IJCRR

IJCRR - 13(18), September, 2021

Pages: 94-105

Date of Publication: 26-Sep-2021

The Utilization of Mobile-Based Information Technology in the Management of Dengue Fever in the Community Year 2019-2020: Systematic Review

Author: Kholis Ernawati, Heramitha Azahra, Alya Namira, Lathifah H. Yuhen, Asa G. Karuniawan, Ali A. Mecca, Raudha Kasmir, Nurmaya, Muhamad Fathurrahman, Dewi Susanna, Zwasta P. Mahardhika

Category: Healthcare

Abstract:Introduction: Dengue fever is a public health problem that causes outbreaks in various regions of the country, including Indonesia, with high morbidity and mortality rates. Advances in information technology have introduced new design approaches that support patient education. Objective: This article aims to discuss mobile-based information technology to prevent dengue fever in society using a systematic review approach. Methods: This research method used a systematic review approach with the PRISMA protocol. The article search process was accessed on three electronic databases, namely PubMed, PLOS ONE, and Google Scholar. The keywords used in the search for journal articles are mobile applications, control of dengue fever, health promotion, and community. The articles' criteria are primary data, year of publication (January 1, 2019 - October 6, 2020), in English, peer review, full-text articles, and discuss the use of mobile applications in controlling dengue fever. Result: The result obtained seven articles according to the inclusion criteria. The health applications consist of seven models, Mozzify, SMS, e-learning, FeverDX, Mobuzz, ThaiDengue, and VECTORS. The applications' functions are as an educational medium, a dengue reporting system, and a prediction of dengue cases. Conclusion: The use of mobile-based health applications could improve public knowledge and increase community awareness in handling dengue fever.

Keywords: Mobile application, Dengue fever, Control of Dengue Fever, Health promotion, Health education, Community participation

Full Text:

INTRODUCTION

Dengue fever is a severe public health problem that causes outbreaks in Indonesia's various regions with high morbidity and mortality rates. Dengue fever is an infection caused by the dengue virus and transmitted by the Aedes aegypti and Aedes albopictus mosquitoes. Based on data from the Ministry of Health, nearly 390 million people are infected each year, until April 2020, the number of dengue cases in Indonesia has reached 39,876 cases.¹At the beginning of 2019, data entered until January 29, 2019, 13,683 dengue sufferers, reported from 34 provinces with 132 cases of whom died. Several regions were recorded to have reported extraordinary events of dengue fever, including Manado City (North Sulawesi) and seven districts/cities in NTT, namely East Sumba, West Sumba, West Manggarai, Ngada, South Central Timor, Ende, and East Manggarai.²

Global control strategies have been developed in the form of vector control, including chemical control, biological, and physical.³In controlling dengue fever, Indonesia implements mosquito nest eradication. Mosquito nest eradication is a program to prevent the breeding of the Aedes aegypti mosquito, which acts as a carrier for the dengue virus through 3M-Plus, such as draining or cleaning water reservoirs, closing water reservoirs tightly, burying used goods, raising mosquito larvae-eating fish, spreading larvacides in water storage, using mosquito repellent and fogging using malathion and fenthion.⁴

The success of mosquito nest program can be measured by the larva free rate. If the larva free rate ≥ 95% is expected to prevent or reduce cases of dengue transmission.⁵In 2017, the larva free rate amounted to 46.7%, so that it has not met the program target.⁴Indonesia is starting to handle dengue fever by using mobile-based applications in the form of education (educational game applications) and mapping of areas with dengue cases (SICANTIK and Citra Quickbird).^6,7,8 These applications are expected to assist in the prevention and control of dengue fever cases.^6,7Meanwhile, in the world, Brisbane's method is almost the same as in Indonesia, which shows successful regulation because larvae habitat is regulated and possible. Government decisions are assisted by public compliance so that mosquito control in Brisbane can affect Aedes aegypti.⁹For neighbouring countries such as Malaysia, they still use dengue fever control techniques with WHO recommendations, namely vector control, active disease surveillance, emergency preparedness, room capacity, and vector control training and research.^10,11With the results of vector control of dengue fever in Malaysia, it is considered a slow reaction.¹²Meanwhile, in Brazil, handling dengue fever has been carried out by developing unique technologies such as the transgenic mosquito and the Wolbachia bacteria and supported by the Brazilian national program. This control method is increasing and demonstrating the potential success that science supports.^13,14

