Forecasting influenza-like illness trends in Cameroon using Google Search Data

Although acute respiratory infections are a leading cause of mortality in sub-Saharan Africa, surveillance of diseases such as influenza is mostly neglected. Evaluating the usefulness of influenza-like illness (ILI) surveillance systems and developing approaches for forecasting future trends is important for pandemic preparedness. We applied and compared a range of robust statistical and machine learning models including random forest (RF) regression, support vector machines (SVM) regression, multivariable linear regression and ARIMA models to forecast 2012 to 2018 trends of reported ILI cases in Cameroon, using Google searches for influenza symptoms, treatments, natural or traditional remedies as well as, infectious diseases with a high burden (i.e., AIDS, malaria, tuberculosis). The R-2 and RMSE (Root Mean Squared Error) were statistically similar across most of the methods, however, RF and SVM had the highest average R-2 (0.78 and 0.88, respectively) for predicting ILI per 100,000 persons at the country level. This study demonstrates the need for developing contextualized approaches when using digital data for disease surveillance and the usefulness of search data for monitoring ILI in sub-Saharan African countries.