TY - JOUR
T1 - Modeling a Syphilis Outbreak Through Space and Time Using the Bayesian Maximum Entropy Approach
AU - Gesink Law, Dionne C.
AU - Bernstein, Kyle T.
AU - Serre, Marc L.
AU - Schumacher, Christina M.
AU - Leone, Peter A.
AU - Zenilman, Jonathan M.
AU - Miller, William C.
AU - Rompalo, Anne M.
PY - 2006/11
Y1 - 2006/11
N2 - Purpose: The aim of the study is to describe changes in the spatial distribution of syphilis before, during, and after an outbreak in Baltimore, MD, by using Bayesian maximum entropy (BME), a modern geostatistical technique for space-time analysis and mapping. Methods: BME was used to conduct simple and composite space-time analyses of the density of syphilis infection based on primary, secondary and early latent syphilis cases reported to the Baltimore City Health Department between January 1, 1994, and December 31, 2002. Results: Spatiotemporal covariance plots indicated that the distribution of the density of syphilis cases showed both spatial and temporal dependence. Temporally dependent disease maps suggested that syphilis increased within two geographic core areas of infection and spread outward. A new core area of infection was established to the northwest. As the outbreak waned, density diminished and receded in all core areas. Morbidity remained elevated in the two original central and new northwestern core areas after the outbreak. Conclusions: Density of syphilis infection was a simple informative measure easily compared across years. The BME approach was useful for quantitatively and qualitatively describing the spatial development and spread of syphilis. Our results are specific to Baltimore; however, the BME approach is generalizable to other settings and diseases.
AB - Purpose: The aim of the study is to describe changes in the spatial distribution of syphilis before, during, and after an outbreak in Baltimore, MD, by using Bayesian maximum entropy (BME), a modern geostatistical technique for space-time analysis and mapping. Methods: BME was used to conduct simple and composite space-time analyses of the density of syphilis infection based on primary, secondary and early latent syphilis cases reported to the Baltimore City Health Department between January 1, 1994, and December 31, 2002. Results: Spatiotemporal covariance plots indicated that the distribution of the density of syphilis cases showed both spatial and temporal dependence. Temporally dependent disease maps suggested that syphilis increased within two geographic core areas of infection and spread outward. A new core area of infection was established to the northwest. As the outbreak waned, density diminished and receded in all core areas. Morbidity remained elevated in the two original central and new northwestern core areas after the outbreak. Conclusions: Density of syphilis infection was a simple informative measure easily compared across years. The BME approach was useful for quantitatively and qualitatively describing the spatial development and spread of syphilis. Our results are specific to Baltimore; however, the BME approach is generalizable to other settings and diseases.
KW - Disease Outbreaks
KW - Space-Time Clustering
KW - Spatial Distribution
KW - Surveillance
KW - Syphilis
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U2 - 10.1016/j.annepidem.2006.05.003
DO - 10.1016/j.annepidem.2006.05.003
M3 - Article
C2 - 16882466
AN - SCOPUS:33751218043
SN - 1047-2797
VL - 16
SP - 797
EP - 804
JO - Annals of epidemiology
JF - Annals of epidemiology
IS - 11
ER -