Semantic Web of Things (SWoT) for Global Infectious Disease Control and Prevention

This paper reports on the early-stage development of an analytics framework to support the semantic integration of dynamic surveillance data across multiple scales to inform decision making for malaria eradication. We propose using the Semantic Web of Things (SWoT), a combination of Internet of Things (IoT) and semantic web technologies, to support the evolution and integration of dynamic malaria data sources and improve interoperability between different datasets generated through relevant IoT assets (e.g. computers, sensors, persons, and other smart objects and devices).

Sustainable, healthy cities: protocol of a mixed methods evaluation of a cluster randomized controlled trial for Aedes control in Brazil using a community mobilization approach

Background

Dengue is increasing in its global presence with an estimated 4 billion people at-risk of infection in at least 128 countries. Despite the promising results of EcoHealth and community mobilization approaches to Aedes reduction, more evidence of their efficacy on reducing dengue risk is needed. The principal research question is to determine if interventions based upon community mobilization reduce the risk of dengue virus infection among children 3 to 9 years old compared to usual dengue control practice in Fortaleza, Brazil.

Methods

The present study will follow a pragmatic cluster randomized controlled trial (cRCT) design with randomization at the census tract level with equal allocation to the two arms. In each arm, there will be 34 clusters of 86 children between 3 to 9 years old for an expected total of 5848 children enrolled in the study, assuming a risk reduction of 29.5% based upon findings from a previous multi-site cRCT. The primary outcomes are rates of anti-dengue Immunoglobulin G (IgG) seroconversion and adult female Aedes density. The intervention is based upon a participatory health research approach, Socializing Evidence for Participatory Action (SEPA), where the research evidence is used to foster community engagement and ownership of the health issue and solution. Following allocation, intervention communities will develop and implement their own solutions that will likely include a wide variety of collective events and media approaches. Data collection activities over a period of 3 years include household visits for blood collection, household surveys, and entomological surveys; and qualitative activities including focus groups, in-depth interviews, and document analysis to evaluate the process, acceptability, fidelity, and sustainability of the intervention. Study participants will be aware of their assignment and all research staff will be blinded although the intervention assignment will likely be revealed to field staff through interaction with participants.

Discussion

The results of our study will provide evidence on community mobilization as an intervention for dengue control. We anticipate that if community mobilization is effective in Fortaleza, the results of this study will help develop evidence-based vector control programs in Brazil, and also in other countries struggling with Aedes-transmitted diseases.

Trial registration

ISRCTN66131315, registration date: 1 October 2018.

Water, sanitation, and hygiene risk factors of acute diarrhea among children under five years in the Gaza Strip

This cross-sectional community household-based study aims to evaluate the water, sanitation, and hygiene facilities in the Gaza Strip and to investigate their associations with the occurrence of acute diarrhea among children under five years. A survey using a structured questionnaire was conducted on 1,857 households with an child under five years from August 2017 to June 2018. About 69.7% of heads of households reported a diarrheal episode among their children during the two months preceding the survey. Multivariable logistic regression showed that sewage water observed around the households was associated with an increased risk of acute diarrhea (AOR = 2.45; P < 0.001; 95% CI: 1.83–3.27). Nevertheless, the allocation of a special water tank for desalinated drinking water at home (AOR = 0.3; P = 0.02; 95% CI: 0.1–0.8), the connection of households to a closed sewerage system (AOR = 0.56; P < 0.001; 95% CI: 0.43–0.73), and handwashing practices before and after eating (AOR = 0.42; P = 0.003; 95% CI: 0.24–0.74 and AOR = 0.50; P = 0.03; 95% CI: 0.26–0.94, respectively), as well as using desalinated water sources for drinking purposes, were inversely associated with the incidence of acute diarrhea among children under five. Further improvements in the existing sewerage system and the intensification of sanitation and hygiene promotion programs at the household levels may reduce the risk of acute diarrhea among children under five years in the Gaza Strip.

