Locating and targeting hotspots and hotpops with spatial decision support systems

Transcription

1 Locating and targeting hotspots and hotpops with spatial decision support systems Gerard Kelly Infectious Disease Epidemiology Unit (IDEU) School of Population Health University of Queensland, Australia APMEN V Annual Business and Technical meeting Bali, Republic of Indonesia March 4 7, 2013

2 Surveillance systems for Malaria Elimination: A spatial perspective Effective surveillance-response systems must be able to swiftly identify and locate pockets of transmission and support the effective targeting of appropriate response interventions A geographic / spatial focus is essential A spatial decision support system (SDSS) provides computerised support for decision making where there is a geographic or spatial component to a decision Generally based around a GIS that integrates Database management systems Analytical models Graphical map display Tabular reporting capabilities Expert knowledge of decision makers

3 SDSS based Surveillance-Response Framework Isabel Province, Solomon Islands Case detection & notification Cases detected via routine PCD and ACD of priority areas/ populations immediately reported to provincial M&E unit Case investigation & classification Surveillance database updated & cases mapped at a household level within SDSS Focus investigation & classification Transmission Foci automatically re-classified, updated & mapped (based on type and spatio-temporal distribution of all detected cases) Focus specific targeted action Response Areas of Interest (AOI) generated & mapped (based on pre-defined parameters e.g. location, association and type of recently detected cases) Relevant supportive data generated to assist rapid, targeted and appropriate response (e.g Location maps, target household / population summaries, historical case data, household checklists )

4 Rapid Case Reporting

5 Case Distribution Mapping Cases georeferenced to household locations within SDSS Cases detected within specific date ranges and/or specific species and/or type (e.g. local/imported) can be queried, selected and mapped to support epidemiological investigation

6 Active Transmission Foci Classification & Mapping Active transmission foci automatically updated and mapped as cases are georeferenced within the SDSS - Transmission foci classified based on type and location of cases and associated local epidemiological settings

7 Targeting active Hot-Spots and Hot-Pops Automated summaries to support rapid allocation of finances/resources and deployment of response teams Line lists also generated to assist targeted responses within AOI including: - All households - Historical cases - Known larval sites Appropriate focispecific targeted responses conducted in AOI areas

8 Targeting active Hot-Spots and Hot-Pops

9 Considerations and (some) Challenges! Any effective surveillance-response system is highly dependent upon broader key health system components, particularly at a health facility and community level: Passive case detection, case investigation and timely/rapid reporting Pro-Active case detection in high risk priority areas such as known populations of high mobility (e.g. logging and mining camps) and common entry points (e.g. sea and air ports) Re-Active case detection and targeted foci-specific rapid response Strong community engagement, participatory surveillance and vigilance The provision of technical support to ensure and sustain operational capacity at the program level including both: During the scoping, development and establishment of surveillance-response procedures and supporting information systems AND once these are established, opportunities for program officers to access networks, forums or remote support centres for technical assistance and guidance as required (often to overcome only relatively minor problems!) Considerations and opportunities for us as the APMEN group to move forward Develop strategies and approaches for targeting hotspots and hotpops in Asia Pacific Region Identify knowledge gaps and potential operational tools to maximize effectiveness of surveillance-response Training, implementation and ongoing support to sustain operational capacity