The African Region is making significant strides in its fight against variant poliovirus, responding to multiple outbreaks across several countries. To detect these outbreaks and launch vaccination campaigns to halt the virus’s spread, it relies on efficient national surveillance and diagnostic systems. And central to these systems are laboratories that regularly handle poliovirus-infected materials, such as human stool samples, for testing.
While this work is crucial for polio eradication, it poses an infection risk. Certain protocols need to be followed to ensure it can be conducted safely and responsibly.
Managing risk
Containment involves implementing biosafety and biosecurity measures in facilities that handle or store polioviruses to minimize the risks of worker infection and the virus being released back into communities. In the African Region, these facilities include polio surveillance and diagnostic laboratories, as well as laboratories working with materials potentially contaminated with polioviruses, such as those using human biological samples for measles, rotavirus, or flu research. Depending on the time and place of collection (e.g., if poliovirus were circulating in the population), these samples may also harbour the virus.
Although the labs do not intend to retain polioviruses long-term and thus avoid the lengthy and costly process of becoming a ‘poliovirus-essential facility’ (PEF) certified against strict WHO containment requirements, they are still required to take specific actions to minimize risks, including the destruction of hazardous samples.
Maintaining detailed and accurate inventories of these materials is a critical first step in this process, and a new data collection and reporting system being rolled out in the region is enhancing data timeliness, quality and reliability.
Open Data Kit (ODK)
Open Data Kit (ODK) Collect is an open-source mobile application that allows users to collect and transmit data in real-time via Android devices. Part of a broader ODK ecosystem, ODK Collect is widely used across various sectors, including health and humanitarian aid, particularly in settings with limited internet access.
While the software has been used in the region for surveillance, vaccination, routine immunization, COVID-19 contact tracing, and other activities since 2017, its application for poliovirus containment implementation only began in 2023, replacing outdated spreadsheet and paper-based systems.
“Using ODK Collect for containment purposes has revolutionized how facilities that work with polioviruses in our region record data and how we monitor information related to these samples,” said Dr Jacob Barnor, WHO focal point for poliovirus containment in the African Region and leader of the ODK containment initiative which leverages AFRO’s Geographical Information System (GIS) team expertise.
“Not only does it [ODK Collect] simplify data entry and sharing but it also enables immediate information exchange between facilities and national containment task forces (NTFs), providing real-time snapshots of the national or regional containment situation and allowing for faster follow-up on outstanding actions to reduce risk,” he added.
How does it work?
According to Dr. Barnor, facility users fill out an e-questionnaire on Android phones when they detect poliovirus infectious or potentially infectious sample holdings. They record details such as the specific strain of poliovirus material, the type of sample (e.g., stool, sewage concentrate etc.), if there are any active poliovirus outbreaks or outbreak response activities in the country, and plans for destroying materials. NTFs notify WHO and information collected by the questionnaire feeds a live dashboard that Dr Barnor and his colleagues can view and track.
“The ODK database compiles the data and provides a visual representation of all recorded poliovirus infectious and potentially infectious materials through maps, as the questionnaire logs the geocoordinates of facilities. We can pinpoint where and when problematic materials are being held and follow up with the facility on next steps like sample incineration,” said Dr Barnor.
“Facilities also have the option to transfer materials to a PEF, if needed, and on-site visits are often necessary to sensitize facility staff on options. Whenever possible, we encourage destruction as the only way to completely eliminate risk,” he added.
Training and implementation
To ensure the successful implementation of ODK for poliovirus containment, both on-site and virtual training programs have been conducted for laboratory staff across the region. These programs focus on the proper use of the application, data entry protocols, final reporting and the importance of maintaining accurate records. With support from the AFRO GIS Centre in Brazzaville, an additional series of virtual training sessions has also been held for NTFs.
“Transitioning from previous inventory systems to ODK is a significant but welcome change for many users. We aim to make the software as user-friendly as possible to encourage prompt reporting, and feedback from training participants has been particularly useful in shaping the system,” Dr. Barnor said.
Looking ahead
Since the project’s initiation, 20 countries in the region have adopted the use of the ODK Collect for containment reporting activities. All 47 countries in the region expected to submit reports to the African Regional Certification Commission (ARCC), which annually reviews regional eradication status and containment progress. ODK summaries and analyses are proving valuable, and there is a push to get all countries on board using the tool by the end of 2025.
“We aim to have all countries in the region switch to using ODK for their containment inventories to streamline data collection, reporting and management,” said Dr Barnor. “By leveraging this technology, we’re enhancing data accuracy and biosafety, and health authorities in the region are better equipped to manage polio threats. We hope to make significant progress in institutionalizing ODK use in the coming months,” he concluded.
Lab technician in Tanzania working with environmental samples for poliovirus surveillance. May 2022.
ODK map showing poliovirus infectious and potentially infectious materials, as logged by facilities in countries currently using the software in the African Region. January 2025.
Dr Jacob Barnor reviews poliovirus containment inventories with national containment task force members.
Training participants learning how to use ODK Collect
