{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:03:03Z","timestamp":1782842583103,"version":"3.54.5"},"reference-count":17,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Participatory surveillance involves at-risk populations reporting their symptoms using technology. In Lesotho, a landlocked country of 2 million people in Southern Africa, laboratory and case-based COVID-19 surveillance systems were complemented by a participatory surveillance system called \u201cLeCellPHIA\u201d (Lesotho Cell Phone Population-Based HIV Impact Assessment Survey).<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This report describes the person, place, and time characteristics of influenza-like illness (ILI) in Lesotho from July 15, 2020, to July 15, 2021, and reports the risk ratio of ILI by key demographic variables.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n LeCellPHIA employed interviewers to call participants weekly to inquire about ILI. The average weekly incidence rate for the year-long period was created using a Quasi-Poisson model, which accounted for overdispersion. To identify factors associated with an increased risk of ILI, we conducted a weekly data analysis by fitting a multilevel Poisson regression model, which accounted for 3 levels of clustering.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The overall response rate for the year of data collection was 75%, which resulted in 122,985 weekly reports from 1776 participants. ILI trends from LeCellPHIA mirrored COVID-19 testing data trends, with an epidemic peak in mid to late January 2021. Overall, any ILI symptoms (eg, fever, dry cough, and shortness of breath) were reported at an average weekly rate of 879 per 100,000 (95% CI 782\u2010988) persons at risk. Compared to persons in the youngest age group (15\u201019 years), all older age groups had an elevated risk of ILI, with the highest risk of ILI in the oldest age group (\u226560 years; risk ratio 2.6, 95% CI 1.7\u20103.8). Weekly data were shared in near real time with the National COVID-19 Secretariat and other stakeholders to monitor ILI trends, identify and respond to increases in reports of ILI, and inform policies and practices designed to reduce COVID-19 transmission in Lesotho.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n LeCellPHIA, an innovative and cost-effective system, could be replicated in countries where cell phone ownership is high but internet use is not yet high enough for a web- or app-based surveilance system.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/55208","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T17:01:46Z","timestamp":1728406906000},"page":"e55208-e55208","source":"Crossref","is-referenced-by-count":2,"title":["Influenza-Like Illness in Lesotho From July 2020 to July 2021: Population-Based Participatory Surveillance Results"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8261-7025","authenticated-orcid":false,"given":"Abigail R","family":"Greenleaf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6723-482X","authenticated-orcid":false,"given":"Sarah","family":"Francis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5221-1489","authenticated-orcid":false,"given":"Jungang","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0321-5974","authenticated-orcid":false,"given":"Shannon M","family":"Farley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0523-2096","authenticated-orcid":false,"given":"T\u0161epang","family":"Lekhela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0369-7144","authenticated-orcid":false,"given":"Fred","family":"Asiimwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4199-1766","authenticated-orcid":false,"given":"Qixuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2024,10,8]]},"reference":[{"key":"R1","unstructured":"Public health surveillance for COVID-19: interim guidance. World Health Organization; 2020. URL: https:\/\/iris.who.int\/handle\/10665\/337897 [Accessed 30-09-2024]"},{"issue":"11","key":"R2","doi-asserted-by":"publisher","first-page":"1630","DOI":"10.1016\/j.jiph.2020.07.019","article-title":"Epidemiologic surveillance for controlling Covid-19 pandemic: types, challenges and implications","volume":"13","author":"Ibrahim","journal-title":"J Infect Public Health"},{"issue":"4","key":"R3","doi-asserted-by":"publisher","DOI":"10.2196\/publichealth.7540","article-title":"Participatory disease surveillance: engaging communities directly in reporting, monitoring, and responding to health threats","volume":"3","author":"Smolinski","journal-title":"JMIR Public Health Surveill"},{"issue":"8","key":"R4","doi-asserted-by":"publisher","DOI":"10.2196\/38551","article-title":"The landscape of participatory surveillance