Unique Initiatives – University of Copenhagen


The overall aim of the Choleraphone is to establish a novel method for identification of diarrhoea cases in a study population in Bangladesh through a mobile telephone reporting system.

The specific objectives of this project are to:
• Conduct a literature review of related Mobile health technologies and mobile sampling methods.

• Design the mobile reporting system and to implement it in households of the cohort households.

• Evaluate the sensitivity and specificity of the method through interviews with a randomly selected subset of households in the cohort.

Dock workers in Dhaka 2009. Source: Newley Purnell

Project description:

The distribution and magnitude of cholera in non-hospitalized cases in Bangladesh is still largely unknown. The Choleraphone will develop a novel method for household surveillance of cholera in Bangladesh through a mobile telephone reporting system of diarrhoea cases.

This system addresses the problem of diarrheal recall, which is optimal within 48 hours. Previous diarrhoea studies have shown that recall periods longer than 48 hours are prone to recall bias. However, limitations of funding and manpower make 48 hour sampling impossible in many settings.

Choleraphone attempts to tackle this issue by providing a mobile phone to each participant in the cohort. Participants will be trained on how to identify diarrhoea and how to report it the day it occurs by calling the project’s medical officer using their Choleraphones. A recorded refresher lesson and reminders on reporting will be given to participants via the Choleraphone at regular intervals. This way we hope to greatly decrease the recall bias for diarrhoeal cases through innovative mobile surveillance.

Previous studies have shown that the Bangladeshi population is very positive about the usage of mobile phones, especially because of the ability to convey emergency warning messages. Based on current work in the project area, it is assumed that at least one person in every family has a mobile phone.

Peer-reviewed studies have also shown promising results in Mobile health (a term used for the practice of medicine and public health, supported by mobile devices), reducing transmission delays and error rates in disease surveillance, as well as saving time compared to conventional paper-based reporting systems. However, Mobile health has never been applied in studies concerning diarrhoea or cholera in Bangladesh or elsewhere.

Research Plan:

1. Preparation for field study and project implementation at the University of Copenhagen

2. January 2014 – December 2015: Field study and project implementation in Bangladesh (International Centre for Diarrhoeal Disease Research, Bangladesh, University of Dhaka, B)

3. Data processing and writing of findings in Denmark