An Evaluation of Healthcare Use and Child Morbidity 4 Years After User Fee Removal in Rural Burkina Faso

Objectives Increasing financial access to healthcare is proposed to being essential for improving child health outcomes, but the available evidence on the relationship between increased access and health remains scarce. Four years after its launch, we evaluated the contextual effect of user fee removal intervention on the probability of an illness occurring and the likelihood of using health services among children under 5. We also explored the potential effect on the inequality in healthcare access. Methods We used a comparative cross-sectional design based upon household survey data collected years after the intervention onset in one intervention and one comparison district. Propensity scores weighting was used to achieve balance on covariates between the two districts, which was followed by logistic multilevel modelling to estimate average marginal effects (AME). Results We estimated that there was not a significant difference in the reduced probability of an illness occurring in the intervention district compared to the non-intervention district [AME 4.4; 95% CI  1.0-9.8)]. However, the probability of using health services was 17.2% (95% CI 15.0-26.6) higher among children living in the intervention district relative to the comparison district, which rose to 20.7% (95% CI 9.9-31.5) for severe illness episodes. We detected no significant differences in the probability of health services use according to socio-economic status [χ2 (5) = 12.90, p = 0.61]. Conclusions for Practice In our study, we found that user fee removal led to a significant increase in the use of health services in the longer term, but it is not adequate by itself to reduce the risk of illness occurrence and socioeconomic inequities in the use of health services.

Containment measures for emerging and re-emerging vector-borne and other infectious diseases of poverty in urban settings: a scoping review

BACKGROUND

The emergence and re-emergence of vector-borne and other infectious diseases of poverty pose a threat to the health of populations living in urban and low-income settings. A detailed understanding of intervention strategies, including effectiveness of past outbreak containment, is necessary to improve future practices. The objective was to determine what is known about the effectiveness of containment measures for emerging and re-emerging vector-borne and other infectious diseases of poverty in urban settings and identify research gaps and implications for public health practice.

MAIN BODY

We conducted a scoping review and systematically searched peer-reviewed and grey literature published between 2000 and 2016. Different data extraction tools were used for data coding and extraction, and data on implementation process and transferability were extracted from all studies. A quality assessment was conducted for each included study. We screened 205 full-text articles and reports for a total of 31 articles included in the review. The quality of the studies was generally low to moderate. The largest body of evidence concerned control activities for Ebola virus and dengue fever. The majority of interventions (87%) relied on multiple types of measures, which were grouped into four categories: 1) healthcare provision; 2) epidemiological investigation and/or surveillance; 3) environmental or sanitary interventions; and 4) community-based interventions. The quality of the majority of studies (90%) was poor or moderate, and one-third of the studies did not provide a clear description of the outcomes and of the procedures and/or tools used for the intervention.

CONCLUSIONS

Our results highlight the difficulty of establishing causation when assessing the effect of containment measures. Studies that extend beyond solely reporting on effectiveness and take into account the complexity of real-world settings are urgently needed. We recommend the allocation of research efforts to the evaluation of the implementation processes of interventions as well as their comprehensive and systematic description using validated checklists.

Interventions for vector-borne diseases focused on housing and hygiene in urban areas: a scoping review

BACKGROUND

Over half the world's human populations are currently at risk from vector-borne diseases (VBDs), and the heaviest burden is borne by the world's poorest people, communities, and countries. The aim of this study was to conduct a review on VBD interventions relevant to housing and hygiene (including sanitation and waste management) in urban areas.

MAIN BODY

We conducted a scoping review, which involved systematically searching peer-reviewed and grey literature published between 2000 and 2016 using five scientific databases and one database for grey literature. Different data extraction tools were used for data coding and extraction. We assessed the quality of each study using the Mixed Methods Appraisal Tool and extracted descriptive characteristics and data about implementation process and transferability from all studies using the Template for Intervention Description and Replication and ASTAIRE (a tool for analyzing the transferability of health promotion interventions) tools. We reviewed 44 studies. Overall, the studies were judged to be of high risk for bias. Our results suggest multifaceted interventions, particularly community-based interventions, have the potential to achieve wider and more sustained effects than do standard vertical single-component programs. The evaluations of multifaceted interventions tend to include integrated evaluations, using not only entomological indicators but also acceptability and sustainability indicators.

CONCLUSIONS

This review highlighted the important need for higher quality research in VBDs and improved and standardized reporting of interventions. Significant research gaps were found regarding qualitative research and implementation research, and results highlighted the need for more interventions focus on sanitation and hygiene practices.

