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Geographic Information Systems and travel health.

Questions dealing with space and/or location have always been integral to understanding and addressing health issues, such as charting the spread of a disease. Health researchers have traditionally used paper maps to explore the spatial dimensions of health. However, due to advances in technology, it is now possible to ask such questions using a suite of computer-based methods and tools that are collectively known as a Geographic Information System (GIS).

Geographic Information Systems↗
PubMed1997

Normative models and healthcare planning: network-based simulations within a geographic information system environment.

OBJECTIVES: Network analysis to integrate patient, transportation and hospital characteristics for healthcare planning in order to assess the role of geographic information systems (GIS). A normative model of base-level responses of patient flows to hospitals, based on estimated travel times, was developed for this purpose. DATA SOURCES/STUDY SETTING: A GIS database developed to include patient discharge data, locations of hospitals, US TIGER/Line files of the transportation network, enhanced address-range data, and U.S. Census variables. The study area included a 16-county region centered on the city of Charlotte and Mecklenburg County, North Carolina, and contained 25 hospitals serving nearly 2 million people over a geographic area of nearly 9,000 square miles. STUDY DESIGN: Normative models as a tool for healthcare planning were derived through a spatial Network analysis and a distance optimization model that was implemented within a GIS. Scenarios were developed and tested that involved patient discharge data geocoded to the five-digit zip code, hospital locations geocoded to their individual addresses, and a transportation network of varying road types and corresponding estimated travel speeds to examine both patient discharge levels and a doubling of discharge levels associated with total discharges and DRG 391 (Normal Newborns). The Network analysis used location/allocation modeling to optimize for travel time and integrated measures of supply, demand, and impedance. DATA COLLECTION/EXTRACTION METHODS: Patient discharge data from the North Carolina Medical Database Commission, address-ranges from the North Carolina Institute for Transportation Research and Education, and U.S. Census TIGER/Line files were entered-into the ARC/INFO GIS software system for analysis. A relational database structure was used to organize the information and to link spatial features to their attributes. PRINCIPAL FINDINGS: Advances in healthcare planning can be achieved by examining baseline responses of patient flows to distance optimization simulations and healthcare scenarios conducted within a spatial context that uses a normative model to integrate characteristics of population, patients, hospitals, and transportation networks. Model runs for the defined scenarios indicated that a doubling of the 1991 patient discharge levels resulted in an areal constriction of the service areas to those zip codes immediately adjacent to the hospitals, thereby leaving substantial areas unassigned to hospitals during the allocation process, but that doubling the demand for obstetrics care (DRG 391) resulted in little change in the pattern of accessibility to care as indicated by the size, orientation, and pattern of the service areas. CONCLUSIONS: The GIS-Network system supported "what if" simulations, portrayed service areas within a spatial context, integrated disparate data in the execution of the location/allocation model, and used estimated travel time along a transportation network instead of Euclidean distance for calculating accessibility. The results of the simulations suggest that the GIS-Network system is an effective approach for exploring a variety of healthcare scenarios where changes in the supply, demand, and impedance variables can be examined within a spatial context and where variations in system trajectories can be simulated and observed.

Computer Communication Networks↗
PubMed2004

Modeling the suitability of potential wetland mitigation sites with a geographic information system.

Wetland mitigation is frequently required to compensate for unavoidable impacts to wetlands. Site conditions and landscape context are critical factors influencing the functions that created wetlands perform. We developed a spatial model and used a geographic information system (GIS) to identify suitable locations for wetland mitigation sites. The model used six variables to characterize site conditions: hydrology, soils, historic condition, vegetation cover, adjacent vegetation, and land use. For each variable, a set of suitability scores was developed that indicated the wetland establishment potential for different variable states. Composite suitability scores for individual points on the landscape were determined from the weighted geometric mean of suitability scores for each variable at each point. These composite scores were grouped into five classes and mapped as a wetland mitigation suitability surface with a GIS. Sites with high suitability scores were further evaluated using information on the feasibility of site modification and project cost. This modeling approach could be adapted by planners for use in identifying the suitability of locations as wetland mitigation sites at any site or region.

Conservation of Natural Resources↗
PubMed2005

Remote Sensing and Geographic Information Systems and risk of American visceral leishmaniasis in Bahia, Brazil.

