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BACKGROUND The ongoing COVID-19 pandemic in Africa is an urgent public health crisis. Estimated models projected over 150,000 deaths and 4,600,000 hospitalizations in the first year of the disease in the absence of adequate interventions. Therefore, electronic contact tracing and surveillance have critical roles in decreasing COVID-19 transmission; yet, if not conducted properly, these methods can rapidly become a bottleneck for synchronized data collection, case detection, and case management. While the continent is currently reporting relatively low COVID-19 cases, digitized contact tracing mechanisms and surveillance reporting are necessary for standardizing real-time reporting of new chains of infection in order to quickly reverse growing trends and halt the pandemic. OBJECTIVE This paper aims to describe a COVID-19 contact tracing smartphone app that includes health facility surveillance with a real-time visualization platform. The app was developed by the AFRO (African Regional Office) GIS (geographic information system) Center, in collaboration with the World Health Organization (WHO) emergency preparedness and response team. The app was developed through the expertise and experience gained from numerous digital apps that had been developed for polio surveillance and immunization via the WHO’s polio program in the African region. METHODS We repurposed the GIS infrastructures of the polio program and the database structure that relies on mobile data collection that is built on the Open Data Kit. We harnessed the technology for visualization of real-time COVID-19 data using dynamic dashboards built on Power BI, ArcGIS Online, and Tableau. The contact tracing app was developed with the pragmatic considerations of COVID-19 peculiarities. The app underwent testing by field surveillance colleagues to meet the requirements of linking contacts to cases and monitoring chains of transmission. The health facility surveillance app was developed from the knowledge and assessment of models of surveillance at the health facility level for other diseases of public health importance. The Integrated Supportive Supervision app was added as an appendage to the pre-existing paper-based surveillance form. These two mobile apps collected information on cases and contact tracing, alongside alert information on COVID-19 reports at the health facility level; the information was linked to visualization platforms in order to enable actionable insights. RESULTS The contact tracing app and platform were piloted between April and June 2020; they were then put to use in Zimbabwe, Benin, Cameroon, Uganda, Nigeria, and South Sudan, and their use has generated some palpable successes with respect to COVID-19 surveillance. However, the COVID-19 health facility–based surveillance app has been used more extensively, as it has been used in 27 countries in the region. CONCLUSIONS In light of the above information, this paper was written to give an overview of the app and visualization platform development, app and platform deployment, ease of replicability, and preliminary outcome evaluation of their use in the field. From a regional perspective, integration of contact tracing and surveillance data into one platform provides the AFRO with a more accurate method of monitoring countries’ efforts in their response to COVID-19, while guiding public health decisions and the assessment of risk of COVID-19.

Introduction:DRC Ministry of Health declared the 9th outbreak of Ebola Virus Disease (EVD) in the Equator province on May 8, 2018, that ended on July 25, 2018. There were 54 cases with 38 confirmed, 33 deaths (61%), and 21 survivors in three “zones de santé” (districts). On August 1, 2018, the 10th EVD outbreak of the country was declared in the Ituri and North Kivu provinces. This one is the most important outbreak ever experienced. By November 18, 2018, 373 cases were reported with 326 confirmed and 214 deaths (58%) in two provinces including 14 “zones de santé.” While the 9th outbreak occurred in hard-to-reach areas, the 10th is occurring in fragile security settings, requiring specific strategic/operational approaches.Aim:To describe strategic and operational approaches including IMSs used to address these deadly outbreaks.Methods:A case study methodology using response strategy documents and observations was used, coupled with the use of operation review exercises.Results:The response strategy evolved continuously taking into account the epidemiological context, including geographical spread. It also took into account cultural, political, and sociological (community resistances) sensitivities. Conditions of pre-existing health system and services were considered. The prevailing security context (armed groups) was taken into account. The evolving situation impacted implementation of response areas including critical interventions like setting up confirmation and treatment centres, rapid response teams, and IMS structures. Areas of response were reviewed continuously, including response structures with further decentralization, outreach, or locally delegated interventions to ensure geographical access and continuity in response services.Discussion:Response areas to deal with EVD outbreaks are well known. However, an effective response requires a continuous adjustment of the strategy and a flexible response structures with related IMSs based on regular deep situation analysis. Social sciences still have a critical role to play for that purpose.