The associations between malaria, interventions, and the environment: a systematic review and meta-analysis

BACKGROUND

Malaria transmission is driven by multiple factors, including complex and multifaceted connections between malaria transmission, socioeconomic conditions, climate and interventions. Forecasting models should account for all significant drivers of malaria incidence although it is first necessary to understand the relationship between malaria burden and the various determinants of risk to inform the development of forecasting models. In this study, the associations between malaria risk, environmental factors, and interventions were evaluated through a systematic review.

METHODS

Five electronic databases (CAB Abstracts, EMBASE, Global Health, MEDLINE and ProQuest Dissertations & Theses) were searched for studies that included both the effects of the environment and interventions on malaria within the same statistical model. Studies were restricted to quantitative analyses and health outcomes of malaria mortality or morbidity, outbreaks, or transmission suitability. Meta-analyses were conducted on a subset of results using random-effects models.

RESULTS

Eleven studies of 2248 potentially relevant articles that met inclusion criteria were identified for the systematic review and two meta-analyses based upon five results each were performed. Normalized Difference Vegetation Index was not found to be statistically significant associated with malaria with a pooled OR of 1.10 (95% CI 0.07, 1.71). Bed net ownership was statistically associated with decreasing risk of malaria, when controlling for the effects of environment with a pooled OR of 0.75 (95% CI 0.60, 0.95). In general, environmental effects on malaria, while controlling for the effect of interventions, were variable and showed no particular pattern. Bed nets ownership, use and distribution, have a significant protective effect while controlling for environmental variables.

CONCLUSIONS

There are a limited number of studies which have simultaneously evaluated both environmental and interventional effects on malaria risk. Poor statistical reporting and a lack of common metrics were important challenges for this review, which must be addressed to ensure reproducibility and quality research. A comprehensive or inclusive approach to identifying malaria determinants using standardized indicators would allow for a better understanding of its epidemiology, which is crucial to improve future malaria risk estimations.

Exploring Semantic Data Federation to Enable Malaria Surveillance Queries

Malaria is an infectious disease affecting people across tropical countries. In order to devise efficient interventions, surveillance experts need to be able to answer increasingly complex queries integrating information coming from repositories distributed all over the globe. This, in turn, requires extraordinary coding abilities that cannot be expected from non-technical surveillance experts. In this paper, we present a deployment of Semantic Automated Discovery and Integration (SADI) Web services for the federation and querying of malaria data. More than 10 services were created to answer an example query requiring data coming from various sources. Our method assists surveillance experts in formulating their queries and gaining access to the answers they need.

Spatial Determinants of Ebola Virus Disease Risk for the West African Epidemic

INTRODUCTION

Although many studies have investigated the probability of Ebola virus disease (EVD) outbreaks while other studies have simulated the size and speed of EVD outbreaks, few have investigated the environmental and population-level predictors of Ebola transmission once an outbreak is underway. Identifying strong predictors of transmission could help guide and target limited public health resources during an EVD outbreak. We examined several environmental and population-level demographic predictors of EVD risk from the West African epidemic.

METHODS

We obtained district-level estimates from the World Health Organization EVD case data, demographic indicators obtained from the Demographic and Health surveys, and satellite-derived temperature, rainfall, and land cover estimates. A Bayesian hierarchical Poisson model was used to estimate EVD risk and to evaluate the spatial variability explained by the selected predictors.

RESULTS

 We found that districts had greater risk of EVD with increasing proportion of households not possessing a radio (RR 2.79, 0.90-8.78; RR 4.23, 1.16-15.93), increasing rainfall (RR 2.18; 0.66-7.20; 5.34, 1.20-23.90), and urban land cover (RR 4.87, 1.56-15.40; RR 5.74, 1.68-19.67).

DISCUSSION

 The finding of radio ownership and reduced EVD transmission risk suggests that the use of radio messaging for control and prevention purposes may have been crucial in reducing the EVD transmission risk in certain districts, although this association requires further study. Future research should examine the etiologic relationships between the identified risk factors and human-to-human transmission of EVD with a focus on factors related to population mobility and healthcare accessibility, which are critical features of epidemic propagation and control.

