Advancing One Health Data Capture at the Point of Zoonotic Spillover in the Congo Basin Forest Perimeter

Project Summary Due to human encroachment on the fragile ecosystems of the Congo basin forest perimeter, spillover of zoonotic pathogens into border communities have proliferated and resulted in worldwide implications. The region of the Bwindi Impenetrable Forest, located in the southwestern corner of Uganda bordering the Democratic Republic of Congo (DRC) is a biodiversity hotspot harboring among the largest number of primate and bat species of any forest in Africa. It is also situated in one of the most densely human populated regions of Africa. Healthcare facilities in this region remain vigilant for an outbreak of Ebola virus disease (EVD) or Marburg hemorrhagic fever (MHF). This is especially timely given the recent confirmed outbreaks of EVD in neighboring districts. Utilizing a One Health approach, this project will build an essential surveillance infrastructure for investigating ebolavirus and other zoonotic disease spillover events by developing an integrated mHealth system that allows healthcare providers to monitor outbreaks of disease in both humans and wildlife simultaneously. The goal of this surveillance system is to improve detection of zoonotic spillover in the Bwindi region and help to answer decades long questions about the ecological scenarios supporting ebolavirus emergence, enabling forecasting that could help prevent future outbreaks. Specifically, during the R21 phase of this project we will: (1) develop a Village Health Team (VHT) data collection system to capture AFI and wildlife morbidity / mortality information in remote forest settings using a One Health smartphone based APP and community-based SMS system; (2) develop a passive geo-location system using cell-phone tower triangulation with machine learning optimization that can be implemented across smartphone and non-smartphone-based technologies to improve accuracy in localization of outbreaks; and (3) create an integrated One Health AFI outbreak alert system operational in the Bwindi region, optimized for rapid and accurate detection of outbreaks. During the R33 phase of this project we will: (1) refine, expand and evaluate the tiered mHealth surveillance platform for improved longitudinal AFI case identification; and (2) utilize the Bwindi mHealth surveillance system to investigate the epidemiology of ebolavirus exposure associated with wildlife contact in the region. This project is well integrated with existing NIAID funded AFI surveillance programs and collaborates closely with the Ugandan Ministry of Health. This project will provide an optimal scenario for rigorously evaluating the benefits of adding an mHealth component to long term zoonotic disease monitoring, benefiting the sustainability of all developed platforms.