone and SMS data ingestion design and development and was a software developer for OE. RAW was the chief software engineer for all versions of ESSENCE. JFS was the original software technical lead and software developer for OE. JSC was the chief epidemiologist on the project and obtained user input and usage data on the application. ZM developed several key components on the EDE project. CJH, TCC, RAW, JSF, JSC, and SHL helped develop user requirements for these applications. All authors read and approved the final manuscript.
Emerging public health threats often originate in resource-limited countries. In recognition of this fact, the World Health Organization issued revised International Health Regulations in 2005, which call for significantly increased reporting and response capabilities for all signatory nations. Electronic biosurveillance systems can improve the timeliness of public health data collection, aid in the early detection of and response to disease outbreaks, and enhance situational awareness.
As components of its Suite for Automated Global bioSurveillance (SAGES) program, The Johns Hopkins University Applied Physics Laboratory developed two open-source, electronic biosurveillance systems for use in resource-limited settings. OpenESSENCE provides web-based data entry, analysis, and reporting. ESSENCE Desktop Edition provides similar capabilities for settings without internet access. Both systems may be configured to collect data using locally available cell phone technologies.
ESSENCE Desktop Edition has been deployed for two years in the Republic of the Philippines. Local health clinics have rapidly adopted the new technology to provide daily reporting, thus eliminating the two-to-three week data lag of the previous paper-based system.
OpenESSENCE and ESSENCE Desktop Edition are two open-source software products with the capability of significantly improving disease surveillance in a wide range of resource-limited settings. These products, and other emerging surveillance technologies, can assist resource-limited countries compliance with the revised International Health Regulations.