Reconstruction of Zika Virus Introduction in Brazil

We estimated the speed of Zika virus introduction in Brazil by using confirmed cases at the municipal level. Our models indicate a southward pattern of introduction starting from the northeastern coast and a pattern of movement toward the western border with an average speed of spread of 42 km/day or 15,367 km/year.

Media content about vaccines in the United States and Canada, 2012-2014: An analysis using data from the Vaccine Sentimeter

BACKGROUND

A system for monitoring vaccine-related media content was previously developed and studied from an international perspective. This monitoring approach could also have value at a regional level, but it has yet to be evaluated at this scale. We examined regional patterns of vaccine-related media topics and sentiment in the US and Canada.

METHODS

We extracted vaccine-relevant US and Canadian online media reports between June 2012 and October 2014 from the Vaccine Sentimeter, a HealthMap-based automated media monitoring system for news aggregators and blogs. We analyzed regional distributions of reports about vaccines, categories (i.e., topics), sentiment, and measles outbreaks.

FINDINGS

The Vaccine Sentimeter captured 10,715 reports during the study period. Negative sentiment was highest in reports about vaccine safety (47%), Hepatitis B (19%), and Vermont (18%). Analyses of measles outbreaks revealed geographical variation in media content. For example, religious beliefs were mentioned in 27% of measles reports in Texas and 22% of British Columbia reports, but there were no references to religion in media on measles from California.

INTERPRETATIONS

A regional analysis of online sentiment towards vaccine can provide insights that may give US and Canadian public health practitioners a deeper understanding of media influences on vaccine choices in their regions and consequently lead to more effective public health action.

Measures of Malaria Burden after Long-Lasting Insecticidal Net Distribution and Indoor Residual Spraying at Three Sites in Uganda: A Prospective Observational Study

BACKGROUND

Long-lasting insecticidal nets (LLINs) and indoor residual spraying of insecticide (IRS) are the primary vector control interventions used to prevent malaria in Africa. Although both interventions are effective in some settings, high-quality evidence is rarely available to evaluate their effectiveness following deployment by a national malaria control program. In Uganda, we measured changes in key malaria indicators following universal LLIN distribution in three sites, with the addition of IRS at one of these sites.

METHODS AND FINDINGS

Comprehensive malaria surveillance was conducted from October 1, 2011, to March 31, 2016, in three sub-counties with relatively low (Walukuba), moderate (Kihihi), and high transmission (Nagongera). Between 2013 and 2014, universal LLIN distribution campaigns were conducted in all sites, and in December 2014, IRS with the carbamate bendiocarb was initiated in Nagongera. High-quality surveillance evaluated malaria metrics and mosquito exposure before and after interventions through (a) enhanced health-facility-based surveillance to estimate malaria test positivity rate (TPR), expressed as the number testing positive for malaria/number tested for malaria (number of children tested for malaria: Walukuba = 42,833, Kihihi = 28,790, and Nagongera = 38,690); (b) cohort studies to estimate the incidence of malaria, expressed as the number of episodes per person-year [PPY] at risk (number of children observed: Walukuba = 340, Kihihi = 380, and Nagongera = 361); and (c) entomology surveys to estimate household-level human biting rate (HBR), expressed as the number of female Anopheles mosquitoes collected per house-night of collection (number of households observed: Walukuba = 117, Kihihi = 107, and Nagongera = 107). The LLIN distribution campaign substantially increased LLIN coverage levels at the three sites to between 65.0% and 95.5% of households with at least one LLIN. In Walukuba, over the 28-mo post-intervention period, universal LLIN distribution was associated with no change in the incidence of malaria (0.39 episodes PPY pre-intervention versus 0.20 post-intervention; adjusted rate ratio [aRR] = 1.02, 95% CI 0.36-2.91, p = 0.97) and non-significant reductions in the TPR (26.5% pre-intervention versus 26.2% post-intervention; aRR = 0.70, 95% CI 0.46-1.06, p = 0.09) and HBR (1.07 mosquitoes per house-night pre-intervention versus 0.71 post-intervention; aRR = 0.41, 95% CI 0.14-1.18, p = 0.10). In Kihihi, over the 21-mo post-intervention period, universal LLIN distribution was associated with a reduction in the incidence of malaria (1.77 pre-intervention versus 1.89 post-intervention; aRR = 0.65, 95% CI 0.43-0.98, p = 0.04) but no significant change in the TPR (49.3% pre-intervention versus 45.9% post-intervention; aRR = 0.83, 95% 0.58-1.18, p = 0.30) or HBR (4.06 pre-intervention versus 2.44 post-intervention; aRR = 0.71, 95% CI 0.30-1.64, p = 0.40). In Nagongera, over the 12-mo post-intervention period, universal LLIN distribution was associated with a reduction in the TPR (45.3% pre-intervention versus 36.5% post-intervention; aRR = 0.82, 95% CI 0.76-0.88, p < 0.001) but no significant change in the incidence of malaria (2.82 pre-intervention versus 3.28 post-intervention; aRR = 1.10, 95% 0.76-1.59, p = 0.60) or HBR (41.04 pre-intervention versus 20.15 post-intervention; aRR = 0.87, 95% CI 0.31-2.47, p = 0.80). The addition of three rounds of IRS at ~6-mo intervals in Nagongera was followed by clear decreases in all outcomes: incidence of malaria (3.25 pre-intervention versus 0.63 post-intervention; aRR = 0.13, 95% CI 0.07-0.27, p < 0.001), TPR (37.8% pre-intervention versus 15.0% post-intervention; aRR = 0.54, 95% CI 0.49-0.60, p < 0.001), and HBR (18.71 pre-intervention versus 3.23 post-intervention; aRR = 0.29, 95% CI 0.17-0.50, p < 0.001). High levels of pyrethroid resistance were documented at all three study sites. Limitations of the study included the observational study design, the lack of contemporaneous control groups, and that the interventions were implemented under programmatic conditions.

