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Tatem AJ. Small area population denominators for improved disease surveillance and response. Epidemics 2022; 41:100641. [PMID: 36228440 PMCID: PMC9534780 DOI: 10.1016/j.epidem.2022.100641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/12/2022] [Accepted: 10/04/2022] [Indexed: 12/29/2022] Open
Abstract
The Covid-19 pandemic has highlighted the value of strong surveillance systems in supporting our abilities to respond rapidly and effectively in mitigating the impacts of infectious diseases. A cornerstone of such systems is basic subnational scale data on populations and their demographics, which enable the scale of outbreaks to be assessed, risk to specific groups to be determined and appropriate interventions to be designed. Ongoing weaknesses and gaps in such data have however been highlighted by the pandemic. These can include outdated or inaccurate census data and a lack of administrative and registry systems to update numbers, particularly in low and middle income settings. Efforts to design and implement globally consistent geospatial modelling methods for the production of small area demographic data that can be flexibly integrated into health-focussed surveillance and information systems have been made, but these often remain based on outdated population data or uncertain projections. In recent years, efforts have been made to capitalise on advances in computing power, satellite imagery and new forms of digital data to construct methods for estimating small area population distributions across national and regional scales in the absence of full enumeration. These are starting to be used to complement more traditional data collection approaches, especially in the delivery of health interventions, but barriers remain to their widespread adoption and use in disease surveillance and response. Here an overview of these approaches is presented, together with discussion of future directions and needs.
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Affiliation(s)
- A J Tatem
- WorldPop, School of Geography and Environmental Science, University of Southampton, UK
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2
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Hierink F, Boo G, Macharia PM, Ouma PO, Timoner P, Levy M, Tschirhart K, Leyk S, Oliphant N, Tatem AJ, Ray N. Differences between gridded population data impact measures of geographic access to healthcare in sub-Saharan Africa. COMMUNICATIONS MEDICINE 2022; 2:117. [PMID: 36124060 PMCID: PMC9481590 DOI: 10.1038/s43856-022-00179-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/01/2022] [Indexed: 12/04/2022] Open
Abstract
Background Access to healthcare is imperative to health equity and well-being. Geographic access to healthcare can be modeled using spatial datasets on local context, together with the distribution of existing health facilities and populations. Several population datasets are currently available, but their impact on accessibility analyses is unknown. In this study, we model the geographic accessibility of public health facilities at 100-meter resolution in sub-Saharan Africa and evaluate six of the most popular gridded population datasets for their impact on coverage statistics at different administrative levels. Methods Travel time to nearest health facilities was calculated by overlaying health facility coordinates on top of a friction raster accounting for roads, landcover, and physical barriers. We then intersected six different gridded population datasets with our travel time estimates to determine accessibility coverages within various travel time thresholds (i.e., 30, 60, 90, 120, 150, and 180-min). Results Here we show that differences in accessibility coverage can exceed 70% at the sub-national level, based on a one-hour travel time threshold. The differences are most notable in large and sparsely populated administrative units and dramatically shape patterns of healthcare accessibility at national and sub-national levels. Conclusions The results of this study show how valuable and critical a comparative analysis between population datasets is for the derivation of coverage statistics that inform local policies and monitor global targets. Large differences exist between the datasets and the results underscore an essential source of uncertainty in accessibility analyses that should be systematically assessed.
