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Spatial Epidemiology in Zoonotic Parasitic Diseases: Insights Gained

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Spatial Epidemiology in Zoonotic Parasitic Diseases: Insights Gained Parasites & Vectors BioMed Central Meeting report Open Access Spatial epidemiology in zoonotic parasitic diseases: insights gained at the 1st International Symposium on Geospatial Health in Lijiang, China, 2007 Xiao-Nong Zhou*1, Shan Lv1,2, Guo-Jing Yang3, Thomas K Kristensen4, N Robert Bergquist5, Jürg Utzinger2 and John B Malone6 Address: 1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, PR China, 2Department of Public Health and Epidemiology, Swiss Tropical Institute, Basel, Switzerland, 3Jiangsu Institute of Parasitic Diseases, Wuxi, PR China, 4DBL – Institute for Health Research and Development, University of Copenhagen, Denmark, 5Ingerod, Brastad, Sweden and 6Department of Pathobiological Sciences, School of Veterinary Medicine, Skip Bertman Drive, Louisiana State University, Baton Rouge, LA, USA Email: Xiao-Nong Zhou* - [email protected]; Shan Lv - [email protected]; Guo-Jing Yang - [email protected]; Thomas K Kristensen - [email protected]; N Robert Bergquist - [email protected]; Jürg Utzinger - [email protected]; John B Malone - [email protected] * Corresponding author Published: 4 February 2009 Received: 12 August 2008 Accepted: 4 February 2009 Parasites & Vectors 2009, 2:10 doi:10.1186/1756-3305-2-10 This article is available from: http://www.parasitesandvectors.com/content/2/1/10 © 2009 Zhou et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract The 1st International Symposium on Geospatial Health was convened in Lijiang, Yunnan province, People's Republic of China from 8 to 9 September, 2007. The objective was to review progress made with the application of spatial techniques on zoonotic parasitic diseases, particularly in Southeast Asia. The symposium featured 71 presentations covering soil-transmitted and water- borne helminth infections, as well as arthropod-borne diseases such as leishmaniasis, malaria and lymphatic filariasis. The work made public at this occasion is briefly summarized here to highlight the advances made and to put forth research priorities in this area. Approaches such as geographical information systems (GIS), global positioning systems (GPS) and remote sensing (RS), including spatial statistics, web-based GIS and map visualization of field investigations, figured prominently in the presentation. Background in Tropical Diseases (TDR) [1], was held in conjunction The goal of the '1st International Symposium on Geospa- with the '7th Annual Meeting of the Regional Network for tial Health', convened in Lijiang, Yunnan province, Peo- Asian Schistosomiasis and Other Zoonotic Helminthi- ple's Republic of China from 8 to 9 September, 2007, was ases' (RNAS+; http://www.rnas.org.cn) [2]. It attracted to review advances made in the control of zoonotic para- more than 150 participants from 19 countries/regions sitic diseases through the use of geospatial tools. The sym- and international organizations and the 71 presentations, posium, organized by the Global Network for Geospatial including 10 plenary sessions, dealt with intervention Health http://www.gnosisGIS.org and supported by the strategies, risk profiling, spatio-temporal modeling of par- Ministry of Health (MoH) of China, the World Health asitic disease transmission, biological investigations to Organization (WHO), and the UNICEF/UNDP/World further our understanding of the interaction between vec- Bank/WHO Special Programme for Research and Training tors and/or intermediate hosts with the definitive human Page 1 of 16 (page number not for citation purposes) Parasites & Vectors 2009, 2:10 http://www.parasitesandvectors.com/content/2/1/10 host, as well as database management and sharing of data. other snail-borne diseases of medical and veterinary Geostatistical approaches and time series analyses have importance, and resulted in the establishment of the 'Glo- been employed in schistosomiasis control in China, bal Network for Geospatial Health' whose scope has since including random-effect modeling, transmission dynam- expanded to include also other widespread infectious dis- ics and Bayesian geostatistics. eases [1]. The current objectives of the network are to: The symposium was essentially an initiative intended to • facilitate the development of GIS-based early warning encourage local and international scientists to share data systems concerning infectious diseases; and geospatial health applications in compatible format with special emphasis on the region represented by the • collect data, produce risk maps, develop ecological site of the annual RNAS+ meeting. It had the form of an niche models, and distribute GIS health applications of open forum where the information from different regions general interest via its website; and diseases was freely exchanged. Results from simple cross-sectional surveys as well as advanced modeling, • offer training courses on health applications of geospa- such as that based on random-effects, spatio-temporal tial tools through an 'International School of Geospatial studies or transmission dynamics, were presented along Health'; and with Bayesian statistics and multidisciplinary theory. The overarching theme was 'Towards a Regional Information • publish Geospatial Health, an open-access, peer-reviewed System for Control of Parasitic Diseases in the Greater journal that focusses on health applications in the geospa- Mekong Sub-Region'. tial sciences, which accepts articles on all aspects of the application of GIS, RS and other spatial analytical tools in In the remote past, doctors could only observe the veterinary and public health. progress of, say the Black Death, but were powerless to interfere due to inadequate understanding of the cause, Zoonotic diseases, in particular parasitic diseases with while we now have an essentially full understanding of their dependence on intermediate hosts and/or vectors, infectious agents and their interrelation with humans, are closely linked to environment, ecology and climate vectors and intermediate hosts [3,4]. Moreover, technical [12,13]. Therefore, the spatial distribution of these dis- progress in recent decades has provided the necessary eases can reveal important information of their transmis- instruments to study these interrelationships in great sion. The symposium emphasized spatial techniques and detail using geographical information systems (GIS) and spatial analytic methods. GIS, global positioning systems satellite-based remote sensing (RS). This new approach to (GPS) and RS belong to the general toolbox of any studies the epidemiology has come into its own during the last in this field, while spatial statistics (spatial point pattern few years as it has become increasingly clear that, from the analysis and clustering analysis) lends itself particularly geological point of view, we live in a period of rapid envi- well to the study of schistosomiasis and leishmaniasis as ronmental transformation [5-7]. Already, areas have been shown below. identified where new incursions of diseases can be expected, e.g., schistosomiasis in northern China [8], General approach malaria at higher altitudes in Africa [9], and zoonotic dis- In the developing world, parasitic infections by multiple eases in southern Europe [10]. GIS and RS provide the species are the norm rather than the exception [14]. In early-warning tools needed to permit preemptive plan- view of the growing political and financial commitment ning to limit risk and impact. Remotely-sensed data on to control these parasitic diseases, there is a need to terrestrial characteristics and variables such as tempera- develop spatially-explicit databases so that control efforts ture, rainfall, humidity, along with other environmental can be targeted in an efficient and cost-effective manner factors, govern the distribution of infectious agents as well [15,16]. Therefore, the symposium had, as the main focus, as the intermediate hosts and vectors they might utilize. the establishment of spatial databases for risk profiling of Therefore, the application of this new technology has multiple species parasitic diseases. The introductory dis- been growing rapidly and nowhere is this more evident cussion illustrates how demographic, environmental and than with regard to parasitic diseases [11]. socio-economic data can be readily obtained from exist- ing village registries, simple cross-sectional questionnaire The application of geospatial activities summarized here surveys and remotely-sensed environmental data emanates originally from a team residency in April 2000 obtained from satellite sensors [17]. The information at the Bellagio Study and Conference Center in Italy, sought is very often available in the form of ground maps, sponsored by the Rockefeller Foundation. It was dedi- aerial photos, satellite images, whereas geographical coor- cated to the development of computer-based models for dinates are readily obtained by a GPS tool. When official improving control programmes for schistosomiasis and censuses cannot be obtained, the population data, includ- Page 2 of 16 (page number not for citation purposes) Parasites & Vectors 2009, 2:10 http://www.parasitesandvectors.com/content/2/1/10 ing demography and socio-economy, in the confined area retrieved by NDVI (FNDVI) and
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