GEOGRAPHICAL INFORMATION SYSTEM

IN LYMPHATIC FILARIASIS

Bala Sakthi
Geographic Informatics
 Geographic Informatics is the science and
technology of gathering, storing,
analyzing, interpreting, modeling,
distributing and using spatially referenced
(georeferenced) information.
 Geographic Informatics is multidisciplinary
by nature and comprises a broad range of
disciplines, including surveying and
mapping, remote sensing, geographical
information systems (GIS), and the Global
Positioning System (GPS).
GIS: a formal definition

“A system for capturing, storing,

checking, integrating, manipulating,
analysing and displaying data which
are spatially referenced to the
Earth. This is normally considered
to involve a spatially referenced
computer database and appropriate
applications software”
 Digital
Mapping
Computer
Aided Photo-
Design grammetry

GIS

Databases Surveying

Remote
Sensing

Cross-disciplinary nature of GIS

GIS components

Spatial
data

GIS
Computer hardware /
?
Specific applications /
software tools decision making objectives
Spatial data storage
7,10
5,9
10

 Vector model
9,8
4,7
polygon as geometric objects:
1,6 8,6

5 2,5
6,6 points, lines, polygons
line 5,4

point
2,2 4,1

5 10

as image files
composed of grid-cells
(pixels)

 Raster model

7
Vector data model

 advantage of the vector data format: allows precise

representation of points, boundaries, and linear features.
 useful for analysis tasks that require accurate positioning,
 for defining spatial relationship (ie the connectivity and
adjacency) between coverage features (topology),
important for such purposes as network analysis (for
example to find an optimal path between two nodes in a
complex transport network)
 main disadvantage of vector data is that the boundaries of
the resulting map polygons are discrete (enclosed by well-
defined boundary lines), whereas in reality the map polygons
may represent continuous gradation or gradual change, as in
soil maps.
Raster data model

 good for representing indistinct boundaries

 thematic information on soil types, soil
moisture, vegetation, ground and
temperatures
 as reconnaissance satellites and aerial
surveys use raster-based scanners, the
information (ie scanned images) can be
directly incorporated into GIS
 the higher the grid resolution, the larger the
data file is going to be
 Modelling the real world

y
1 1 20 50
1 2 24 45
1 3 52 55
2 1 0 45 46 40
x ...

0000000200
0000100002
0010000000
0200002220
1 ...
11
DATA - Overlays

 Layer: A thematic plane of GIS features containing

geographically and logically related data
 Overlaying involves superimposing two or more map layers to
produce a new map layer.
 Overlaying (superimposing) several maps of a specific area
showing (separately) the Altitude, Temperature distribution, Soil
type, Rainfall, Relative humidity and so on.
GIS into Public Health
 Geographic Information Science (GIS) has many applications in the
field of Public Health.
 GIS has the ability to combine data from many sources for
identification and mapping of environmental factors associated with
disease factors which make it particularly useful for disease
surveillance and monitoring.
 It can be a useful tool for analyzing the spread of diseases in both
developed and developing countries as well as a management
strategy for allocating resources and for understanding high risk
areas of disease.
 Intervention in NTDs (Neglected Tropical Diseases) requires:
 Project planning in program context and population environment
 Situational awareness & decision support of ongoing issues,
problems, concerns
 Program and resource management (limited budget, personnel,
time, access)
 Evaluation of program efforts and outcomes
 GIS role in integrating public health practice: Information systems
to
 Enhance Surveillance in space and time
 Improve Intervention practices and policies
 Conduct Evaluation activities and assessment
GIS concepts are not new!
 London cholera epidemic 1854

Soho

+ Cholera death
Water pump

Summers, Judith. Soho -- A History of London's Most Colourful Neighborhood, Bloomsbury, London, 1989, pp. 113-117.
GIS in Lymphatic Filariasis

 Lymphatic Filariasis represents a major, vector-borne,

public-health problem in India.
 The existence of a national programme for Filariasis
control [designated the National Filaria Control
Programme (NFCP)] since 1955 attests to the
recognition by health planners of the public-health
importance of the disease in India.
 Mapping the geographical distribution of filarial infection
within countries allows the visualization, identification
and prioritization of target areas for intervention.
 Secondly, such maps are prerequisite for more precise
assessments of the endemic populations at risk,
enabling more accurate estimations of the overall drug
requirements for national programs for control.
FILARIA ENDEMIC DISTRICTS
Trend Of Average MF rate

Year 2004 2008

National 1.24 0.63

Average
DAYTIME SURVEY

“Front Door” survey data

collection
 Questionnaire for LF sampling field visit
Name of the individual:
Age: Sex: Marital status:
Infection status: MF/ LF/ Symptomatic MF/ Asymptomatic LF
District: Block: Village: Pincode:
Immunological Antigens tested: Antibodies tested: Other tests:
Testing Results:
Blood film test results Blood collected at: ___ PM/AM Blood smear result:
Positive MF / Negative
Locality Hygiene information Is there any water stagnant present nearby: Is there mosquitoes spread observed: Is there water drainage is proper in the
Yes/ No/NA Heavily/ Moderately/ No /NA locality:
Yes/ No /NA
Personal Hygiene information Is there clean lavatories and bathrooms with Is there mosquito nets surround the house: Is there mosquito propellant used
proper drainage: Yes/ No /NA regularly:
Yes/ No / NA Yes/ No / NA