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Affiliation(s)
- Fleur Hierink
- GeoHealth group, Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Institute for Environmental Sciences, University of Geneva, Geneva, Switzerland
| | - Gianluca Boo
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK
- Small Arms Survey, The Graduate Institute, Geneva, Switzerland
| | - Peter M. Macharia
- Population Health Unit, Kenya Medical Research Institute - Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Health Informatics, Computing and Statistics, Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Paul O. Ouma
- Population Health Unit, Kenya Medical Research Institute - Wellcome Trust Research Programme, Nairobi, Kenya
| | - Pablo Timoner
- GeoHealth group, Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Institute for Environmental Sciences, University of Geneva, Geneva, Switzerland
| | - Marc Levy
- CIESIN, The Center for International Earth Science Information Network, Columbia University, Palisades, NY USA
| | - Kevin Tschirhart
- CIESIN, The Center for International Earth Science Information Network, Columbia University, Palisades, NY USA
| | - Stefan Leyk
- Department of Geography, University of Colorado in Boulder, Boulder, CO USA
| | - Nicholas Oliphant
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - Andrew J. Tatem
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, UK
| | - Nicolas Ray
- GeoHealth group, Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Institute for Environmental Sciences, University of Geneva, Geneva, Switzerland
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3
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Mahachi K, Kessels J, Boateng K, Jean Baptiste Achoribo AE, Mitula P, Ekeman E, Nic Lochlainn L, Rosewell A, Sodha SV, Abela-Ridder B, Gabrielli AF. Zero- or missed-dose children in Nigeria: Contributing factors and interventions to overcome immunization service delivery challenges. Vaccine 2022; 40:5433-5444. [PMID: 35973864 PMCID: PMC9485449 DOI: 10.1016/j.vaccine.2022.07.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 06/11/2022] [Accepted: 07/24/2022] [Indexed: 11/28/2022]
Abstract
Comprehensive review of recent literature on zero- or missed-dose children in Nigeria. Risk factors are well-known and widely studied. Literature on interventions was scattered, and focussed on campaigns and polio. Gaps exist in investigating how to deliver sustainable immunization programs. Further work is needed to operationalise findings of this review.
'Zero-dose' refers to a person who does not receive a single dose of any vaccine in the routine national immunization schedule, while ‘missed dose’ refers to a person who does not complete the schedule. These people remain vulnerable to vaccine-preventable diseases, and are often already disadvantaged due to poverty, conflict, and lack of access to basic health services. Globally, more 22.7 million children are estimated to be zero- or missed-dose, of which an estimated 3.1 million (∼14 %) reside in Nigeria. We conducted a scoping review to synthesize recent literature on risk factors and interventions for zero- and missed-dose children in Nigeria. Our search identified 127 papers, including research into risk factors only (n = 66); interventions only (n = 34); both risk factors and interventions (n = 18); and publications that made recommendations only (n = 9). The most frequently reported factors influencing childhood vaccine uptake were maternal factors (n = 77), particularly maternal education (n = 22) and access to ante- and perinatal care (n = 19); heterogeneity between different types of communities – including location, region, wealth, religion, population composition, and other challenges (n = 50); access to vaccination, i.e., proximity of facilities with vaccines and vaccinators (n = 37); and awareness about immunization – including safety, efficacy, importance, and schedules (n = 18). Literature assessing implementation of interventions was more scattered, and heavily skewed towards vaccination campaigns and polio eradication efforts. Major evidence gaps exist in how to deliver effective and sustainable routine childhood immunization. Overall, further work is needed to operationalise the learnings from these studies, e.g. through applying findings to Nigeria’s next review of vaccination plans, and using this summary as a basis for further investigation and specific recommendations on effective interventions.
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Affiliation(s)
- Kurayi Mahachi
- College of Public Health, University of Iowa, Iowa City, Iowa, United States
| | | | - Kofi Boateng
- Nigeria Country Office, World Health Organization, Abuja, Nigeria
| | | | - Pamela Mitula
- Inter-Country Support Team, Regional Office for Africa, World Health Organization, Ouagadougou, Burkina Faso
| | - Ebru Ekeman
- Department of Immunization, Vaccines and Biologicals (IVB), World Health Organization, Geneva, Switzerland
| | - Laura Nic Lochlainn
- Department of Immunization, Vaccines and Biologicals (IVB), World Health Organization, Geneva, Switzerland
| | - Alexander Rosewell
- Department of Immunization, Vaccines and Biologicals (IVB), World Health Organization, Geneva, Switzerland
| | - Samir V Sodha
- Department of Immunization, Vaccines and Biologicals (IVB), World Health Organization, Geneva, Switzerland
| | - Bernadette Abela-Ridder
- Department of Control of Neglected Tropical Diseases (NTD), World Health Organization, Geneva, Switzerland
| | - Albis Francesco Gabrielli
- Department of Control of Neglected Tropical Diseases (NTD), World Health Organization, Geneva, Switzerland.
