Malaria Surveillance

A district malaria officer in Zanzibar tests a household member for malaria. Coconut Surveillance, and mHealth application developed by RTI, is being used in an active effort to eradicate the disease from Zanzibar.

In Zanzibar, the prevalence of Malaria is now at 1%. Global health technologies have helped Zanzibar to accomplish this goal. However, constant traffic with mainland Tanzania and foreign countries continues to pose a risk of outbreaks. The challenge is to detect them and to respond quickly to contain them.


Vodafone Americas Foundation, Wireless Innovation Project, FINALIST.RTI International, working closely with the Zanzibar Malaria Elimination Program (ZAMEP), developed Coconut Surveillance, a mobile application that builds on the Malaria Early Epidemic Detection System (MEEDS) that has helped to contribute to Zanzibar’s fight against Malaria. MEEDS is currently used by all of Zanzibar’s 150 health facilities. Since January 2013, the integrated MEEDS/Coconut Surveillance system has been used to follow-up more than 5,132 malaria cases to the household level. At the household, rapid diagnostic tests (RDTs) have been administered to and data collected from 22,350 household members, and 1,328 (6%) new cases have been diagnosed and treated.

Notifications of new cases are issued by facilities using MEEDS. Each District Surveillance Malaria Officer (DMSO) is equipped with a tablet computer running Coconut Surveillance. Once a DMO is alerted of a Malaria case via MEEDS, he or she is guided through an active case response protocol by Coconut Surveillance. Additional case data are entered into the tablet at the facility and the household. Coconut Surveillance uses the GPS capability of the tablet to automatically record the location of the household. Each household member is tested, and new cases are treated immediately.

How it Works

All of the health information collected from the household interview and testing is synced and aggregated in the cloud. Coconut Surveillance performs basic analysis on malaria incidence rates based by age, number of individuals who report using their malaria nets the night prior, etc. This analysis is essential for officials for understanding the success of public health campaigns for malaria reduction.

Image of Coconut Surveillance dashboard.

Coconut enables the efficient development of mobile data collection and management by storing data locally on any device and synchronizing data with a remote server when a network connection is available.

Coconut Surveillance also features a tool for mapping malaria outbreaks by region. The data can be clustered or individually mapped (as shown). Furthermore, users can zoom in to look at each outbreak and check health worker response/additional malaria cases uncovered.

MEEDS and Coconut Surveillance are helping Zanzibar to identify and treat many otherwise undiagnosed malaria cases, identifying hot spots and transmission patterns, and responding rapidly to new outbreaks.

These mHealth applications are helping Zanzibar to sustain the remarkable gains it has made against this dangerous and debilitating disease.


MEEDS and Coconut Surveillance have been developed in close collaboration with the Zanzibar Malaria Elimination Program, the U.S. Agency for International Development (USAID), and the U.S. Centers for Disease Control and Prevention (CDC). 

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