A Geographical Database for the Control of ...

A Geographical Database for the Control of Leishmaniasis: 21st ESRI European Conference

The Case of Greater Athens, Greece. Tsatsaris A.1, Iliopoulou P.1, Katsios J.L1, Panagiotopoulou A.1, Koutsoumbis V.1, Tselentis Y.2, Papadopoulos V.2, Antoniou M.2 , Myridis M.3 1: Technological Educational Institute (T.E.I.) of Athens 2: University of Crete 3: Aristotelian University of Thessaloniki

NOVEMBER 2006 Greece

21st ESRI European Conference

The creation of the Geographical Database for the disease of Leishmaniasis is the main aim of a research project titled: “Peak Technologies in the Geographical Research. Study of Geographical Parameters of Distribution and Dissemination of Spatial Phenomena: Application in Zoonoses”. The project has started since 2004 in the framework of “Operational Program for Education and Initial Vocational Training (Archimedes Ι)” and funded by the Hellenic Ministry of Education and Religion Affairs. Research leader of this project is the Laboratory of GeoInformatics of the Dept. of Topography at the Technological Educational Institution of Athens. Scientifically cooperators are: The Laboratory of Microbiology, Parasitology, Zoonoses and Geographic Medicine of the Medical School of the University of Crete. The sector of Cartography, Photogrammetry and Cadastre of the School of Surveying at the University of Thessalonica. NOVEMBER 2006 Greece

A few words for the disease of Leishmaniasis


The disease of leishmaniasis caused from Leishmania parasite. In Greece occurred visceral and cutaneous type of the disease. Visceral Leishmaniasis known as kala – azar located almost in the whole country and offence mainly the small children. Source: Hellenic Ministry of Food and Agricultural Development NOVEMBER 2006 Greece

The parasite transmitted from dogs to other dogs and humans through arthropods called phlevotomines. Healthy Dog Infected Dog


Human

Phlevotomines are activated when the weather is hot (usually from May to October) and byte humans during the night. Source: Hellenic Ministry of Food and Agricultural Development NOVEMBER 2006 Greece

International Geographical Distribution Distribution of Visceral type of disease


Distribution of Cutaneous type of disease

Source: Leishnet (Network of 32 countries, supported by WHO) NOVEMBER 2006 Greece

Hypotheses of the study Based on the empirical evidence of the research carried out in 1992 :


There is a geographical dimension in the diffusion of the disease of leishmaniasis in the Greater Athens region The incidents of the disease are clustered in the foothills of the mountains which surround the Athens Basin The incidents of the disease tend to follow the urban expansions towards the mountains


Leishmaniasis in Greece The greater Athens region is one of the endemic areas of visceral leishmaniasis (VL) in Greece.


In 1992 a survey was carried out and sandflies were collected from May to October. Results of the study : sandflies and patients are concentrated in the foothills of the mountains surrounding the Athens Basin, while the main environmental factors accounting for the spread of the disease were temperature, rainfall and the existence of quarries.


Environmental Factors Elevation Vegetation (Presence and Density) Meteorological factors


Soil type

Ecological disturbances Presence of quarries and dump sites Socioeconomic factors Urbanization NOVEMBER 2006 Greece


Study Area: Athens’ Greater Basin

An urban area of 2026 sq km, situated to the west of Mount Ymittos, the east of Mount Egaleo, the south-west of Mount Penteli, the south-east of Mount Parnis, and the north of the Gulf of Saronikos. NOVEMBER 2006 Greece


Study Area: Main issues

Most of the suburbs of the city of Athens which are near the mountains surrounding the city have been expanded towards the slopes.

In several cases, many quarries and dumps are found very close or adjacent to the urban areas of the suburbs of Athens.


Materials and Methods


Primary conception: to “reconstruct” the 1992 survey’s results in a GIS in order to define the high risk areas for the disease as they were in 1992, focusing on the same study area. Take the 1992 survey into consideration: as a “starting control point” for measures and calibrations concerning the influence of spatiotemporal data related to the spread of the disease. Comparisons between contemporary, past and forthcoming data using GIS, RS and GPS technology. Investigation of the ways through which leishmaniasis can be spread in the study area, so as to substantiate the environmental factors corresponding to this diffusion both in time and space. NOVEMBER 2006 Greece

Data Collection 1. HUMAN CASES (Hospitals’ Archives) Human cases data for the period 1961 – 2004.


1341 cases were officially reported for this period. Of these, 209 cases have been excluded from spatial analysis. Only 381 cases can be used for point pattern analysis.

2. DATA COLLECTED FROM 1992 RESEARCH

3. FIELD COLLECTION OF PHLEBOTOMINE A new survey of sandflies in the Greater Athens Region is being carried out for the year 2005 and the results will be compared to those of the 1992 survey NOVEMBER 2006 Greece

Field Research Data


Reactivation of 41 out of 70 sandfly collection stations used in the 1992 research, located through GPS.

47 new stations were created in as close a proximity as the old ones to fully cover the study area. Total number of stations used: 88. The field research was supported by a specialized map series depicting basic urban and road network elements.