CONCLUSIONS

Universal distribution of LLINs at three sites with varying transmission intensity was associated with modest declines in the burden of malaria for some indicators, but the addition of IRS at the highest transmission site was associated with a marked decline in the burden of malaria for all indicators. In highly endemic areas of Africa with widespread pyrethroid resistance, IRS using alternative insecticide formulations may be needed to achieve substantial gains in malaria control.

Assessing temporal associations between environmental factors and malaria morbidity at varying transmission settings in Uganda

Background

Environmental factors play a major role in transmission of malaria given their relationship to both the development and survival of the mosquito and parasite. The associations between environmental factors and malaria can be used to inform the development of early warning systems for increases in malaria burden. The objective of this study was to assess temporal relationships between rainfall, temperature and vegetation with malaria morbidity across three different transmission settings in Uganda.

Methods

Temporal relationships between environmental factors (weekly total rainfall, mean day time temperature and enhanced vegetation index series) and malaria morbidity (weekly malaria case count data and test positivity rate series) over the period January 2010–May 2013 in three sites located in varying malaria transmission settings in Uganda was explored using cross-correlation with pre-whitening. Sites included Kamwezi (low transmission), Kasambya (moderate transmission) and Nagongera (high transmission).

Results

Nagongera received the most rain (30.6 mm) and experienced, on average, the highest daytime temperatures (29.8 °C) per week. In the study period, weekly TPR and number of malaria cases were highest at Kasambya and lowest at Kamwezi. The largest cross-correlation coefficients between environmental factors and malaria morbidity for each site was 0.27 for Kamwezi (rainfall and cases), 0.21 for Kasambya (vegetation and TPR), and −0.27 for Nagongera (daytime temperature and TPR). Temporal associations between environmental factors (rainfall, temperature and vegetation) with malaria morbidity (number of malaria cases and TPR) varied by transmission setting. Longer time lags were observed at Kamwezi and Kasambya compared to Nagongera in the relationship between rainfall and number of malaria cases. Comparable time lags were observed at Kasambya and Nagongera in the relationship between temperature and malaria morbidity. Temporal analysis of vegetation with malaria morbidity revealed longer lags at Kasambya compared to those observed at the other two sites.

Conclusions

This study showed that temporal associations between environmental factors with malaria morbidity vary by transmission setting in Uganda. This suggests the need to incorporate local transmission differences when developing malaria early warning systems that have environmental predictors in Uganda. This will result in development of more accurate early warning systems, which are a prerequisite for effective malaria control in such a setting.