In Nicaragua, researchers found maps that allow health workers to identify areas at greater risk of an outbreak. The smartphone is a product of technological innovation that offers essential features to spread the disease to follow. It can consolidate almost instantly when reports from the public use smartphone-based surveillance applications for health workers. It can shorten response times and provide authorities with a more accurate picture of the disease situation for intervention planning and execution.¹⁵

Based on the explanation above, this article will discuss mobile-based information technology to prevent dengue fever in the community using a systematic review approach.

METHOD

The research method used a systematic review approach based on the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) protocol.¹⁶ The PRISMA protocol is used to identify research articles relevant to the purpose of writing articles. The article search process was accessed on three electronic databases, namely PLOS ONE, PubMed, and Google Scholar. The keywords used in the search for journal articles are mobile applications, control of dengue fever, health promotion, and community.

The criteria for the articles used are primary data, year of publication (January 1, 2019 - October 6, 2020), in English, have gone through the peer review stage, full-text articles, and discuss the use of mobile applications in controlling dengue fever. Data extraction was carried out through the identification stage by searching for articles from the database, screening to determine the period, feasibility, and screening in determining the title of the item to be selected based on inclusion criteria. The search results for articles are then grouped by; (a) research location, research design, respondent involvement, and research results, (b) article frequency distribution based on socio-demographic factors, and (c) health applications based on components, strengths, weaknesses, benefits, and recommendations for improvement.             

The descriptive narrative analyses are based on the utilization of information technology in the health sector, advantages and weaknesses of using information technology in the health sector, the effect of information technology media on increasing knowledge of dengue fever, the effect of education with mobile-based media on knowledge of dengue fever, and the influence of knowledge of dengue fever on changes in dengue fever management behaviour.

RESULT

The selection results based on keywords and following the PRISMA protocol obtained 36,187 articles. Furthermore, at the screening based on the year of publication (January 1, 2019 - October 6, 2020), there were 5,474 articles. Screening of journals in English, full text, and the peer review phase obtained from PLOS ONE, PubMed, and Google Scholar, received 212 articles. An eligibility study was conducted to eliminate articles that did not meet the established inclusion criteria. In the last stage, seven articles were obtained according to the inclusion criteria.

DISCUSSION

Utilization of Information Technology in the Health Sector

People are increasingly using the use of information technology at various economic and social strata levels.²³ To overcome challenges in the health sector due to limited resources and sustainability, the strategy that can be taken is increasing information and communication technology (ICT).²⁴ In recent years, in fighting dengue, public health authorities worldwide have adopted new technology and developed and implemented a different digital vector surveillance system where public members can participate in some form of active surveillance of mosquitoes in the field.¹⁵

Given the complexities of modern medicine, it cannot be denied that information technology will increase the quality of health care.²⁵ The world health organization has urged its member countries to develop the infrastructure for information and communication technology (ICT). The use of ICTs in health care has shown great potential in improving the quality of life by facilitating community support for independent living.²⁶

            Technology information has the potential to improve the quality, safety, and efficiency of health services. Delivering quality health care requires providers and patients to integrate complex information from multiple sources. For example, Telehealth uses telecommunications technology to provide health-related services and information supporting patient care, administrative activities, health education, health services, and private information.²⁷Mirzayi and Rafe stated that Health Information Technology (HIT) is an information processing application that involves computer hardware and software that can be used to manage information about individuals and groups of patients' health and medical care.²⁸

            In Thailand, there is a technology called a geographic information system (GIS). The technology is an initiative to support dengue fever control with an automated computer-based system to capture, retrieve, manage, display, and analyze large amounts of spatial and temporal data in a geographic context. Roads, residential buildings, and other relevant data can be obtained and mapped to form a base map layer using Arcview GIS software.²⁹Data with mapping in an area and monitoring the severity of dengue cases can be quickly identified. Epidemiological analysis of the Application can reduce the impact severity when an outbreak occurs.³⁰

