Using Mobile Health (mHealth) and geospatial mapping technology in a mass campaign for reactive oral cholera vaccination in rural Haiti.

BACKGROUND: In mass vaccination campaigns- large volumes of data must be managed efficiently and accurately. In a reactive oral cholera vaccination (OCV) campaign in rural Haiti during an ongoing epidemic- we used a mobile health (mHealth) system to manage data on 50-000 participants in two isolated communities. METHODS: Data were collected using 7-inch tablets. Teams pre-registered and distributed vaccine cards with unique barcodes to vaccine-eligible residents during a census in February 2012. First stored on devices- data were uploaded nightly via Wi-fi to a web-hosted database. During the vaccination campaign between April and June 2012- residents presented their cards at vaccination posts and their barcodes were scanned. Vaccinee data from the census were pre-loaded on tablets to autopopulate the electronic form. Nightly analysis of the day\'s community coverage informed the following day\'s vaccination strategy. We generated case-finding reports allowing us to identify those who had not yet been vaccinated. RESULTS: During 40 days of vaccination- we collected approximately 1.9 million pieces of data. A total of 45-417 people received at least one OCV dose/ of those- 90.8% were documented to have received 2 doses. Though mHealth required up-front financial investment and training- it reduced the need for paper registries and manual data entry- which would have been costly- time-consuming- and is known to increase error. Using Global Positioning System coordinates- we mapped vaccine posts- population size- and vaccine coverage to understand the reach of the campaign. The hardware and software were usable by high school-educated staff. CONCLUSION: The use of mHealth technology in an OCV campaign in rural Haiti allowed timely creation of an electronic registry with population-level census data- and a targeted vaccination strategy in a dispersed rural population receiving a two-dose vaccine regimen. The use of mHealth should be strongly considered in mass vaccination campaigns in future initiatives.