Davies et al. Malar J (2019) 18:45 https://doi.org/10.1186/s12936-019-2683-4 RESEARCH Efectiveness of 24-h mobile reporting tool during a malaria outbreak in Mpumalanga Province, South Africa Craig Davies 1 , Rebecca Graffy 1 , Mbavhalelo Shandukani 2 , Ednah Baloyi 2 , Laura Gast 1 , Gerdalize Kok 3 , Frans Mbokazi 3 , Alpheus Zita 3 , Mandla Zwane 4 , Ray Magagula 3 , Aaron Mabuza 1 , Wayne Ramkrishna 2 , Natashia Morris 5 , Jacqueline Porteous 1 , George Shirreff 1 , Lucille Blumberg 6 , Eunice Misiani 2 and Devanand Moonasar 2,7* Abstract Background: As surveillance is a key strategy for malaria elimination in South Africa, ensuring strong surveillance systems is a National Department of Health priority. Historically, real time tracking of case trends and reporting within 24 h—a requirement in South Africa’s National surveillance guidelines—has not been possible. To enhance surveil- lance and response efficiency, a mobile surveillance tool, MalariaConnect, was developed using Unstructured Supple- mentary Service Data (USSD) technology. It was rolled out in health facilities in malaria endemic areas of South Africa to provide 24-h reporting of malaria cases. Methods: To evaluate the efficiency of the mobile tool to detect an outbreak data were extracted from the paper based and MalariaConnect reporting systems in Bushbuckridge from 1 January to 18 June 2017. These data were subject to time series analyses to determine if MalariaConnect provided sufficient data reliably to detect increasing case trends reported through the paper system. The Chi squared test was used to determine goodness of fit between the following indicator data generated using MalariaConnect and paper reporting systems: timeliness, completeness, and precision. Results: MalariaConnect adequately tracked case trends reported through the paper system. Timeliness of reporting increased significantly using MalariaConnect with 0.63 days to notification compared to 5.65 days using the paper- system (p < 0.05). The completeness of reporting was significantly higher for the paper system (100% completion; p < 0.05), compared to confirmed MalariaConnect cases (61%). There was a moderate association between data preci- sion and the reporting system (p < 0.05). MalariaConnect provided an effective way of reliably and accurately identify- ing the onset of the malaria outbreak in Bushbuckridge. Conclusion: Timeliness significantly improved using MalariaConnect and in a malaria elimination setting, can be used to markedly improve case investigation and response activities within the recommended 72-h period. Although data completeness and precision were lower compared to paper reporting, MalariaConnect data can be used to trig- ger outbreak responses. Keywords: Malaria, South Africa, Surveillance, Outbreak, Mobile reporting, MalariaConnect © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Open Access Malaria Journal *Correspondence: Patric.Moonasar@health.gov.za 2 Department of Health, Malaria and Other Vector Borne Diseases, Pretoria, South Africa Full list of author information is available at the end of the article