Advantages and Weaknesses of Using IT in the Health Sector

The use of technology in the dengue epidemic in several journals has made research participants get practical and satisfactory information. In Japan, the Mozzify Application (Table 3) has succeeded in getting the research participants' satisfaction. 37 of the 50 people whose data were taken gave a value of 4 out of 5 indicators of satisfaction.¹⁷Even in Thailand, an application called ThaiDengue Application (Table 3) succeeded in providing satisfaction to the 400 people tested.²¹

Information technology application-based systems can increase public awareness to take preventive measures, especially dengue fever attacks. ³¹ An application called RadarAedes App was even developed independently by a local community in Brazil to assist local governments in monitoring their area from the potential spread of dengue fever infection.³²

Technology-based preventive measures provide users with various information about dengue fever, such as case reports, spread areas, and preventive procedures.¹⁷In Nepal, a study was conducted that compared the community who received information on knowledge of dengue virus prevention conventionally with those who received information from applications based on short message services (SMS), and it turned out to have significant results compared to people who received conventional information.¹⁸

An application-based early warning system was developed and tested in Brazil, Malaysia, and Mexico to make the early warning system more effective and efficient for dengue fever cases. As a result, this system proved to be pragmatic in making the early warning system more effective and efficient.^31,33 In Saraphi, Thailand, a digital data collection application called GIS, which functions to collect geographic data, was tested. It was proven that the data collected was more accurate and undoubtedly more efficient.³⁴ A digital data collection application called GeoApps, which was tested in Brazil, has been proven to be able to collect data related to health in this case, including dengue fever cases to make it faster and more efficient and to be able to help Brazil's integrated health service provider (SIAB).³⁵

Effect of Information Technology Media on Increasing Knowledge of Dengue Fever

Over the past ten years, mobile phones have provided innovative and cost-effective strategies for the global health community to address dengue prevention and management challenges. Marquez's research in 2020, the Mozzify Application (Table 3) is useful as an integrated strategic health intervention system that promises to report and map dengue fever cases, and disseminating information about dengue among the general public and health professionals.¹⁷

Besides, there is also a Mobile Short Message Service (SMS), a low-cost health promotion intervention that can increase knowledge and implementation in preventing dengue in affected communities. Mobile SMS is a practical, acceptable, and appropriate health intervention tool to improve dengue fever prevention in the community. These interventions can be used as promising tools in health education regarding dengue and other diseases. People are accustomed to using mobile phones daily, so shifting health promotion via SMS is an appropriate and realistic step.¹⁸

In addition to helping the more comprehensive community access information more quickly, information technology media can also be designed to make it easier for doctors and medical personnel to increase compliance with clinical practice guidelines in managing and preventing diseases such as arbovirus infection in health care settings. For example, the mHealth FeverDx Application shows adequate performance in simulated emergency consultations. The guide module allows general practitioners to quickly get an offline reference to practical clinical guides for acute fever symptoms such as Zika, dengue, Chikungunya, and various infections commonly found in tropical regions.²⁰

In the future, researchers must develop more modern designs to become more interesting virtual games for children.³⁶Advances in information technology have introduced new design approaches that support health care delivery and patient education. Health care information technology can empower patients and support the transition from a role in which the patient is a recipient of passive care services to an active role in which the patient is informed, has choices, and is involved in the decision-making process.³⁷

The Effect of Education with Mobile-based Media on Knowledge of Dengue Fever

Knowledge is an essential determinant that becomes the final determinant of health behaviour, such as attitudes, subjective norms, risk perception, and independence often begins with knowledge.³⁸ The utilization of knowledge about dengue fever to the community using the mHealth application in videos, diagnosis, management, management of dengue and mosquito vector control methods, and having an online discussion forum. This feature can increase awareness of symptoms, management of dengue fever, and vector control.¹⁷The use of e-learning in education is easier to understand and can provide information quickly so that health education can be received via mobile phones.¹⁹This shows that the quality of active dengue fever prevention behaviour increases after health education with mobile application-based media.^39,40The effect of education on knowledge of dengue fever is in line with research conducted by Ernawati et al. in 2019, which said that there was a relationship between knowledge and exposure to information in the vector control of dengue mosquitoes (p-value = 0.000) dengue fever in Koper Village, Kresek District, Tangerang Regency.⁴¹In the research of Elsa et al. in 2017, health education for the community can increase the level of knowledge and participation in eradicating mosquito nests (p-value = 0.000).⁴²Education does not necessarily change people's knowledge. As found in research conducted by Ernawati et al. in 2018, there is no difference in knowledge about dengue fever before and after counselling conducted to homemakers in Serdang, Kemayoran, and Jakarta (p-value = 0.087).⁴³

