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

Abstract

OBJECTIVE:

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 (N = 247) 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.

• Authors: Neela 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
• Journal: PloS one (PLoS One) Vol. 7 Issue 10 Pg. e46029 ( 2012) ISSN: 1932-6203 [Electronic] United States
• PMID: 23056227 (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