Innovations in Early Detection and Interventions in Human, Animal, and Plant Health

The majority of human pathogens are zoonotic (60%) and 75% of emerging zoonotic pathogens are from wildlife species. Not only do infectious diseases greatly impact people and livestock, they adversely affect local and national economies. Recent examples of new and emerging diseases in animals and humans (Ebola, Zika, MERS, influenza, SARS).

Health care systems in the Philippines are overburdened and under-resourced, limiting early identification of public health and medical concerns. Low cost, sustainable approaches directed at grassroot community-based interventions can play an important role in mitigating the effects of some common causes of morbidity and mortality. Without real time surveillance, data coming from the community, policy makers are unable to effectively allocate resources and provide evidence-based interventions back to health professionals.

This project seeks to develop a visually based app tool that functions on a structured knowledge database and is completely scalable and adaptable to any type of diagnostic or management challenge. We will focus this project to include some of the major infectious illnesses common in the Philippines as well as probable emerging pathogens. The illnesses include acute watery diarrhea, TB, rabies, bronchitis/pneumonia, acute febrile illness, and common plant diseases that pose a risk to food security for livestock and humans.

Our first objective is to develop and assess the innovative use of a mobile phone app capable of assisting municipal health professionals (human, livestock, or agricultural agents), and grassroots community health workers in the triage, diagnosis, and treatment of common, pathologies affecting plants, humans, and animals (AgHuAn). This Global Positioning System (GPS)-enabled mobile phone will specify geo-location information and provide real-time surveillance. This information will be analyzed at a central location, providing real-time surveillance and targeted feedback. Our intervention trial will employ the tool at two levels of providers -- municipal professionals and lay health workers facilitating the formation of a social network for health.

A second significant objective is training and evaluating One Health Workers (OHWs) as we task shift and broaden the scope of barangay health workers (BHWs) beyond human health. Task shifting is a strategy to improve access and is defined as the rational distribution of duties from experts to non-expert healthcare providers. While BHWs still have a major mission in addressing human health, we will add issues related to animal and agricultural health. This new type of community worker, OHW, will expand basic delivery of health services in areas where expertise and services are limited.

To our knowledge, there have been no previous attempts to: 1) define and train OHWs, 2) develop a mobile app that collects data across multiple sectors and feeds it to a consolidating tool (server) at a national health center, and 3) provide an mHealth tool to allow lay workers to identify the best local intervention or contact a specific health professional. Human-smart phone hybrid communication (smart phones plus OHWs) combines the strength of technology with the high-touch approach of a OHW on-site. We hypothesize that combining these two approaches (tech and touch) are a plausible approach to lowering costs, monitoring health problems, and scaling up surveillance for early interventions at the AgHuAn interface.