Key data for outbreak evaluation: building on the Ebola experience

Cori, Anne; Donnelly, Christl A.; Dorigatti, Ilaria; Ferguson, Neil M.; Fraser, Christophe; Garske, Tini; Jombart, Thibaut; Nedjati-Gilani, Gemma; Nouvellet, Pierre; Riley, Steven; Van Kerkhove, Maria D.; Mills, Harriet L.; Blake, Isobel M.

With any data system there is potential for delays in data entry and dissemination due to limitations in personnel and hardware, and logistical constraints in data delivery (e.g. reliable electricity, Internet access and transport). Although the latter limitations are arguably outside the scope of outbreak control, delays from data collection to dissemination could be reduced by increasing training in data entry and providing more data entry facilities where possible. Delays in data entry and release during the Ebola epidemic meant that real-time analyses of the line-list data could not be performed on fully up-to-date data. In the world today, an epidemic emerging anywhere is a global threat due to high population connectivity [141, 142] and, as such, a response will have to operate across multiple languages. Ideally, the same data entry system would be used in every affected country to allow easy collation into a single case line-list. However, a global response requires careful translation of the questions and the system to ensure they make sense and are identical in every language. Additionally, different languages, dialects or alphabets could be challenging due to differing pronunciations, accents, alternate names or spellings, and these should be acknowledged in the form design. The language barrier was not a major problem during the Ebola response: Guinea had a form in French, while in Sierra Leone and Liberia the form was in English, though there were some minor differences in formulations between the two (for example the English version of the form asked 'In the past one month prior to symptom onset: did the patient have contact with (. . .) any sick person before becoming ill' (see §4 in the form in electronic supplementary material, figure S1), while the French form did not specify 'before becoming ill').