With the current outbreak of COVID-19, Sri Lanka needed to implement adequate precautions to prevent the disease from entering the country as a significant number of tourists from at-risk countries are traveling to Sri Lanka regularly.
One of the main preventive activities for this purpose was screening travelers at the ports of entries and carry out active surveillance until the incubation period is over in the community setting using the existing public health infrastructure.
Establishing a proper information system for surveillance of COVID-19 as a prime requirement of the Ministry of Health and as an initial stage of the surveillance system, the ministry wanted to capture information related to the tourists who enter the country from at-risk countries. To facilitate the above process, the Ministry of Health of Sri Lanka with the collaboration of HISP Sri Lanka developed a DHIS2 based solution for active surveillance for COVID-19 in Sri Lanka.
This COVID-19 Surveillance System of Sri Lanka was developed by using the tracker component of DHIS2 2.33. Brief technical overview is as follows.
The system consists of one tracker program which has three program stages.
Name, DOB, gender, email, passport number, telephone number, and few other sociodemographic factors are captured at the registration as tracked entity attributes. The first programme stage is also captured at the port of entry along with information for registration. The first which is a compulsory program stage captures information related to immigration, symptoms of COVID-19 disease, possible contacts and the stay in the country.
Second program stage, follow-up (within 14 days) is a non-compulsory repeatable program stage that captures symptoms of COVID-19 disease and any action taken during the surveillance process.
Follow-up (at the end of 14 days), the third program stage is a non-repeatable, compulsory program stage and captures symptoms of COVID-19 disease and any action taken at the end of the surveillance period. This programme stage is the conclusion of the surveillance process.
Currently, contact tracing and treatment modules are not included in the system and there are discussions underway to design them if required.
System implementation was planned at National, Province, District and Medical Officer of Health areas covering the entire country with separate access and dashboards for each level. System implementation and training were reinforced with standard operating procedures and simple user guides. The system also has dashboards which facilitate national level administrators to track the progression of surveillance activities.
As of now, data entry at the point of entry to the country is established and training programmes are being conducted to the provincial level staff on the use of the system. The familiarity of public health staff with the DHIS2 platform has greatly facilitated the implementation.