LF Relevant Symptoms Hydrocele / Breastocele Lymphatic ducts Fever/ nausea/ others

Family and neighbor’s infection status Any of the family members with LF history: Any of the neighbors with LF history: If Yes Information regarding the
Yes / No/NA Yes / No/ NA infection:

History of any other vector borne Malarial infection status of the subject, family Any other parasitic and vector born disease among If Yes Information regarding the
diseases like malaria and neighbors the family and neighbors: infection:
Yes/ No / NA Yes/ No /NA

History of any other chronic infections Is there any chronic viral/ bacterial infections in Is there any chronic viral/ bacterial infections in the If Yes Information regarding the
among the individual family and the family: Neighbors: infection:
neighbors Yes / No / NA Yes / No / NA

History of Smoking and Alcoholic Does the subject have Smoking habit: Does the subject have Alcoholism:
behavior Heavily/ Moderately/ No / NA Heavily/ Moderately/ No

History of Non/ infectious diseases of Does the subject suffer from any non-infectious Does the subject suffer from any Auto-immune If Yes Information regarding the disease:
the subject diseases: disorders:
Yes / No/ NA Yes / No / NA
Treatment procedures underway Is DEC treatment is implemented to the subject: Is Mass Drug Administration is implemented to the Any other treatment procedures the
Yes/ No/ NA subject: subject undergoing for LF:
Yes/ No/ NA
Previous survey details: Is the subject surveyed previously for LF: Is the subject given blood sample for LF screening
Yes/ No/ NA before:
Yes/ No/ NA
Other Filarial infection status Loasis: Onchocerciasis:
Yes/ No/ NA Yes/ No/ NA
NFCP implementation details Is there National Filariasis control programme is If yes information regarding the NCFP
implemented: implementations:
Yes/ No/ NA
NIGHTTIME SPECIMEN COLLECTION
Specimen collection and recording
NIGHT is the critical time…
 System Components & Flow Chart of
advancements in GIS

Field Visit
Field Office
-Sampling &
System – Data
Questionnaire Publish
Storage

Research Central Server Repository

Lab analysis

7GP11_LymphFil05
 GOALS OF GIS IN LF
 Goals relevant to Surveillance and
Assessment
 Where are key locations of infected persons in
population
 Where are key locations of infected mosquito
populations
 Goals relevant to Program Intervention
and Management
 Do we need additional vector control (spraying)
of additional ponds?
 Do we need further MDA intervention planning
within 200 yard radius?
 Goals relevant to Program Evaluation and
22 Assessment
 GIS Case study (1073 Subjects)
 GIS mapping of LF in endemic areas in Gampaha District,
Srilanka; based on the epidemiological and entomological
screening.
 Objective: Development of a site directed map for LF
dispersed areas in Gampaha district, Srilanka as a guide to
target control activities.
 Methodology:
 Pre-identified 9 sites in Gampaha district for LF screening
 Epidemiological night-blood screening by blood smear test
 Entomological pool screening of vectors by conventional dissection
method for L1, L2 or L3 staging, PCR-ELISA using NV1&2 primers
specific for SspI repeats.
 Results:
 Epidemiological investigation: only 2 out of 9 sites were having mf +ve
subjects, among those 2 sites, Peliyagoda persists 3.4% of mf+ve
cases and the Hekiththa shows only 0.5% mf+ve subjects.
 Entomological investigation: 0-45 mosquitoes/household were
collected; Conventional microscopic investigation revealed -44.5% rate
of infestation, only 8.54% were positive mosquitoes and L1 density
was 1 per +ve mosquito.
gunawardana et al., Molecular Medicine Unit,Faculty of Medicine, University of Kelaniya,Ragama,Sri Lanka
 Objective of The present study

 Improvement of the analytical strategies in GIS tools

currently used in lymphatic filariasis
 Characterization of PCR-based, alt-2 intron-3 tandem
repeats (IR3) variation analysis to differentially
diagnose the major lymphatic filarial species B.
malayi and W. bancrofti among patients.
Methodology
 Development of the GIS by improving the analytical strategies
to improvise the LF-GIS.
 Consolidation of the old GIS data in LF among India.
 Addition of various new data in the current GIS survey of
the LF samples presently collected
 Subjecting the new data with the filarial infection details in
multiple analysis databases to upgrade the present LF-GIS.
 PCR analysis of IR3 variation among patients
 Collection of clinical samples from endemic areas during GIS
studies and isolation of mf genomic DNA.
 PCR analysis of IR3 variation among the mf DNA samples to
confirm and differentiate brugian filariasis from bancroftian
filariasis.
 
 Outcome of the Present study

 The improvement of GIS could potentially helps in

monitoring the LF endemic regions and the various
factors attribute the LF spread out also it helps to
develop new LF detection, monitoring and
eradication strategies. The development of sensitive
PCR based and Immunological based differential
detection methods could possibly provide a sensitive
LF diagnostic protocol and reduces the error rates.
Molecular Medicine Unit,Faculty of Medicine,UNiversity of
Kelaniya,Ragama,Sri Lanka