TWO COLUMN FORMAT

№ Source (EN-US) Target (ID)

1 TB INDONESIA
2 Contact tracing bot
3 TB CONTACT TRACING SERVICE
ON WHATSAPP
4 An overview of the service
5 Background and landscape
6 TB IN INDONESIA
7 In Indonesia, TB infection rates are
among the world's highest, and
diagnosis and treatment targets are
falling well behind what is needed to
address this crisis.
8 One of the most significant barriers in
Indonesia is that the case finding rate is
very low, with a Case Detection Rate
(CDR) at 33% in 2016 (Putra, 2019).
9 Household contacts of TB patients
(index case) are at the highest risk for
TB infection.
10 Around a quarter (25%) of household
contacts were infected when the index
case was diagnosed.
11 According to NTP’s TB contact
investigation, only 21% of the Index
cases completed contact tracing.
12 There is a need to raise awareness of
the fact that investigation of index
cases’ contacts is a systematic,
efficient, and effective strategy to look
for new TB cases and should be
conducted consistently not only for the
benefit of identifying new TB cases but
also to promote treatment success of
index cases.
13 Audience and contact tracing
14 CONTACT TRACING
15 According to the World Health
Organisation, below are some of the
contact tracing steps:
16 Recommendation 1
17 It is recommended that contact
investigation be conducted for
household and close contacts when the
index case has any of the following
characteristics:
18 • has sputum smear-positive pulmonary
TB,
19 • has multi-drug-resistant TB
20 • is a PLHIV or
21 • is a child < 5 years of age.
22 Recommendation 2
23 It is suggested that a contact
investigation be conducted for
household and close contacts of all
other index cases with pulmonary
tuberculosis.
24 Recommendation 3
25 Clinical evaluation of household and
close contacts for active TB is
recommended as a priority on the basis
of their risk for having or developing
active TB or for the potential
consequences of the disease if it
develops.
26 “Index and Contact cases +” Chatbot
27 Index patients used as a mechanism for
informing contacts.
28 Design and develop a mobile platform
accessible to index patients and their
respective contacts through IP
Messaging (WhatsApp).
29 Proposed Solution
30 Chatbot and contact tracing Impact
31 CHATBOT IMPACT
32 Contact Tracing
33 There are several mobile tools that have
been used for contact tracing
particularly for COVID19
34 Community Health Toolkit-Malawi,
Uganda
35 Contact Tracing with the CHT offers a
rapidly scalable surveillance strategy
by registering patient cases and their
contacts within communities in a
responsive and empathetic way.
36 Through proactive tracing of contacts,
active symptom screening, and referrals
to care or self-isolation in order to
promptly contain the spread of COVID-
19.
37 This is a mobile app and sms service
that requires a community health
worker as a middle man.
38 Not enough data on impact, however
metrics collected include: # of COVID
cases registered (total, by location), #
of contacts registered (total, by
 location), average # of contacts per
COVID case registered, # of contacts
traced (total, by location), % of
contacts traced and the average # of
contacts traced per COVID case
registered.
39 A study by Johnson et al.,on
Prioritizing COVID-19 Contact Tracing
During a Surge Using Chatbot
Technology showed that the number of
contacts identified across periods
increased by 210%, from 3121 to 9660,
whereas the mean number of contacts
named per case participant decreased
from 1.35 to 0.74.
40 WhatsApp Chatbot
41 Project goal
42 Proposed user journey
43 Key roles
44 Long term goals
45 AIM
46 The main aim of this project is to
ensure that index cases can effectively
contribute to early contact tracing
activities when empowered with
innovative mobile solutions, with
contacts’ benefiting directly through
knowledge empowerment,
psychological support and ongoing
reminders.
47 This will ideally lead to an increased
awareness of TB symptoms, and
prevention and thereby encourage the
subsequent diagnosis and early
treatment by a health professional
among TB contacts.
48 HOW IT WOULD WORK
49 User journey, algorithms, technology
50 User journey
51 INDEX PATIENT
52 Index patient onboarding / registration
53 Milestone tasks*
54 Contact forwards a message to any
contacts / is able to send an anonymous
message to contacts
55 3
56 4
57 5
58 Ongoing support messaging*
59 6
60 See slide 15 for a breakdown of the
facilitating contact tracing
61 Index patient is positively diagnosed
with TB by Health worker
62 Health worker informs index patient
about mobile contact tracing tool
63 1
64 2
65 *see slide 12 breakdown
66 User journey
67 CONTACT
68 Contact receives a forwarded message
from the index patient (WA)
69 Message has instructions to send in a
specific code to wa.me link
70 User sends in the unique code
71 User does symptoms screening
72 TB result and action points
73 Milestone tasks*
74 Ongoing support messaging*
75 Additional resources
76 1a
77 2
78 3
79 4
80 5
81 *see slide 12 breakdown
82 Contact receives an anonymous
channel message (SMS/email)
83 1b
84 Contact screening tool basic algorithm
85 TB RISK ALGORITHM
86 User has cough
87 Remaining TB symptom questions
(fever / sweats / weight loss)
88 High risk
89 (TB exposure or HIV)
90 HIGH RISK - GET TESTED
91 SYMPTOMATIC - GET TESTED
92 LOW RISK
93 NO
94 NO
95 NO
96 YES
97 YES
98 YES
99 Temporary algorithm - would make use
of the STOPTB integration
10 Outline of TB resources and tasks
0
10 Additional resources
1
10 Learning about how TB spreads
2 (Content)
10 Learning about the risks associated
3 with TB infections (Content)
10 Understanding symptoms (Content)
4
10 Understanding preventative measures -
5 TPT (Content)
10 Understanding the importance of
6 contact tracing (Quiz)
10 Facilitated contacting of contacts (See
7 next slide)
10 Milestone tasks
8
10 Psychosocial support
9
11 Treatment adherence
0
11 Reminders/nudges to complete the
1 incomplete milestone tasks
11 Ongoing support messages
2
11 Assisting index patients with contact
3 tracing
11 Facilitated contacting of contacts
4
11 On completion of reaching milestones
5 outlined in 2a - 2e, as per concept note,
index patients will be presented with
the option to inform contacts whose
WhatsApp mobile number they have
access to in 1 of 2 ways.