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4
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Using Community Engagement and Geographic Information Systems to Address COVID-19 Vaccination Disparities. Trop Med Infect Dis 2022; 7:tropicalmed7080177. [PMID: 36006269 PMCID: PMC9413290 DOI: 10.3390/tropicalmed7080177] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 11/25/2022] Open
Abstract
The COVID-19 pandemic has exacerbated existing health disparities and had a disproportionate impact on racial and ethnic minority groups in the United States. Limited COVID-19 data for Asian Americans have led to less attention for this population; nevertheless, available statistics have revealed lesser known impacts of COVID-19 on this population. Even with significant increases in vaccine supply and recent increases in COVID-19 vaccination rates, racial and ethnic disparities in vaccine uptake still persist. These disparities are amplified for individuals with limited English proficiency (LEP). The purpose of this paper is to apply community-engaged and geographic information system (GIS) strategies to increase equitable access to COVID-19 vaccination uptake by decreasing the structural barriers to COVID-19 vaccine uptake, with a particular focus on Asian Americans with LEP. Building upon existing community-academic partnerships between the academic unit and community-based organizations, the project team established community-led mobile and pop-up COVID-19 vaccination clinics to reach underserved individuals in their communities, worked with commercial pharmacies and reserved appointments for community-based organizations, used GIS to establish COVID-19 vaccination sites close to communities with the greatest need, and deployed trusted messengers to deliver linguistically and culturally relevant COVID-19 vaccine messages which built vaccine confidence among the community members. The implementation of mobile clinics expanded COVID-19 vaccine access and community-driven, multi-sector partnerships can increase the capacity to enhance efforts and facilitate access to COVID-19 vaccination for hard-to-reach populations.
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5
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Tatem AJ. Small area population denominators for improved disease surveillance and response. Epidemics 2022; 40:100597. [PMID: 35749928 PMCID: PMC9212890 DOI: 10.1016/j.epidem.2022.100597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022] Open
Abstract
The Covid-19 pandemic has highlighted the value of strong surveillance systems in supporting our abilities to respond rapidly and effectively in mitigating the impacts of infectious diseases. A cornerstone of such systems is basic subnational scale data on populations and their demographics, which enable the scale of outbreaks to be assessed, risk to specific groups to be determined and appropriate interventions to be designed. Ongoing weaknesses and gaps in such data have however been highlighted by the pandemic. These can include outdated or inaccurate census data and a lack of administrative and registry systems to update numbers, particularly in low and middle income settings. Efforts to design and implement globally consistent geospatial modelling methods for the production of small area demographic data that can be flexibly integrated into health-focussed surveillance and information systems have been made, but these often remain based on outdated population data or uncertain projections. In recent years, efforts have been made to capitalise on advances in computing power, satellite imagery and new forms of digital data to construct methods for estimating small area population distributions across national and regional scales in the absence of full enumeration. These are starting to be used to complement more traditional data collection approaches, especially in the delivery of health interventions, but barriers remain to their widespread adoption and use in disease surveillance and response. Here an overview of these approaches is presented, together with discussion of future directions and needs.
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Affiliation(s)
- A J Tatem
- WorldPop, School of Geography and Environmental Science, University of Southampton, UK
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6
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Rivas AL, van Regenmortel MHV. COVID-19 related interdisciplinary methods: Preventing errors and detecting research opportunities. Methods 2021; 195:3-14. [PMID: 34029715 PMCID: PMC8545872 DOI: 10.1016/j.ymeth.2021.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/12/2022] Open
Abstract
More than 130,000 peer-reviewed studies have been published within one year after COVID-19 emerged in many countries. This large and rapidly growing field may overwhelm the synthesizing abilities of both researchers and policy-makers. To provide a sinopsis, prevent errors, and detect cognitive gaps that may require interdisciplinary research methods, the literature on COVID-19 is summarized, twice. The overall purpose of this study is to generate a dialogue meant to explain the genesis of and/or find remedies for omissions and contradictions. The first review starts in Biology and ends in Policy. Policy is chosen as a destination because it is the setting where cognitive integration must occur. The second review follows the opposite path: it begins with stated policies on COVID-19 and then their assumptions and disciplinary relationships are identified. The purpose of this interdisciplinary method on methods is to yield a relational and explanatory view of the field -one strategy likely to be incomplete but usable when large bodies of literature need to be rapidly summarized. These reviews identify nine inter-related problems, research needs, or omissions, namely: (1) nation-wide, geo-referenced, epidemiological data collection systems (open to and monitored by the public); (2) metrics meant to detect non-symptomatic cases -e.g., test positivity-; (3) cost-benefit oriented methods, which should demonstrate they detect silent viral spreaders even with limited testing; (4) new personalized tests that inform on biological functions and disease correlates, such as cell-mediated immunity, co-morbidities, and immuno-suppression; (5) factors that influence vaccine effectiveness; (6) economic predictions that consider the long-term consequences likely to follow epidemics that growth exponentially; (7) the errors induced by self-limiting and/or implausible paradigms, such as binary and reductionist approaches; (8) new governance models that emphasize problem-solving skills, social participation, and the use of scientific knowledge; and (9) new educational programs that utilize visual aids and audience-specific communication strategies. The analysis indicates that, to optimally address these problems, disciplinary and social integration is needed. By asking what is/are the potential cause(s) and consequence(s) of each issue, this methodology generates visualizations that reveal possible relationships as well as omissions and contradictions. While inherently limited in scope and likely to become obsolete, these shortcomings are avoided when this 'method on methods' is frequently practiced. Open-ended, inter-/trans-disciplinary perspectives and broad social participation may help researchers and citizens to construct, de-construct, and re-construct COVID-19 related research.