The traps were put at places where the insects were likely to be found during the day (sewers and gutters, crevices and holes in ruins, etc.).



Retrieval of traps documentation



Retrieval of measurements


Fluctuations in seasonal density of P. papatasi P. neglectus and P. tobbi during the years 1992 and 2005 The bimodal seasonal activity was more or less pronounced for the three main members of the genus Leishmania in the Greater Athens region. 0.40 P. papatasi (1992) P. papatasi (2005)

0.35

P.neglectus (1992) P.neglectus (2005)

sandflies/papertrap


0.30

P. tobbi (1992) P. tobbi (2005)

0.25 0.20 0.15 0.10 0.05

0.00 May

June

July

August

months NOVEMBER 2006 Greece

September

October

Fluctuations in seasonal density of Phlebotomus spp. and Sergentomyia minuta during 1992 and 2005 The seasonal activity of Phlebotomus spp. was bimodal with two peaks in early summer and early autumn, while Sergentomyia minuta showed an unimodal activity with a peak in September. 1.20

sandflies/papertrap


1.00

Phlebotomus spp. (1992) Phlebotomus spp. (2005) Sergentomyia minuta (1992) Sergentomyia minuta (2005)

0.80

0.60

0.40

0.20

0.00 May

June

July

August

months NOVEMBER 2006 Greece

September

October

Spatial Analysis of the Data Temporal description of the disease


Spatial patterns of the disease at the municipality level (area units) Spatial patterns of the disease at the address level (x,y coordinates)



Temporal description of the disease

Temporal analysis for 1341 cases There were peaks of the reported incidents with approximately 50 cases per year, while the average for the whole time period is 30 cases per year and some time periodicity. NOVEMBER 2006 Greece

Age + Sex Distribution


Min : 0.2 years Mean : 19.22 years Max: 93 years

Data were divided in 5-year age groups The 0-5 years age group accounts for 40.9% of the cases The 0-10 years age group accounts for 53.5% of the cases Males were 59% while Females, 41% NOVEMBER 2006 Greece

Geographical Information The geographical information was classified into 3 categories:


a. Natural and man-made geographical objects (roads, houses, rivers, administrative boundaries, etc.) b. Natural, environmental and social factors (precipitation, temperature, humidity, pollution, poverty level, etc.) c. Spatial indicators (diffusion of cases, proximities, high risk area rates, etc.)

ESRI, ArcGIS 9.0. Geodatabase Structure


Spatially referenced data 1. Raster structured


• Orthophotomaps Year 1996 Scale 1:5000 Resolution 2 m


• Remote Sensed Data (Panchromatic LANDSAT TM) Year 2000 Scale 1:100,000 Resolution 30m.,


2. Vector structured

• • • • • • • • NOVEMBER 2006 Greece

Administrative dataset Gazetteer dataset Health dataset Hydrology dataset Landcover dataset PointsOfInterest dataset Topography dataset Transportation dataset

Non spatially referenced data NewStations [Data concerning the description of phlebotomine collection stations]

Sandflies


[Data concerning the collected phlebotomine (kind, classification, etc.)]

HumanChar [Data concerning the human cases (address, sex, age, etc.)]

Meteo [Data concerning meteorological measurements]



Data mapping

Visualization of the location of the human VL cases for the period 1961-2000 (381 cases).



Data analyzing and mapping

(Geographic reference unit is the boundaries of the municipality) Visualization of human VL cases by the frequency of disease appearance per 10000 residents (1132 cases). NOVEMBER 2006 Greece

Mapping the collected species 


The size of the circle depends on the phlevotomine population.  The blue square symbol means “absent” of the specific species.  The sign “Σ” shows the location of the paper-traps.


Preliminary results of the study


Higher concentration of Leishmaniasis cases in :

• The foothills of mountains and hills

• High vegetation density areas • Areas with proximity to quarries and dumps


Further Analysis The study will include socioeconomic and meteorological data


The results of the newest surveys concerning the Phlebotomine sandfly population in the Athens region will be incorporated into the analysis The scope is the prediction and the surveillance of Leishmaniasis through the construction of a model based on Spatial Statistics



Web-Mapping Software production* for the disease surveillance

(*) based on ArcGIS and Internet Explorer platforms


International Co-operations


The final results will feed the GeodataBase of an International Research Project named “Emerging Diseases in a changing European eNviroment (EDEN)”.

http://www.eden-fp6project.net/

EDEN’s aims are to identify, evaluate and catalogue European ecosystems and environmental conditions linked to global change, which can influence the spatial and temporal distribution and dynamics of human pathogenic agents, which are transmitted from animals to humans (zoonoses). NOVEMBER 2006 Greece

The partners and the members of the project, Iliopoulou P,Tsatsaris A, Katsios J, Panagiotopoulou A, Koutsoumbis V, Vlastaras V, Skordili I, Cristal I.


Tselentis Y, Papadopoulos V, Antoniou M, Ivovic V,

Myridis M.

would like to thank you very much for your patience. NOVEMBER 2006 Greece

A Geographical Database for the Control of ...

A Geographical Database for the Control of ...

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