Abstract
In Colombia, as in many Latin American countries, decision making and development of effective strategies for vector control of urban diseases such as dengue, Zika, and chikungunya is challenging for local health authorities. The heterogeneity of transmission in urban areas requires an efficient risk-based allocation of resources to control measures. With the objective of strengthening the capacity of local surveillance systems to identify variables that favor urban arboviral transmission, a multidisciplinary research team collaborated with the local Secretary of Health officials of 3 municipalities in Colombia (Giron, Yopal, and Buga), in the design of an integrated information system called VECTOS from 2015 to 2018. Information and communication technologies were used to develop 2 mobile applications to capture entomological and social information, as well as a web-based system for the collection, geo-referencing, and integrated information analysis using free geospatial software. This system facilitates the capture and analysis of epidemiological information from the Colombian national surveillance system (SIVIGILA), periodic entomological surveys-mosquito larvae and pupae in premises and peridomestic breeding sites-and surveys of knowledge, attitudes, and practices (KAP) in a spatial and temporal context at the neighborhood level. The data collected in VECTOS are mapped and visualized in graphical reports. The system enables real-time monitoring of weekly epidemiological indicators, entomological indices, and social surveys. Additionally, the system enables risk stratification of neighborhoods, using selected epidemiological, entomological, demographic, and environmental variables. This article describes the VECTOS system and the lessons learned during its development and use. The joint analysis of epidemiological and entomological data within a geographic information system in VECTOS gives better insight to the routinely collected data and identifies the heterogeneity of risk factors between neighborhoods. We expect the system to continue to strengthen vector control programs in evidence-based decision making and in the design and enhanced follow-up of vector control strategies.
Highlights
Global Health: Science and Practice 2019 | Volume 7 | Number 1 there is a concentration of larval habitats, especially artificial water containers, and an abundance of human hosts within the relatively short flight range of the Aedes vectors.[1]
There are still limitations to be addressed in terms of routine application of the system. These limitations include infrequent updating of municipal planning information in terms of neighborhood definitions and numbers of inhabitants; an unclear legal process required for the national heath entities (Colombian Ministry of Health and Social Protection and National Institute of Health) to authorize technological tools to capture official information; lack of knowledge and use of the software components among officials; and inadequate primary data collection in terms of frequency, sample size, and design of vector control strategies based on the analyses
Identification of risks in the 3 municipalities enabled us to identify neighborhoods with higher transmission risk aIndicated by purple dots over the epidemiological risk map
Summary
Global Health: Science and Practice 2019 | Volume 7 | Number 1 there is a concentration of larval habitats, especially artificial water containers, and an abundance of human hosts within the relatively short flight range of the Aedes vectors.[1]. The design of the VECTOS web system was based on the characterization of routine data collection and analysis by the Municipal Health Secretariat and the Colombian national guidance on epidemiology and entomology. These data were analyzed based on city maps and demographic information. VECTOS captures epidemiological, entomological, and social data at the neighborhood level, which can be aggregated by commune (comuna) administrative division or sector It is a web-based information system with a service-oriented architecture that offers robustness in terms of stability and security access and flexibility when interacting with other systems. No automatic alerts have yet been created for the system
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