The spatial distribution of American visceral leishmaniasis (VL) was studied within the context of the environmental characteristics of northwest Bahia State in Brazil during an epidemic year. Geographic Information Systems (GIS) and Remote Sensing (RS) were used to characterize the landscape epidemiology of VL in order to identify and map high risk areas and endemic zones in a northwestern Bahia study area. Normalized Difference Vegetation Index (NDVI) was shown to be one of the most important risk factors in the area of study. Low NDVI values were related to high numbers of sand flies and high numbers of human and canine VL positive cases. Caatinga vegetation type was the dominant vegetation type in the endemic area. The use of RS and GIS allowed the identification of classes of VL risk that may be useful information to guide control program interventions.

Animals↗
PubMed2006

Modelling and understanding primary health care accessibility and utilization in rural South Africa: an exploration using a geographical information system.

Physical access to health care affects a large array of health outcomes, yet meaningfully estimating physical access remains elusive in many developing country contexts where conventional geographical techniques are often not appropriate. We interviewed (and geographically positioned) 23,000 homesteads regarding clinic usage in the Hlabisa health sub-district, KwaZulu-Natal, South Africa. We used a cost analysis within a geographical information system to estimate mean travel time (at any given location) to clinic and to derive the clinic catchments. The model takes into account the proportion of people likely to be using public transport (as a function of estimated walking time to clinic), the quality and distribution of the road network and natural barriers, and was calibrated using reported travel times. We used the model to investigate differences in rural, urban and peri-urban usage of clinics by homesteads in the study area and to quantify the effect of physical access to clinic on usage. We were able to predict the reported clinic used with an accuracy of 91%. The median travel time to nearest clinic is 81 min and 65% of homesteads travel 1h or more to attend the nearest clinic. There was a significant logistic decline in usage with increasing travel time (p < 0.0001). The adjusted odds of a homestead within 30 min of a clinic making use of the clinics were 10 times (adjusted OR = 10; 95 CI 6.9-14.4) those of a homestead in the 90-120 min zone. The adjusted odds of usage of the clinics by urban homesteads were approximately 20/30 times smaller than those of their rural/peri-urban counterparts, respectively, after controlling for systematic differences in travel time to clinic. The estimated median travel time to the district hospital is 170 min. The methodology constitutes a framework for modelling physical access to clinics in many developing country settings.

Computer Simulation↗
PubMed2001

Use of satellite remote sensing and geographic information systems to model the distribution and abundance of snail intermediate hosts in Africa: a preliminary model for Biomphalaria pfeifferi in Ethiopia.

Geographic information system (GIS) risk models for the snail-borne diseases caused by Schistosoma spp. and Fasciola spp. have recently been developed based on climate and satellite-retrieved data on temperature and vegetation coverage. By using these models, it was possible to describe a relationship between vegetation index (Normalized Differences Vegetation Index (NDVI)), land surface temperature (T(max)) and disease prevalence, but little reference was made to the distribution of the corresponding intermediate host snail. Presence of the intermediate host snail is a key factor determining distribution of the disease in sub-Saharan Africa and a good snail distribution mode would probably mirror the endemic area of schistosomiasis. In the present analysis, it was shown that snail distribution data corresponds with schistosomiasis prevalence data in relation to a forecast model based on NDVI and T(max) data derived from the Advanced Very High Resolution Radiometer (AVHRR) onboard the National Oceanic and Atmospheric Administration satellite series. The 'best fit' model included NDVI values from 125 to 145 and a T(max) data range of 10-32 degrees C. This model included 92.3, 90.4 and 94.6% of the positive snail sample sites in GIS query overlay areas extracted from annual, dry season and wet season composite maps, respectively. For other sites in Africa, other NDVI and T(max) ranges may be more appropriate, depending on the species of snail present, a topic that will be examined in further studies.

Africa↗
PubMed2003

The use of Geographic Information System (GIS) in the frame of the contingency plan implemented during the 1999-2001 avian influenza (AI) epidemic in Italy.

A Geographic Information System (GIS) is a very powerful and flexible software tool for effective management of spatially referenced data (e.g., geodata). Coupling database and GIS technology provides the tools for a detailed analysis of spatial patterns and distributions in veterinary applications. A specific veterinary GIS (VetGIS) toolbox was developed to perform the calculation of indices such as Lorenz curve, GINI index, and a kernel-based animal density estimation. This software was employed for the analysis and management of avian influenza in Italy during the 1999-2000 epidemic.

