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. 2013 Aug 6;8(8):e70231.
doi: 10.1371/journal.pone.0070231. Print 2013.

Nation-wide, web-based, geographic information system for the integrated surveillance and control of dengue fever in Mexico

Juan Eugenio Hernández-Ávila  1 , Mario-Henry Rodríguez, René Santos-Luna, Veronica Sánchez-Castañeda, Susana Román-Pérez, Víctor Hugo Ríos-Salgado, Jesús Alberto Salas-Sarmiento
Affiliations

Nation-wide, web-based, geographic information system for the integrated surveillance and control of dengue fever in Mexico

Juan Eugenio Hernández-Ávila et al. PLoS One. .

Abstract

Dengue fever incidence and its geographical distribution are increasing throughout the world. Quality and timely information is essential for its prevention and control. A web based, geographically enabled, dengue integral surveillance system (Dengue-GIS) was developed for the nation-wide collection, integration, analysis and reporting of geo-referenced epidemiologic, entomologic, and control interventions data. Consensus in the design and practical operation of the system was a key factor for its acceptance. Working with information systems already implemented as a starting point facilitated its acceptance by officials and operative personnel. Dengue-GIS provides the geographical detail needed to plan, asses and evaluate the impact of control activities. The system is beginning to be adopted as a knowledge base by vector control programs. It is used to generate evidence on impact and cost-effectiveness of control activities, promoting the use of information for decision making at all levels of the vector control program. Dengue-GIS has also been used as a hypothesis generator for the academic community. This GIS-based model system for dengue surveillance and the experience gathered during its development and implementation could be useful in other dengue endemic countries and extended to other infectious or chronic diseases.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Incidence of dengue cases in Mexico during the period 2008 to 2011.
Dengue cases have been reported in 30 of the 32 Mexican states. Geo-referenced case reporting started in 2008 when the EPS began interoperating with Dengue-GIS.
Figure 2
Figure 2. Conceptual Framework.
Epidemiological and entomological data are entered and analyzed to produce risk maps which are then used to direct vector control activities. New epidemiological and entomological data are used to assess the impact of control activities thus generating a knowledge database which can be used to evaluate cost-effectiveness of control measures, accountability and operational research. Control interventions are directed according to the risk maps and entered into the system for impact evaluation in the reduction of cases and/or vector population.
Figure 3
Figure 3. Web-based geographic Information System for integrated dengue epidemiologic surveillance and control data flow diagram.
Epidemiological data on probable case is entered into the system at the health center or sent in paper form to the sanitary jurisdiction where is entered into the EPS system. The case is simultaneously geo-coded and data stored in the geodatabase. Laboratory results from blood samples, taken to a portion of the probable cases, enters the system and serves to update the EPS and Dengue GIS data base. Entomological surveillance data and control activities are entered into the Geodatabase by vector control personnel. The integration of these data is used to produce risk maps.
Figure 4
Figure 4. Screenshot of Dengue-GIS application.
Dengue-GIS screenshot showing the distribution of probable cases and case clusters (high transmission areas) during the CDC weeks 22–24 2012 in Linares City, Nuevo Leon. Locations of entomological survey activities during the same period are shown in red. DF cases accumulation in space and time is showed by a set of ellipses which represent the graphical output of the cluster detection algorithm. Two areas, one very close to downtown Linares, and the other to the west of the city show three intersecting ellipses, this indicates that transmission occurred uninterrupted during the three week period showed. Cases are represented by dots; red dots are laboratory confirmed cases, green dots are cases discarded by laboratory tests (other disease) and yellow dots are those for which there is not available laboratory data (either because it was not selected for blood test, according to surveillance protocol or because the public health laboratory has not yet got/entered the respective results). Red squares represent the city block where the entomological surveys were carried out, showing emergency results. Entomological surveys are a separate surveillance activity in which information about the conditions of households is collected. Pictures presented here were modified to translate the text presented to English; the actual Dengue-GIS is an all-Spanish language system.
Figure 5
Figure 5. Screenshot of Dengue-GIS application showing the transmission risk index.
Every Tuesday an evaluation of the abundance of the vector population, estimated by the mean number of eggs per city block and the presence of probable dengue cases is carried-out. The color coded circles represent areas of differential dengue transmission risk: high (red), moderate-high (orange) and moderate-low (yellow). Low risk areas are not shown.
See this image and copyright information in PMC

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Publication types

Grants and funding

This study was funded by the National Council for Science and Technology “CONACyT” (http://www.conacyt.gob.mx). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.