The online version of this article (doi:10.1186/1475-2875-11-43) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
RC, VC, SRM, CCF and JSB conceived the study, VC, SB and RC implemented the study. RC and SB undertook data extraction and analysis, interpretation of results and drafted the manuscript. EC assisted in data analysis. SRM and JSB were involved in critical revision of the manuscript. All authors read and approved the final manuscript.
The objective of this study was to investigate the use of novel surveillance tools in a malaria endemic region where prevalence information is limited. Specifically, online reporting for participatory epidemiology was used to gather information about malaria spread directly from the public. Individuals in India were incentivized to self-report their recent experience with malaria by micro-monetary payments.
Self-reports about malaria diagnosis status and related information were solicited online via Amazon's Mechanical Turk. Responders were paid $0.02 to answer survey questions regarding their recent experience with malaria. Timing of the peak volume of weekly self-reported malaria diagnosis in 2010 was compared to other available metrics such as the volume over time of and information about the epidemic from media sources. Distribution of Plasmodium species reports were compared with values from the literature. The study was conducted in summer 2010 during a malaria outbreak in Mumbai and expanded to other cities during summer 2011, and prevalence from self-reports in 2010 and 2011 was contrasted.
Distribution of Plasmodium species diagnosis through self-report in 2010 revealed 59% for Plasmodium vivax, which is comparable to literature reports of the burden of P. vivax in India (between 50 and 69%). Self-reported Plasmodium falciparum diagnosis was 19% and during the 2010 outbreak and the estimated burden was between 10 and 15%. Prevalence between 2010 and 2011 via self-reports decreased significantly from 36.9% to 19.54% in Mumbai (p = 0.001), and official reports also confirmed a prevalence decrease in 2011.
With careful study design, micro-monetary incentives and online reporting are a rapid way to solicit malaria, and potentially other public health information. This methodology provides a cost-effective way of executing a field study that can act as a complement to traditional public health surveillance methods, offering an opportunity to obtain information about malaria activity, temporal progression, demographics affected or Plasmodium-specific diagnosis at a finer resolution than official reports can provide. The recent adoption of technologies, such as the Internet supports self-reporting mediums, and self-reporting should continue to be studied as it can foster preventative health behaviours.
Additional file 1: Amazon Mechanical Turk Mumbai survey responses, July 16-August 26 2011. Summarized results for each of the questions in which Turkers selected a response from a list of options (DOCX 52 KB)12936_2011_2015_MOESM1_ESM.DOCX
Additional file 2: Description of change from multiple batches of surveys (2010) to one release of the survey (2011). (DOCX 95 KB)12936_2011_2015_MOESM2_ESM.DOCX
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- Online reporting for malaria surveillance using micro-monetary incentives, in urban India 2010-2011
Sumiko R Mekaru
Emily H Chan
Clark C Freifeld
John S Brownstein
- BioMed Central
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