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Affiliation(s)
- Ariel L Rivas
- Center for Global Health, School of Medicine, University of New Mexico, Albuquerque, NM, United States.
| | - Marc H V van Regenmortel
- University of Vienna, Austria; and Higher School of Biotechnology, University of Strasbourg, and French National Research Center, France
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7
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Awad SF, Musuka G, Mukandavire Z, Froass D, MacKinnon NJ, Cuadros DF. Implementation of a Vaccination Program Based on Epidemic Geospatial Attributes: COVID-19 Pandemic in Ohio as a Case Study and Proof of Concept. Vaccines (Basel) 2021; 9:1242. [PMID: 34835173 PMCID: PMC8625927 DOI: 10.3390/vaccines9111242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/05/2021] [Accepted: 10/21/2021] [Indexed: 12/20/2022] Open
Abstract
Geospatial vaccine uptake is a critical factor in designing strategies that maximize the population-level impact of a vaccination program. This study uses an innovative spatiotemporal model to assess the impact of vaccination distribution strategies based on disease geospatial attributes and population-level risk assessment. For proof of concept, we adapted a spatially explicit COVID-19 model to investigate a hypothetical geospatial targeting of COVID-19 vaccine rollout in Ohio, United States, at the early phase of COVID-19 pandemic. The population-level deterministic compartmental model, incorporating spatial-geographic components at the county level, was formulated using a set of differential equations stratifying the population according to vaccination status and disease epidemiological characteristics. Three different hypothetical scenarios focusing on geographical subpopulation targeting (areas with high versus low infection intensity) were investigated. Our results suggest that a vaccine program that distributes vaccines equally across the entire state effectively averts infections and hospitalizations (2954 and 165 cases, respectively). However, in a context with equitable vaccine allocation, the number of COVID-19 cases in high infection intensity areas will remain high; the cumulative number of cases remained >30,000 cases. A vaccine program that initially targets high infection intensity areas has the most significant impact in reducing new COVID-19 cases and infection-related hospitalizations (3756 and 213 infections, respectively). Our approach demonstrates the importance of factoring geospatial attributes to the design and implementation of vaccination programs in a context with limited resources during the early stage of the vaccine rollout.