Decentralized control of human visceral leishmaniasis in endemic urban areas of Brazil: a literature review

OBJECTIVES

Human migration and concomitant HIV infections are likely to bring about major changes in the epidemiology of some parasitic infections in Brazil. Human visceral leishmaniasis (HVL) control is particularly fraught with intricacies. It is against a backdrop of decentralized health care that the complex HVL control initiatives are brought to bear. This comprehensive review aims to explore the obstacles facing decentralized HVL control in urban endemic areas in Brazil.

METHOD

A literature search was carried out in December 2015 by means of three databases: MEDLINE, Google Scholar, and Web of Science.

RESULTS

Although there have been many strides that have been made in elucidating the eco-epidemiology of Leishmania infantum, which forms the underpinnings of the national control program, transmission risk factors for HVL are still insufficiently elucidated in urban settings. Decentralized HVL epidemiological surveillance and control for animal reservoirs and vectors may compromise sustainability. In addition, it may hamper timely human HVL case management. With the burgeoning of the HIV-HVL co-infection, the potential human transmission may be underestimated.

CONCLUSION

HVL is a disease with focal transmission at a critical juncture, which warrants that the bottlenecks facing the control program within contexts of decentralized healthcare systems be taken into account. In addition, HIV-driven HVL epidemics may substantially increase the transmission potential of the human reservoir. Calculating the basic reproductive number to fine-tune interventions will have to take into consideration the specific socio-economic development context.

Forecasting malaria in a highly endemic country using environmental and clinical predictors

Background

Malaria thrives in poor tropical and subtropical countries where local resources are limited. Accurate disease forecasts can provide public and clinical health services with the information needed to implement targeted approaches for malaria control that make effective use of limited resources. The objective of this study was to determine the relevance of environmental and clinical predictors of malaria across different settings in Uganda.

Methods

Forecasting models were based on health facility data collected by the Uganda Malaria Surveillance Project and satellite-derived rainfall, temperature, and vegetation estimates from 2006 to 2013. Facility-specific forecasting models of confirmed malaria were developed using multivariate autoregressive integrated moving average models and produced weekly forecast horizons over a 52-week forecasting period.

Results

The model with the most accurate forecasts varied by site and by forecast horizon. Clinical predictors were retained in the models with the highest predictive power for all facility sites. The average error over the 52 forecasting horizons ranged from 26 to 128% whereas the cumulative burden forecast error ranged from 2 to 22%.

Conclusions

Clinical data, such as drug treatment, could be used to improve the accuracy of malaria predictions in endemic settings when coupled with environmental predictors. Further exploration of malaria forecasting is necessary to improve its accuracy and value in practice, including examining other environmental and intervention predictors, including insecticide-treated nets.

Electronic supplementary material

The online version of this article (doi:10.1186/s12936-015-0758-4) contains supplementary material, which is available to authorized users.

Determining health-care facility catchment areas in Uganda using data on malaria-related visits

OBJECTIVE

To illustrate the use of a new method for defining the catchment areas of health-care facilities based on their utilization.

METHODS

The catchment areas of six health-care facilities in Uganda were determined using the cumulative case ratio: the ratio of the observed to expected utilization of a facility for a particular condition by patients from small administrative areas. The cumulative case ratio for malaria-related visits to these facilities was determined using data from the Uganda Malaria Surveillance Project. Catchment areas were also derived using various straight line and road network distances from the facility. Subsequently, the 1-year cumulative malaria case rate was calculated for each catchment area, as determined using the three methods.

FINDINGS

The 1-year cumulative malaria case rate varied considerably with the method used to define the catchment areas. With the cumulative case ratio approach, the catchment area could include noncontiguous areas. With the distance approaches, the denominator increased substantially with distance, whereas the numerator increased only slightly. The largest cumulative case rate per 1000 population was for the Kamwezi facility: 234.9 (95% confidence interval, CI: 226.2-243.8) for a straight-line distance of 5 km, 193.1 (95% CI: 186.8-199.6) for the cumulative case ratio approach and 156.1 (95% CI: 150.9-161.4) for a road network distance of 5 km.