Animals↗
PubMed2001

[Geographic Information Systems and health: application to Antananarivo city].

The general health status of the population in the capital, Antananarivo, is determined by a number of different socio-economical and environmental factors. A study was undertaken in 1998 by which the Geographic Information System (GIS) was implemented in order to describe characteristics in town areas (fokontany) suffering from a high disease burden. It was observed that there was a heterogeneous distribution of health care supporting facilities in comparison to population density in the different areas of the capitol. A risk-score system by use of an image-technique was elaborated. The most important problem encountered in the study was the reduced availability of standardized collected data. The results suggest that GIS constitutes a useful tool in assessment of urban health problems in order to identify fokontany in particular need of additional health care support.

Data Collection↗
PubMed2003

Some entomological observations on temporal and spatial distribution of malaria vectors in three villages in northwestern Thailand using a geographic information system.

This spatial and temporal heterogeneity in the distribution of Anopheles mosquitos were studied during August 2001 to December 2002 in three villages Ban Khun Huay, Ban Pa Dae, and Ban Tham Seau, in northwestern Thailand in Mae Sot district, Tak Province. The three Karen villages are located about 20 km east of the city of Mae Sot near the Myanmar border. Twenty-one species were collected on human collections during 68 nights of 17 months. Anopheles minimus comprised of 86% of the specimens biting man. An. minimus was implicated as a vector based on the detection of sporozoite infections using enzyme-linked immunosorbent assays for Plasmodium falciparum and P. vivax. Seasonal comparison of vectorial capacity and entomological inoculation rate was calculated. An. dirus was rarely encountered and probably played little part in transmission in these three villages during the period of study. Information is provided on nightly biting activity, parity rate, infectivity, and adult and larval bionomics. Spatial and temporal comparisons among the collections were displayed on different satellite images including the Normalized Difference Vegetation Index data from on the National Oceanographic and Atmospheric Administration satellites (NOAA/NDVI), the LANDSAT satellite Thematic Mapper (spatial resolution 30x30 m) and the IKONOS satellite (spatial resolution 1x1 m) in a Geographical Information System (GIS).

Animals↗
PubMed1994

Predicting Ixodes scapularis abundance on white-tailed deer using geographic information systems.

We collected 1,410 Ixodes scapularis from 139 white-tailed deer in Kent County, Maryland during the 1990 hunting season. A geographic information system was used to extract 41 environmental variables in the areas surrounding the collection sites of the deer. Stepwise linear regression was used to evaluate the association between the abundance of ticks on deer and the environmental data. A significant statistical association was observed between the abundance of I. scapularis and seven environmental variables (R = 0.69). Tick abundance was negatively correlated with urban land use patterns, wetlands, the amount of privately owned land, soils that tended to be saturated with water, and one drainage system. Tick abundance was positively correlated with well-drained, sandy soils having low water tables. These results indicate that geographically referenced environmental data may be useful in anticipating the risk of exposure to vectors over large areas.

Animals↗
PubMed1994

Framework for application of geographic information system to the monitoring of dengue vectors.

In a successful management program of dengue vectors, not only health education, source reduction or insecticide application should be conducted, but all basic information should also be manipulated properly and efficiently. This information includes the surveys of species, dispersal and dynamics of vectors, as well as the detection of breeding sources, and the records of dengue cases and epidemic periods. Most of the above information expressed as regionalized variables always varies spatially and/or temporally. However, due to the deficiency of topological information, the conventional database management system cannot efficiently analyze those dengue related data. Thus, we have applied the geographic information system (GIS) to the monitoring of dengue vectors. The purpose of this report is to introduce the basic concepts of GIS, to describe the framework of the prototype dengue vector monitoring system which was built using data collected from the Sanmin area, Kaoshiung city, Taiwan, and to indicate the possibility of using this system to manipulate spatially correlated data and support decision making in the control of dengue disease.

Animals↗
PubMed2005

Assessment and mapping of water pollution indices in zone-III of municipal corporation of hyderabad using remote sensing and geographic information system.