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Affiliation(s)
- Susanne F. Awad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine—Qatar, Cornell University, Doha 24144, Qatar;
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine—Qatar, Cornell University, Doha 24144, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY 10065, USA
| | | | - Zindoga Mukandavire
- Centre for Data Science and Artificial Intelligence, Emirates Aviation University, Dubai 53044, United Arab Emirates;
| | - Dillon Froass
- College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA;
| | - Neil J. MacKinnon
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Diego F. Cuadros
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, OH 45221, USA
- Health Geography and Disease Modeling Laboratory, University of Cincinnati, Cincinnati, OH 45221, USA
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8
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Augusto Hernandes Rocha T, Grapiuna de Almeida D, Shankar Kozhumam A, Cristina da Silva N, Bárbara Abreu Fonseca Thomaz E, Christine de Sousa Queiroz R, de Andrade L, Staton C, Ricardo Nickenig Vissoci J. Microplanning for designing vaccination campaigns in low-resource settings: A geospatial artificial intelligence-based framework. Vaccine 2021; 39:6276-6282. [PMID: 34538526 PMCID: PMC8496523 DOI: 10.1016/j.vaccine.2021.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/30/2021] [Accepted: 09/03/2021] [Indexed: 11/30/2022]
Abstract
Existing campaign-based healthcare delivery programs used for immunization often fall short of established health coverage targets due to a lack of accurate estimates for population size and location. A microplan, an integrated set of detailed planning components, can be used to identify this information to support programs such as equitable vaccination efforts. Here, we presents a series of steps necessary to create an artificial intelligence-based framework for automated microplanning, and our pilot implementation of this analysis tool across 29 countries of the Americas. Further, we describe our processes for generating a conceptual framework, creating customized catchment areas, and estimating up-to-date populations to support microplanning for health campaigns. Through our application of the present framework, we found that 68 million individuals across the 29 countries are within 5 km of a health facility. The number of health facilities analyzed ranged from 2 in Peru to 789 in Argentina, while the total population within 5 km ranged from 1,233 in Peru to 15,304,439 in Mexico. Our results demonstrate the feasibility of using this methodological framework to support the development of customized microplans for health campaigns using open-source data in multiple countries. The pandemic is demanding an improved capacity to generate successful, efficient immunization campaigns; we believe that the steps described here can increase the automation of microplans in low resource settings.
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Affiliation(s)
| | | | | | - Núbia Cristina da Silva
- Methods, Analytics and Technology for Health (M.A.T.H) Consortium, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Luciano de Andrade
- Department of Medicine, State University of Maringá, Maringá, Paraná, Brazil..
| | - Catherine Staton
- Duke Global Health Institute, Duke University, Durham, NC, United States of America; Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Duke University, North Carolina, United States of America.
| | - João Ricardo Nickenig Vissoci
- Duke Global Health Institute, Duke University, Durham, NC, United States of America; Division of Emergency Medicine, Department of Surgery, Duke University School of Medicine, Duke University, North Carolina, United States of America.
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Chaney SC, Mechael P, Thu NM, Diallo MS, Gachen C. Every Child on the Map: A Theory of Change Framework for Improving Childhood Immunization Coverage and Equity Using Geospatial Data and Technologies. J Med Internet Res 2021; 23:e29759. [PMID: 34342584 PMCID: PMC8371486 DOI: 10.2196/29759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/14/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
The effective use of geospatial data and technologies to collect, manage, analyze, model, and visualize geographic data has great potential to improve data-driven decision-making for immunization programs. This article presents a theory of change for the use of geospatial technologies for immunization programming-a framework to illustrate the ways in which geospatial data and technologies can contribute to improved immunization outcomes and have a positive impact on childhood immunization coverage rates in low- and middle-income countries. The theory of change is the result of a review of the state of the evidence and literature; consultation with implementers, donors, and immunization and geospatial technology experts; and a review of country-level implementation experiences. The framework illustrates how the effective use of geospatial data and technologies can help immunization programs realize improvements in the number of children immunized by producing reliable estimates of target populations, identifying chronically missed settlements and locations with the highest number of zero-dose and under-immunized children, and guiding immunization managers with solutions to optimize resource distribution and location of health services. Through these direct effects on service delivery, geospatial data and technologies can contribute to the strengthening of the overall health system with equity in immunization coverage. Recent implementation of integrated geospatial data and technologies for the immunization program in Myanmar demonstrate the process that countries may experience on the path to achieving lasting systematic improvements. The theory of change presented here may serve as a guide for country program managers, implementers, donors, and other stakeholders to better understand how geospatial tools can support immunization programs and facilitate integrated service planning and equitable delivery through the unifying role of geography and geospatial data.