systems across the one health spectrum: systematic review","volume":"8","author":"McNeil","journal-title":"JMIR Public Health Surveill"},{"issue":"6","key":"R5","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1111\/irv.13037","article-title":"Influenza surveillance systems using traditional and alternative sources of data: a scoping review","volume":"16","author":"Hammond","journal-title":"Influenza Other Respir Viruses"},{"issue":"5","key":"R6","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1016\/j.jiph.2021.02.003","article-title":"A comparative study between the incidence and epidemiological features of influenza-like illness and laboratory-confirmed COVID-19 cases in the Italian epicenter (Lombardy)","volume":"14","author":"Grosso","journal-title":"J Infect Public Health"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1093\/cid\/ciaa684","article-title":"Monitoring coronavirus disease 2019 (COVID-19) through trends in influenza-like illness, laboratory-confirmed influenza, and COVID-19-New York State, excluding New York City, 1 January 2020-12 April 2020","volume":"72","author":"Rosenberg","journal-title":"Clin Infect Dis"},{"issue":"8","key":"R8","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1016\/j.ajic.2020.05.007","article-title":"Identifying potential undocumented COVID-19 using publicly reported influenza-like-illness and laboratory-confirmed influenza disease in the United States: an approach to syndromic surveillance?","volume":"48","author":"Wiemken","journal-title":"Am J Infect Control"},{"issue":"Suppl 1","key":"R9","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1097\/QAI.0000000000002701","article-title":"HIV general population surveys: shedding light on the status of HIV epidemics and informing future actions","volume":"87","author":"Porter","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"9","key":"R10","doi-asserted-by":"publisher","DOI":"10.2196\/31236","article-title":"Participatory surveillance of COVID-19 in Lesotho via weekly calls: protocol for cell phone data collection","volume":"10","author":"Greenleaf","journal-title":"JMIR Res Protoc"},{"key":"R11","unstructured":"Lesotho Population-Based HIV Impact Assessment 2020 (LePHIA 2020): final report. Lesotho Ministry of Health; URL: https:\/\/phia.icap.columbia.edu\/wp-content\/uploads\/2021\/11\/260622_LePHIA_RR3_Final_Digital_v2.pdf [Accessed 19-09-2024]"},{"key":"R12","unstructured":"Standard definitions: final dispositions of case codes. The American Association for Public Opinion Research; 2016. URL: https:\/\/aapor.org\/wp-content\/uploads\/2022\/11\/Standard-Definitions20169theditionfinal.pdf [Accessed 30-09-2024]"},{"key":"R13","unstructured":"Ritchie H Ortiz-Ospina E Beltekian D et al. Lesotho: coronavirus pandemic country profile. Our World in Data. URL: https:\/\/ourworldindata.org\/coronavirus\/country\/lesotho [Accessed 25-07-2021]"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1186\/s12879-023-08664-4","article-title":"Comparison of influenza-like illness (ILI) incidence data from the novel LeCellPHIA participatory surveillance system with COVID-19 case count data, Lesotho, July 2020 - July 2021","volume":"23","author":"Francis","journal-title":"BMC Infect Dis"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1186\/s13031-018-0177-6","article-title":"SMS-based smartphone application for disease surveillance has doubled completeness and timeliness in a limited-resource setting - evaluation of a 15-week pilot program in Central African Republic (CAR)","volume":"12","author":"El-Khatib","journal-title":"Confl Health"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1016\/j.epidem.2021.100462","article-title":"Participatory syndromic surveillance as a tool for tracking COVID-19 in Bangladesh","volume":"35","author":"Mahmud","journal-title":"Epidemics"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2018-001157","article-title":"Assessing global preparedness for the next pandemic: development and application of an Epidemic Preparedness Index","volume":"4","author":"Oppenheim","journal-title":"BMJ Glob Health"}],"container-title":["JMIR Public Health and Surveillance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publichealth.jmir.org\/2024\/1\/e55208","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:42:45Z","timestamp":1782841365000},"score":1,"resource":{"primary":{"URL":"https:\/\/publichealth.jmir.org\/2024\/1\/e55208"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,8]]},"references-count":17,"URL":"https:\/\/doi.org\/10.2196\/55208","relation":{},"ISSN":["2369-2960"],"issn-type":[{"value":"2369-2960","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,8]]},"article-number":"v10i11e55208"}}