11 Forwarding a message with a uniquely
6 generated URL
11 Sharing mobile numbers for the service
7 to automatically inform anonymously
via an alternative channel such as SMS
or Email
11 Index patient informs contacts
8 anonymously or via a forwarded
message on WA
11 Contacts do a screening on the bot to
9 determine their risk level.
12 If contact is low risk, has the ability to
0 send a digital “get better soon” card to
the index patient.
12 TB WA service
1
12 2
2
12 1
3
12 Index patient is TB positive.
4
12 Health worker informs/ assists index
5 patient in contact tracing via the WA
bot.
12 Bot also provides various milestone
6 tasks and additional support messages
for the index patient.
12 4
7
12 Contact receives TB risk result post
8 screening and informed about next
steps.
12 5
9
13 6
0
13 Contact
1
13 WA check-in
2
13 Contacts
3
13 Contacted by index/bot
4
13 Follow-up replies saved
5
13 If contact had a mid/high risk result
6 then follow-up messages will be sent to
contacts to confirm if a test has taken
place, with the option to disclose test
results.
13 7
7
13 Index patient performs contact tracing
8
13 Contact Tracing Workflow
9
14 Confirmed case
0
14 Contact
1
14 A
2
14 Contact
3
14 B
4
14 Contact
5
14 C
6
14 SMS /WA or email alert
7
14 Contact
8
14 Health Worker
9
15 Index
0
15 Index receives get better soon card
1 from contact
15 3
2
15 Bot sends anonymous alert to contacts/
3 contacts receive forwarded WA from
index patient
15 If contact is TB positive, then return to
4 step 01 and process completed as a new
index patient.
15 8
5
15 Screening results saved
6
15 Powered by
7
15 TECHNOLOGY
8
15 HOW IT RUNS
9
16 Hosted on AWS
0
16 Screening tool built with Rasa
1
16 Follow-up reminders are sent from
2 RapidPro
16 Data analysis is done in BigQuery
3
16 Monitoring and evaluation dashboards
4 are built in Tableau
16 GOING FORWARD
5
16 Technology informed by features and
6 hosting requirements
16 Rasa is harder to learn and changes are
7 hard.
16 Only recommended if NLU is required
8
16 Tableau can be expensive/tricky but it
9 is very powerful.
17 Google Data Studio can be sufficient as
0 well
17 Timeline
1
17 Month
2
17 August
3
17 September
4
17 October
5
17 November
6
17 December
7
17 Activity
8
17 Discovery and defining requirements
9
18 Content design,creation
0
18 Building prototype
1
18 User testing
2
18 MVP developed and launched
3
18 MVP live, data analysis,
4 recommendations,
18 Packaging and handover
5
18 Roles and responsibilities
6
18 Collaboration
7
18 Praekelt
8
18 Chatbot development
9
19 Discovery
0
19 Finalise desktop research into current
1 landscape
19 Develop Research design document
2
19 Finalise mapping of user journeys and
3 personas
19 Prototyping
4
19 Build Prototype "Implement
5 flows/wireframes on Rapid pro
19 Collect feedback and update where
6 necessary
19 Developing user testing plan
7
19 User testing
8
19 Build and Launch
9
20 Content loading and deployment to
0 Production.
20 QA
1
20 Launch the MVP for two months
2
20 Roles and responsibilities
3
20 Collaboration
4
20 STPI
5
20 Provide a supportive role
6
20 Provide input, review all work to
7 ensure the product is aligned with the
National Tuberculosis Program
20 Delegate a point of contact to work
8 directly with the praekelt team in
collaboration with Johnson and
Johnson
20 Consultations and reference to the
9 appropriate personnel to provide
information on contact tracing
21 Provision of documentation
0
21 In order to produce the appropriate
1 content for TB contact tracing
documents such as national TB
Management and contact tracing
guidelines would be required
21 Support on the ground stakeholder
2 engagement
21 Foster relationships between the
3 relevant stakeholders in order to
 facilitate buy in
21 Support the handover and sustainability
4 of the TB contact tracing service
21 Terima kasih
5