A preliminary survey of area under Zone-III of MCH was undertaken to assess the ground water quality, demonstrate its spatial distribution and correlate with the land use patterns using advance techniques of remote sensing and geographical information system (GIS). Twenty-seven ground water samples were collected and their chemical analysis was done to form the attribute database. Water quality index was calculated from the measured parameters, based on which the study area was classified into five groups with respect to suitability of water for drinking purpose. Thematic maps viz., base map, road network, drainage and land use/land cover were prepared from IRS ID PAN + LISS III merged satellite imagery forming the spatial database. Attribute database was integrated with spatial sampling locations map in Arc/Info and maps showing spatial distribution of water quality parameters were prepared in Arc View. Results indicated that high concentrations of total dissolved solids (TDS), nitrates, fluorides and total hardness were observed in few industrial and densely populated areas indicating deteriorated water quality while the other areas exhibited moderate to good water quality.

Environmental Monitoring↗
PubMed2004

Mapping the potential distribution of Phlebotomus martini and P. orientalis (Diptera: Psychodidae), vectors of kala-azar in East Africa by use of geographic information systems.

The distribution of two principal vectors of kala-azar in East Africa, Phlebotomus martini and Phlebotomus orientalis were analysed using geographic information system (GIS) based on (1) earth observing satellite sensor data: Normalized Difference Vegetation Index (NDVI) and midday Land Surface Temperature (LST) derived from advanced very high resolution radiometer (AVHRR) of the global land 1km project of United States Geological Survey (USGS), (2) agroclimatic data from the FAO Crop Production System Zone (CPSZ) of the Intergovernmental Authority on Development (IGAD) sub-region, and (3) the FAO 1998 soils digital map for the IGAD sub-region. The aim was to produce a predictive risk model for the two vectors. Data used for the analysis were based on presence and absence of the two species from previous survey collections in the region (mainly Ethiopia, Kenya and Somalia). Annual, wet season and dry season models were constructed. Although all models resulted in more than 85% positive predictive values for both species, the best fit for the distribution of P. martini was the dry season composite (NDVI 0.07-0.38 and LST 22-33 degrees C) with a predictive value of 93.8%, and the best fit for P. orientalis was the wet season composite (NDVI -0.01 to 0.34 and LST 23-34 degrees C) with a predictive value of 96.3%. The two seasonal composites models derived from satellite data were largely similar with best fit models developed based on the CPSZ climate data: average altitude (12-1900m), average annual mean temperature (15-30 degrees C), annual rainfall (274-1212mm), average annual potential evapotranspiration (1264-1938mm) and readily available soil moisture (62-113mm) for P. martini; and average altitude (200-2200m), annual rainfall (180-1050mm), annual mean temperature (16-36 degrees C) and readily available soil moisture (67-108mm) for P. orientalis. Logistic regression analysis indicated LST dry season composite of the satellite data, average altitude, mean annual temperature and readily available soil moisture of the CPSZ data as the best ecological determinants for P. martini while LST annual composite was the only important ecological determinant for P. orientalis. Spearman's rank correlation revealed several factors to be important determinants for the distribution of the two vectors. None of the soil types analysed appeared to be important determinant for the two species in East Africa, unlike in Sudan where P. orientalis is mainly associated with eutric vertisol (black cotton clay soil).

Africa, Eastern↗
PubMed1997

Spatial analysis of the distribution of LaCrosse encephalitis in Illinois, using a geographic information system and local and global spatial statistics.

The spatial and temporal distribution of LaCrosse encephalitis cases in Illinois was analyzed using a geographic information system (GIS) and spatial statistics. Case data were obtained from the Illinois Department of Public Health and mapped on the county, town, and address level. Human cases were concentrated in and around the city of Peoria in central Illinois. Local spatial statistics were used to identify hot spots where cases appear to be concentrated in the Peoria region. Several small towns surrounding the city of Peoria appeared as foci where cases were most common. Second-order spatial analysis of the case distribution was conducted on the address level. Cases were clustered within a range of 3.0 km in the city of Peoria. Since most cases appear to be associated with residential (peridomestic) exposure, and since several cases have been reported from neighboring addresses, transmission may be concentrated around specific sites (hardwood ravines, tire piles). The GIS and spatial analysis may be useful in identifying and targeting for intervention potential sites of enzootic transmission.

Adolescent↗
PubMed1997

Role of geographic information system in malaria control.

