Application of Call Centre as COVID 19 Alert and Surveillance System in Pastoralist Communities of Somali Region of Ethiopia

Aims: Ethiopia recorded the first confirmed case of COVID 19 pandemic on 13th March 2020 and the surveillance and alert systems were immediately activated. In Somali Region, the toll-free call center was used as alert and surveillance system in addition to the routine health facility surveillance system because of poor coverage of health facilities and pastoral lifestyle in the region. Study Design: This was a retrospective chart review of COVID 19 alerts and surveillance database.  Place and Duration of Study: Somali Region between 13th March and 30th June 2020. Methodology: A retrospective chart review of alert database from the two COVID 19 alert and surveillance systems. The sensitivity for each system was calculated as the proportion of confirmed cases and test of association was done using chi-square test at significant level of 5%. Results: 414 alerts were reported during the study period, 259( 62.5%) alerts  from the  toll-free call centre,(49.3%) of which  met the criteria as  suspected cases and  22(8.5%) confirmed positive for COVID compared to 155( 37.5%) alerts from the health facilities,145(50.7%)  of which  met the criteria as suspected cases and  43(27.7%) confirmed positive. The positivity rate was statistically significant, p=0.045. However, alerts were received from all the 11 zones in the region through the call centre compared to six zones through the health facilities. Conclusion: The call centre is an effective system with wide coverage for monitoring alerts and can be explored as a long-term  surveillance  system  during disease outbreaks and other public health interventions post COVID pandemic.