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Affiliation(s)
| | | | | | - Mamadou S Diallo
- Data and Analytics Unit, Department of Analysis, Planning & Monitoring, UNICEF, New York, NY, United States
| | - Carine Gachen
- Gavi, the Vaccine Alliance, Health Information Systems and Digital Health Information, Geneva, Switzerland
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Rocha TAH, Boitrago GM, Mônica RB, Almeida DGD, Silva NCD, Silva DM, Terabe SH, Staton C, Facchini LA, Vissoci JRN. National COVID-19 vaccination plan: using artificial spatial intelligence to overcome challenges in Brazil. CIENCIA & SAUDE COLETIVA 2021; 26:1885-1898. [PMID: 34076129 DOI: 10.1590/1413-81232021265.02312021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/14/2021] [Indexed: 11/22/2022] Open
Abstract
This article explores the use of spatial artificial intelligence to estimate the resources needed to implement Brazil's COVID-19 immu nization campaign. Using secondary data, we conducted a cross-sectional ecological study adop ting a time-series design. The unit of analysis was Brazil's primary care centers (PCCs). A four-step analysis was performed to estimate the popula tion in PCC catchment areas using artificial in telligence algorithms and satellite imagery. We also assessed internet access in each PCC and con ducted a space-time cluster analysis of trends in cases of SARS linked to COVID-19 at municipal level. Around 18% of Brazil's elderly population live more than 4 kilometer from a vaccination point. A total of 4,790 municipalities showed an upward trend in SARS cases. The number of PCCs located more than 5 kilometer from cell towers was largest in the North and Northeast regions. Innovative stra tegies are needed to address the challenges posed by the implementation of the country's National COVID-19 Vaccination Plan. The use of spatial artificial intelligence-based methodologies can help improve the country's COVID-19 response.
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Affiliation(s)
- Thiago Augusto Hernandes Rocha
- Duke Global Health Institute, Duke University, Global Emergency Medicine Innovation and Implementation Research. 310, Trent Drive, Durham North Carolina USA.
| | | | | | | | - Núbia Cristina da Silva
- Duke Global Health Institute, Duke University, Global Emergency Medicine Innovation and Implementation Research. 310, Trent Drive, Durham North Carolina USA.
| | | | - Sandro Haruyuki Terabe
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
| | - Catherine Staton
- Duke Global Health Institute, Duke University, Global Emergency Medicine Innovation and Implementation Research. 310, Trent Drive, Durham North Carolina USA.
| | - Luiz Augusto Facchini
- Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal de Pelotas. Pelotas RS Brasil
| | - João Ricardo Nickenig Vissoci
- Duke Global Health Institute, Duke University, Global Emergency Medicine Innovation and Implementation Research. 310, Trent Drive, Durham North Carolina USA.
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Mendes A, Palmer T, Berens A, Espey J, Price R, Mallya A, Brown S, Martinez M, Farag N, Kaplan B. Mapathons versus automated feature extraction: a comparative analysis for strengthening immunization microplanning. Int J Health Geogr 2021; 20:27. [PMID: 34098981 PMCID: PMC8185952 DOI: 10.1186/s12942-021-00277-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/09/2021] [Indexed: 11/20/2022] Open
Abstract
Background Social instability and logistical factors like the displacement of vulnerable populations, the difficulty of accessing these populations, and the lack of geographic information for hard-to-reach areas continue to serve as barriers to global essential immunizations (EI). Microplanning, a population-based, healthcare intervention planning method has begun to leverage geographic information system (GIS) technology and geospatial methods to improve the remote identification and mapping of vulnerable populations to ensure inclusion in outreach and immunization services, when feasible. We compare two methods of accomplishing a remote inventory of building locations to assess their accuracy and similarity to currently employed microplan line-lists in the study area. Methods The outputs of a crowd-sourced digitization effort, or mapathon, were compared to those of a machine-learning algorithm for digitization, referred to as automatic feature extraction (AFE). The following accuracy assessments were employed to determine the performance of each feature generation method: (1) an agreement analysis of the two methods assessed the occurrence of matches across the two outputs, where agreements were labeled as “befriended” and disagreements as “lonely”; (2) true and false positive percentages of each method were calculated in comparison to satellite imagery; (3) counts of features generated from both the mapathon and AFE were statistically compared to the number of features listed in the microplan line-list for the study area; and (4) population estimates for both feature generation method were determined for every structure identified assuming a total of three households per compound, with each household averaging two adults and 5 children. Results The mapathon and AFE outputs detected 92,713 and 53,150 features, respectively. A higher proportion (30%) of AFE features were befriended compared with befriended mapathon points (28%). The AFE had a higher true positive rate (90.5%) of identifying structures than the mapathon (84.5%). The difference in the average number of features identified per area between the microplan and mapathon points was larger (t = 3.56) than the microplan and AFE (t = − 2.09) (alpha = 0.05). Conclusions Our findings indicate AFE outputs had higher agreement (i.e., befriended), slightly higher likelihood of correctly identifying a structure, and were more similar to the local microplan line-lists than the mapathon outputs. These findings suggest AFE may be more accurate for identifying structures in high-resolution satellite imagery than mapathons. However, they both had their advantages and the ideal method would utilize both methods in tandem.