In this paper we provide an account of our experience in the application of remote sensing (RS) and geographic information system (GIS) in understanding malaria transmission dynamics at the local level. Two studies have been briefly reviewed. One is the application of RS on the mosquito production in the Sanjay lake and surrounding areas in Delhi. Studies are demonstrated that remote sensing data were useful in assessing relative mosquito abundance from large water bodies. The second study was carried out in Nadiad taluka, Kheda district, Gujarat on the application of RS and GIS in a village-wise analysis of receptivity and vulnerability to malaria. For this study, remote sensed data and topo sheets of 1:50,000 and 1:125,000 were used in preparing thematic maps. Digitised overlaid maps were subjected to computer analysis using ARC/INFO 3.1 software. Malaria annual parasite incidence (API) showed relationship with water table followed by soil type, irrigation and water quality, other parameters also contributed to malaria receptivity but less significantly. Based on GIS analysis location specific malaria control strategy was suggested to achieve cost effective control of malaria on a sustainable basis.

Animals↗
PubMed1996

Impact of pesticides to groundwater resources in an alluvial plain using a geographical information system.

A methodology to evaluate the impact of pesticides to drinking water resources in an agricultural region has been applied in an Italian alluvial plain using a Geographical Information System (GIS). With this technology it is possible to store, process and represent geographical data and update them according to the environmental characteristics. The studied area, covering a surface of 500 km2, is located immediately south of Milan, in the alluvial plain of the Po river. The DRASTIC model (1) has been utilized in order to evaluate the intrinsic vulnerability of aquifers, DRASTIC is a quantitative method proposed by EPA to identify pollution potential especially referred to pesticides in USA. The application of this model, combined with data of land use has provided maps identifying areas at risk for groundwater pollution. Information derived from risk maps is of primary importance in territorial planning such as: selection of areas to be monitored, identification of areas to be protected, correct management of agricultural practices and use of pesticides. These maps should provide an useful instrument for agricultural and territorial management.

Agriculture↗
PubMed2006

Application of a geographic information system to explore associations between air pollution and micronucleus frequencies in African American children and adults.

Exposure to air pollution has been associated with adverse respiratory and cardiovascular health outcomes in both children and adults. In this study, we used geographic information systems (GISs) to explore possible associations between chromosomal damage in 65 African American children and their mothers from Oakland, California, and both proximity to traffic and regional ozone levels. Study participants were interviewed at the Healthy Child Clinic of Children's Hospital, Oakland, and their blood and buccal cells were collected for assessment of chromosomal damage by the micronucleus (MN) assay. Regional ozone levels, which decreased from April to November with a secondary peak in late summer, were highly correlated with season by month (r=-0.84, P=0.02) and strongly associated with MN frequency (frequency ratio (FR): 3.37, 95% confidence interval (CI): 1.30-8.72) in both cell types of children and adults. Additionally, MN frequencies were modestly associated with individual measures of traffic density in children (FR=2.45, 95% CI=0.86-7.10), but not in adults; this suggests a greater vulnerability to traffic-related air pollution in children. Smoking in the household also increased MN frequency in the lymphocytes of children (FR: 1.13, 95%CI: 1.01-1.24) and adults (FR: 1.06, 95%CI: 0.99-1.13), whereas vitamin use in adults decreased MN frequency in both lymphocytes and buccal cells (FR: 0.17, 95%CI: 0.02-1.31; FR: 0.18, 95%CI: 0.03-1.18, respectively). Our data indicate that GIS-generated measures of traffic density for individual households augment regional ozone monitoring data used to assess effects of air pollution. This approach helped to demonstrate elevated cytogenetic damage in exposed minority children.

Adult↗
PubMed2000

Earth observation, geographic information systems and Plasmodium falciparum malaria in sub-Saharan Africa.

This review highlights the progress and current status of remote sensing (RS) and geographical information systems (GIS) as currently applied to the problem of Plasmodium falciparum malaria in sub-Saharan Africa (SSA). The burden of P. falciparum malaria in SSA is first summarized and then contrasted with the paucity of accurate and recent information on the nature and extent of the disease. This provides perspective on both the global importance of the pathogen and the potential for contribution of RS and GIS techniques. The ecology of P. falciparum malaria and its major anopheline vectors in SSA in then outlined, to provide the epidemiological background for considering disease transmission processes and their environmental correlates. Because RS and GIS are recent techniques in epidemiology, all mosquito-borne diseases are considered in this review in order to convey the range of ideas, insights and innovation provided. To conclude, the impact of these initial studies is assessed and suggestions provided on how these advances could be best used for malaria control in an appropriate and sustainable manner, with key areas for future research highlighted.

Africa South of the Sahara↗