SAPRIN Covid-19 Surveillance

A coordinated system of disease surveillance will be critical to effectively control the coronavirus disease 2019 (Covid-19) pandemic. Such systems enable rapid detection and mapping of epidemics and inform allocation of scarce prevention and intervention resources. Although many lower- and middle-income settings lack infrastructure for optimal disease surveillance, health and demographic surveillance systems (HDSS) provide a unique opportunity for epidemic monitoring.
The South African Population Research Infrastructure Network, has repurposed the health and demographic surveillance systems at its three existing nodes to add telephonic screening for Covid-19 symptoms and household impact for the 60 000 households under surveillance. The primary aims include: describing the epidemiology of the Covid-19 epidemic in rural populations; determining the impact of the Covid-19 outbreak and non-pharmaceutical control interventions (NPI) on behaviour and wellbeing; and using collected data to support the local public-sector health response. The program involves telephone-based interviews with over 60,000 households every four months, plus a sub-study calling 750 households in each node every two weeks. Each call asks a household representative how the epidemic and NPI are affecting the household and conducts a Covid-19 risk screen for all resident members. Any individuals screening positive are invited to a clinical screen, potential test and referral to necessary care – conducted in-person near their home following careful risk minimization procedures.