Geographic epidemiology of gonorrhoea and chlamydia on a large military installation: Application of a GIS system

Jonathan Mark Zenilman, G. Glass, Timothy M Shields, P. R. Jenkins, J. C. Gaydos, K. T. McKee

Research output: Contribution to journalArticle

Abstract

Objectives: The geographic epidemiology of infectious diseases can help in identifying point source outbreaks, elucidating dispersion patterns, and giving direction to control strategies. We sought to establish a geographic information system (GIS) infectious disease surveillance system at a large US military post (Fort Bragg, North Carolina) using STDs as the initial outcome for the model. Methods: Addresses of incident cases were plotted onto digitised base maps of Fort Bragg (for on-post addresses) and surrounding Cumberland County, NC (for off-post addresses) using MAPINFO Version 5. We defined 26 geographic sectors on the installation. Active duty soldiers attending the post preventive medicine clinic were enrolled between July 1998 and June 1999. Results: Gonorrhoea (GC) was diagnosed in 210/2854 (7.4%) and chlamydia (CT) in 445/2860 (15.6%). African-American male soldiers were at higher risk for GC (OR = 4.6 (95% CL 3.0 to 7.2)) and chlamydia (OR = 2.0 (1.4 to 2.7)). For women, there were no ethnic differences in gonorrhoea prevalence, but chlamydia was higher in African-Americans (OR = 2.0 (1.4-2.7)). Rank and housing type were associated with gonorrhoea and chlamydia in men, but were not significant factors in women. For gonorrhoea, two geographic sectors had prevalences between 14.0%-16.5%, three between 10.3%-13.9%, three between 7.1%-10.2%, and five between 3.0%-7.1%. The geographic distribution demonstrated a core-like pattern where the highest sectors were contiguous and were sectors containing barracks housing lower enlisted grade personnel. In contrast, chlamydia prevalence was narrowly distributed. Conclusion: GIS based disease surveillance was easily and rapidly implemented in this setting and should be useful in developing preventive interventions.

Original languageEnglish (US)
Pages (from-to)40-44
Number of pages5
JournalSexually Transmitted Infections
Volume78
Issue number1
DOIs
StatePublished - 2002

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Geographic Information Systems
Chlamydia
Gonorrhea
Epidemiology
Military Personnel
African Americans
Communicable Diseases
Preventive Medicine
Sexually Transmitted Diseases
Disease Outbreaks

ASJC Scopus subject areas

  • Dermatology
  • Microbiology (medical)
  • Immunology

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Geographic epidemiology of gonorrhoea and chlamydia on a large military installation : Application of a GIS system. / Zenilman, Jonathan Mark; Glass, G.; Shields, Timothy M; Jenkins, P. R.; Gaydos, J. C.; McKee, K. T.

In: Sexually Transmitted Infections, Vol. 78, No. 1, 2002, p. 40-44.

Research output: Contribution to journalArticle

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abstract = "Objectives: The geographic epidemiology of infectious diseases can help in identifying point source outbreaks, elucidating dispersion patterns, and giving direction to control strategies. We sought to establish a geographic information system (GIS) infectious disease surveillance system at a large US military post (Fort Bragg, North Carolina) using STDs as the initial outcome for the model. Methods: Addresses of incident cases were plotted onto digitised base maps of Fort Bragg (for on-post addresses) and surrounding Cumberland County, NC (for off-post addresses) using MAPINFO Version 5. We defined 26 geographic sectors on the installation. Active duty soldiers attending the post preventive medicine clinic were enrolled between July 1998 and June 1999. Results: Gonorrhoea (GC) was diagnosed in 210/2854 (7.4{\%}) and chlamydia (CT) in 445/2860 (15.6{\%}). African-American male soldiers were at higher risk for GC (OR = 4.6 (95{\%} CL 3.0 to 7.2)) and chlamydia (OR = 2.0 (1.4 to 2.7)). For women, there were no ethnic differences in gonorrhoea prevalence, but chlamydia was higher in African-Americans (OR = 2.0 (1.4-2.7)). Rank and housing type were associated with gonorrhoea and chlamydia in men, but were not significant factors in women. For gonorrhoea, two geographic sectors had prevalences between 14.0{\%}-16.5{\%}, three between 10.3{\%}-13.9{\%}, three between 7.1{\%}-10.2{\%}, and five between 3.0{\%}-7.1{\%}. The geographic distribution demonstrated a core-like pattern where the highest sectors were contiguous and were sectors containing barracks housing lower enlisted grade personnel. In contrast, chlamydia prevalence was narrowly distributed. Conclusion: GIS based disease surveillance was easily and rapidly implemented in this setting and should be useful in developing preventive interventions.",
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