To identify potential cases and ensure timely management of symptoms, we conduct syndromic surveillance at the household level. The eight tier mechanism entails detection, management and follow-up.

Anecdotal reports, which we refer to as the ‘word of mouth’ approach, is the primary source of data on potential cases. When community members report a potential case, our CHWs coordinate a household visit with the consent of the individual showing symptoms.

At the household, CHWs collect data on a digital platform using a structured questionnaire. The predetermined algorithm confirms suspected cases and assigns risk levels. The data is uploaded to the case data dashboard, while the CHW connects with a doctor via our dedicated telemedicine service. The doctor determines the severity of symptoms, prescribes medication and recommends testing when necessary. Irrespective of the risks of the suspected case, CHWs advice on quarantine and isolation protocols.

CHWs and telemedicine doctors conduct follow-ups on regular intervals and facilitate hospital referrals when symptoms escalate. Suspected case data accumulated on the dashboard is used to facilitate decision making of government agencies.