CONCLUSION

Use of the cumulative case ratio for malaria-related visits to determine health-care facility catchment areas was feasible. Moreover, this approach took into account patients' actual addresses, whereas using distance from the facility did not.

A qualitative study of health information technology in the Canadian public health system

Background

Although the adoption of health information technology (HIT) has advanced in Canada over the past decade, considerable challenges remain in supporting the development, broad adoption, and effective use of HIT in the public health system. Policy makers and practitioners have long recognized that improvements in HIT infrastructure are necessary to support effective and efficient public health practice. The objective of this study was to identify aspects of health information technology (HIT) policy related to public health in Canada that have succeeded, to identify remaining challenges, and to suggest future directions to improve the adoption and use of HIT in the public health system.

Methods

A qualitative case study was performed with 24 key stakeholders representing national and provincial organizations responsible for establishing policy and strategic direction for health information technology.

Results

Identified benefits of HIT in public health included improved communication among jurisdictions, increased awareness of the need for interoperable systems, and improvement in data standardization. Identified barriers included a lack of national vision and leadership, insufficient investment, and poor conceptualization of the priority areas for implementing HIT in public health.

Conclusions

The application of HIT in public health should focus on automating core processes and identifying innovative applications of HIT to advance public health outcomes. The Public Health Agency of Canada should develop the expertise to lead public health HIT policy and should establish a mechanism for coordinating public health stakeholder input on HIT policy.

A scoping review of malaria forecasting: past work and future directions

OBJECTIVES

There is a growing body of literature on malaria forecasting methods and the objective of our review is to identify and assess methods, including predictors, used to forecast malaria.

DESIGN

Scoping review. Two independent reviewers searched information sources, assessed studies for inclusion and extracted data from each study.

INFORMATION SOURCES

Search strategies were developed and the following databases were searched: CAB Abstracts, EMBASE, Global Health, MEDLINE, ProQuest Dissertations & Theses and Web of Science. Key journals and websites were also manually searched.

ELIGIBILITY CRITERIA FOR INCLUDED STUDIES

We included studies that forecasted incidence, prevalence or epidemics of malaria over time. A description of the forecasting model and an assessment of the forecast accuracy of the model were requirements for inclusion. Studies were restricted to human populations and to autochthonous transmission settings.

RESULTS

We identified 29 different studies that met our inclusion criteria for this review. The forecasting approaches included statistical modelling, mathematical modelling and machine learning methods. Climate-related predictors were used consistently in forecasting models, with the most common predictors being rainfall, relative humidity, temperature and the normalised difference vegetation index. Model evaluation was typically based on a reserved portion of data and accuracy was measured in a variety of ways including mean-squared error and correlation coefficients. We could not compare the forecast accuracy of models from the different studies as the evaluation measures differed across the studies.

CONCLUSIONS

Applying different forecasting methods to the same data, exploring the predictive ability of non-environmental variables, including transmission reducing interventions and using common forecast accuracy measures will allow malaria researchers to compare and improve models and methods, which should improve the quality of malaria forecasting.

Residential address errors in public health surveillance data: a description and analysis of the impact on geocoding

The residential addresses of persons with reportable communicable diseases are used increasingly for spatial monitoring and cluster detection, and public health may direct interventions based upon the results of routine spatial surveillance. There has been little assessment, however, of the quality of address data in reportable disease notifications and of the corresponding impact of these errors on geocoding and routine public health practices. The objectives of this study were to examine address errors for a selected reportable disease in a large urban center in Canada and to assess the impact of identified errors on geocoding and the estimated spatial distribution of the disease. We extracted data for all notifications of campylobacteriosis from the Montreal public health department from 1995 to 2008 and used an address verification algorithm to determine the validity of the residential address for each case and to suggest corrections for invalid addresses. We assessed the types of address errors as well as the resulting positional errors, calculating the distance between the original address and the correct address as well as changes in disease density. Address errors and missing addresses were prevalent in the public health records (10% and 5%, respectively) and they influenced the observed distribution of campylobacteriosis in Montreal, with address correction changing case location by a median of 1.1 km. Further examination of the extent of address errors in public health data is essential, as is the investigation of how these errors impact routine public health functions.