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Affiliation(s)
- Amalia Mendes
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substance and Disease Registry, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA.
| | - Tess Palmer
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substance and Disease Registry, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Andrew Berens
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substance and Disease Registry, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Julie Espey
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substance and Disease Registry, 4770 Buford Hwy NE, Atlanta, GA, 30341, USA
| | - Rhiannan Price
- Sustainable Development Practice, Maxar Technologies, 1300 W 120th Avenue, Westminster, CO, 80234, USA
| | - Apoorva Mallya
- Polio Program, Bill & Melinda Gates Foundation, 500 5th Ave N, Seattle, WA, 98109, USA
| | - Sidney Brown
- Polio Program, Bill & Melinda Gates Foundation, 500 5th Ave N, Seattle, WA, 98109, USA
| | - Maureen Martinez
- Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA
| | - Noha Farag
- Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA
| | - Brian Kaplan
- Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA
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12
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Krzysztofowicz S, Osińska-Skotak K. The Use of GIS Technology to Optimize COVID-19 Vaccine Distribution: A Case Study of the City of Warsaw, Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5636. [PMID: 34070378 PMCID: PMC8197485 DOI: 10.3390/ijerph18115636] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/17/2021] [Accepted: 05/24/2021] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic is a global challenge, and the key to tackling it is vaccinating a specified percentage of the population to acquire herd immunity. The observed problems with the efficiency of the vaccination campaigns in numerous countries around the world, as well as the approach used at the initial stage of the National Immunization Program in Poland, prompted us to analyse the possibility of using GIS technology to optimize the distribution of vaccines to vaccination sites so as to minimize the period needed to vaccinate individual population groups. The research work was carried out on the example of Warsaw, the capital of Poland and the city with the largest population in the country. The analyses were carried out for the 60-70 and 50-60 age groups, in various approaches and for vaccines of different companies (Moderna, BioNTech, AstraZeneca), used to vaccinate people in Poland. The proposed approach to optimize vaccine distribution uses Thiessen's tessellation to obtain information on the number of people in a given population group living in the area of each vaccination site, and then to estimate the time needed to vaccinate that group. Compared to the originally used vaccination scenario with limited availability of vaccines, the proposed approach allows practitioners to design fast and efficient distribution scenarios. With the developed methodology, we demonstrated ways to achieve uniform vaccination coverage throughout the city. We anticipate that the proposed approach can be easily automated and broadly applied to various urban settings.
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Affiliation(s)
| | - Katarzyna Osińska-Skotak
- Department of Photogrammetry, Remote Sensing and Spatial Information Systems, Faculty of Geodesy and Cartography, Warsaw University of Technology, 00-661 Warsaw, Poland;
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Brooker SJ, Ziumbe K, Negussu N, Crowley S, Hammami M. Neglected tropical disease control in a world with COVID-19: an opportunity and a necessity for innovation. Trans R Soc Trop Med Hyg 2021; 115:205-207. [PMID: 33367883 PMCID: PMC7798689 DOI: 10.1093/trstmh/traa157] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/05/2020] [Accepted: 11/18/2020] [Indexed: 02/05/2023] Open
Abstract
Countries have seen substantial disruptions to usual health services related to coronavirus disease 2019 and these are likely to have immediate and long-term indirect effects on many disease control programmes, including neglected tropical diseases (NTDs). The pandemic has highlighted the usefulness of mathematical modelling to understand the impacts of these disruptions and future control measures on progress towards 2030 NTD goals. The pandemic also provides an opportunity, and a practical necessity, to transform NTD programmes through innovation.
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Affiliation(s)
| | | | - Nebiyu Negussu
- Children's Investment Fund Foundation, Addis Ababa, Ethiopia
| | | | - Mona Hammami
- Crown Prince Court, Abu Dhabi, United Arab Emirates
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