Abstract
Background Identifying fine-scale spatial patterns of disease is essential for effective disease control and elimination programmes. In low resource areas without formal addresses, novel strategies are needed to locate residences of individuals attending health facilities in order to efficiently map disease patterns. We aimed to assess the use of Android tablet-based applications containing high resolution maps to geolocate individual residences, whilst comparing the functionality, usability and cost of three software packages designed to collect spatial information.ResultsUsing Open Data Kit GeoODK, we designed and piloted an electronic questionnaire for rolling cross sectional surveys of health facility attendees as part of a malaria elimination campaign in two predominantly rural sites in the Rizal, Palawan, the Philippines and Kulon Progo Regency, Yogyakarta, Indonesia. The majority of health workers were able to use the tablets effectively, including locating participant households on electronic maps. For all households sampled (n = 603), health facility workers were able to retrospectively find the participant household using the Global Positioning System (GPS) coordinates and data collected by tablet computers. Median distance between actual house locations and points collected on the tablet was 116 m (IQR 42–368) in Rizal and 493 m (IQR 258–886) in Kulon Progo Regency. Accuracy varied between health facilities and decreased in less populated areas with fewer prominent landmarks.ConclusionsResults demonstrate the utility of this approach to develop real-time high-resolution maps of disease in resource-poor environments. This method provides an attractive approach for quickly obtaining spatial information on individuals presenting at health facilities in resource poor areas where formal addresses are unavailable and internet connectivity is limited. Further research is needed on how to integrate these with other health data management systems and implement in a wider operational context.
Highlights
Identifying fine-scale spatial patterns of disease is essential for effective disease control and elimination programmes
As infectious disease control programmes move towards elimination, it is increasingly important to identify and target foci of transmission areas and understand the factors that may contribute to disease persistence in these locations [2,3,4]
These sites are targets of on-going research projects to enhance surveillance for malaria elimination aiming to establish, integrate and evaluate combinations of laboratory, clinical and epidemiological data collected during health facility surveys to estimate the magnitude and heterogeneity of malaria transmission
Summary
Identifying fine-scale spatial patterns of disease is essential for effective disease control and elimination programmes. As infectious disease control programmes move towards elimination, it is increasingly important to identify and target foci of transmission areas and understand the factors that may contribute to disease persistence in these locations [2,3,4]. [11, 12]) These studies typically use population-based cross-sectional surveys including GPS coordinates for patient households or frequently visited locations to map disease risks. When household surveys are not feasible, convenience sampling approaches targeting easy access groups can be used to estimate risks in a population. Examples of these approaches include school-based surveys These methods may not fully capture risks in the wider population but are substantially more cost effective to implement and may be more feasible in low resource settings
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