The Influence of Knowledge of Dengue Fever on Changes in Dengue Fever Management Behavior

Knowledge of the mosquito that spreads dengue fever and its control is an essential factor in controlling transmission.⁴⁴Although efforts have been made to stop dengue outbreaks in various parts of the world and particularly in tropical countries such as India and Southeast Asian countries, concerning the importance of entomological surveillance, The findings of the current literature study agree that behaviour in controlling dengue fever during an outbreak is also very crucial.⁴⁵The knowledge possessed by a person to promote positive behaviour change in the prevention and control of dengue fever tends to share information and achievements with family and friends.⁴⁶

Lack of awareness of dengue problems tends to reduce behaviour in preventive measures.⁴⁷Lack of awareness of dengue symptoms in the community can lead to delays in patients getting appropriate medical attention.⁴⁸Public knowledge and preventive behaviour regarding the causes, transmission, prevention, and treatment of dengue fever are significant socio-cultural factors that have influenced dengue fever control measures.⁴⁹Behavioral-influenced activities must be supported by proper education regarding a healthy home environment that will reduce the risk of spreading dengue fever.⁵⁰

The health belief model is a model of social cognition that is widely used to predict health behaviour. This model shows that a change in behaviour or action can be expected if a person feels at risk or susceptible to disease (perceived vulnerability).⁵¹People who feel they are at risk of dengue fever immediately visit a health care provider compared to those who feel otherwise.⁵²Health care-seeking behaviour is also greatly influenced by the inadequacy of primary health care facilities in providing adequate services to dengue fever patients.⁵³

People with better knowledge are more likely to have a more severe attitude towards dengue and better prevention practices.⁵⁴Knowledge of dengue fever symptoms, modes of transmission, prevention practices, and disease management tends to change their belief that dengue fever is a severe and threatening disease.¹⁷This is in line with research conducted by Ernawati et al. found that increased knowledge can improve mosquito nest eradication behaviour in Kresek village, rural areas (t-value = 4.68) and information sources mosquito nest eradication behaviour in Kresek village, Tangerang Regency, Indonesia (t-value = -3.32).⁵⁵

CONCLUSION

There are seven mobile-based health applications developed in 2019-2020, namely Mozzify, SMS, e-learning, FeverDX, Mobuzz, ThaiDengue, and VECTOS. The application functions as an educational medium (Mozzify, SMS, e-learning, and Mobuzz), a reporting system (FeverDX, ThaiDengue, and VECTOS), and prediction of dengue cases (ThaiDengue and VECTOS). As an educational medium, health applications that have been tested on the public are proven to be accepted by the community and can increase people's knowledge. The use of mobile-based dengue fever health applications can help increase community early awareness in handling dengue fever. However, not all people can access these health applications because there is limited internet coverage.

RECOMMENDATION

The research results need to be followed up by the government in each country using these health applications worldwide. The limited reach of the internet network, which can become an obstacle in the use of health applications by all society components, also needs to get the local government's attention so that a solution to the problem is immediately sought.

Authors' Contribution: The document should identify all individuals who meet authorship requirements as authors and who are willing to accept public responsibility for the material, design, or revision of the manuscript. The manuscript was revised and reviewed by all contributors and given the final okay by them as well.

Acknowledgement

Thanks to YARSI University and the Ministry of Research and Technology Indonesia for their financial support for the publication. Thanks to the authors of the seven articles (i.e., Marquez Herbuela et al., Bhattarai et al., Mahalingam et al., Rodríguez et al., Lwin et al., Somboonsak, and Ocampo et al.), whose articles were used as material for this writing.

Conflict of Interest: None of the authors declared any conflict of interest.

Source of Funding: The Study was self-financed.

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