T-Cube Web Interface as a Tool for Detecting Disease Outbreaks in Real-Time: A Pilot in India and Sri Lanka

Motivated by existing gaps and inefficiencies in the paper-based manually processed disease surveillance and notification systems in India and Sri Lanka, the Real-Time Biosurveillance Program (RTBP) introduces technology to health departments in Tamil Nadu, India and Sri Lanka, to answer the question: “Can software programs that detect events in public health data, and mobile phones that collect health data and receive health alerts, enable effective identification and mitigation of disease outbreaks in near-real-time?” The processes involve digitizing all clinical health records and analyzing them in near real-time to detect emerging unusual patterns in data to forewarn health workers before the diseases reach epidemic states. Health records from health facilities, namely the patient disease cases, syndrome, and demographic information, are transmitted through the mHealthSurvey mobile phone application and fed in to the T-Cube data structure. T-Cube Web Interface (TCWI) is a browser-based software tool that uses the T-Cube data structure for fast retrieval and display of large volume multivariate time series and spatial information. Interface allows the user to execute complex queries quickly and to run various types of statistical tests on the loaded data. Detected emerging patterns of potentially epidemic events are then disseminated to health workers in the vulnerable and surrounding areas in the form of SMS, Email, and Web published alerts. This paper considers utility and importance of TCWI in support of rapid detection and mitigation of bio-medical threats in developing countries.