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Geographic information system-based screening for TB, HIV, and syphilis (GIS-THIS): a cross-sectional study.

AbstractOBJECTIVE:
To determine the feasibility and case detection rate of a geographic information systems (GIS)-based integrated community screening strategy for tuberculosis, syphilis, and human immunodeficiency virus (HIV).
DESIGN:
Prospective cross-sectional study of all participants presenting to geographic hot spot screenings in Wake County, North Carolina.
METHODS:
The residences of tuberculosis, HIV, and syphilis cases incident between 1/1/05-12/31/07 were mapped. Areas with high densities of all 3 diseases were designated "hot spots." Combined screening for tuberculosis, HIV, and syphilis were conducted at the hot spots; participants with positive tests were referred to the health department.
RESULTS AND CONCLUSIONS:
Participants (Nā€Š=ā€Š247) reported high-risk characteristics: 67% previously incarcerated, 40% had lived in a homeless shelter, and 29% had a history of crack cocaine use. However, 34% reported never having been tested for HIV, and 41% did not recall prior tuberculin skin testing. Screening identified 3% (8/240) of participants with HIV infection, 1% (3/239) with untreated syphilis, and 15% (36/234) with latent tuberculosis infection. Of the eight persons with HIV, one was newly diagnosed and co-infected with latent tuberculosis; he was treated for latent TB and linked to an HIV provider. Two other HIV-positive persons had fallen out of care, and as a result of the study were linked back into HIV clinics. Of 27 persons with latent tuberculosis offered therapy, nine initiated and three completed treatment. GIS-based screening can effectively penetrate populations with high disease burden and poor healthcare access. Linkage to care remains challenging and will require creative interventions to impact morbidity.
AuthorsNeela D Goswami, Emily J Hecker, Carter Vickery, Marshall A Ahearn, Gary M Cox, David P Holland, Susanna Naggie, Carla Piedrahita, Ann Mosher, Yvonne Torres, Brianna L Norton, Sujit Suchindran, Paul H Park, Debbie Turner, Jason E Stout
JournalPloS one (PLoS One) Vol. 7 Issue 10 Pg. e46029 ( 2012) ISSN: 1932-6203 [Electronic] United States
PMID23056227 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
Topics
  • Adult
  • Cross-Sectional Studies
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Geographic Information Systems (statistics & numerical data)
  • Geography
  • HIV Infections (diagnosis, epidemiology, prevention & control)
  • Humans
  • Incidence
  • Male
  • Mass Screening (methods, statistics & numerical data)
  • Middle Aged
  • North Carolina (epidemiology)
  • Prospective Studies
  • Syphilis (diagnosis, epidemiology, prevention & control)
  • Tuberculosis (diagnosis, epidemiology, prevention & control)
  • Young Adult

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