2023 Finalists and Proposals
Yudhy Dharmawan - Universitas Diponegoro, NLR Indonesia - Indonesia
Proposal: Reducing the delay in leprosy detection: evidence of mapping method support in Indonesia's high leprosy endemic areas
Case detection delay (CDD) of leprosy remains a problem in achieving zero leprosy, which has been the global target by 2030, because it may lead to delays in treatment that contribute to continued leprosy transmission and the development of disability in a new leprosy case, such as in Indonesia, one of the leprosy-endemic countries. An active case detection with a targeted health education program in the community that has determinant factors of delay is a promising intervention to reduce CDD, but defining the priority area in which the intervention program will be carried out is very challenging.
Our innovative solution addresses these challenges by a leprosy case mapping using a Geographical Information System (GIS) to define a specific area that has a determinant factor of delay so that the intervention program can be carried out. We will develop a program for the leprosy program's manager and staff to use the CDD questionnaire validated in Indonesia context and a GIS approach as the analyzing tool to define the area prioritized as the intervention area program to decrease CDD.
The implementation of this solution through several steps, i.e., training for leprosy managers and leprosy staff of health care, a data collecting program in case detection delay using a CDD Questionnaire, a data analyzing program using GIS, and implementation of integrated intervention programs combining active case detection with targeted health education based on the CDD mapping. The duration of CDD will be monitored and evaluated within two years of program implementation in one leprosy-endemic district and will be compared with another leprosy-endemic district that does not implement this action research in Indonesia.
Our innovative solution aims to improve early case detection of leprosy in Indonesia by empowering healthcare workers with efficient data collecting and analyzing capacity with GIS tools to make prioritized areas to implement intervention programs to decrease CDD. Moreover, this novel method will encourage National Leprosy Control Program in Indonesia to make policy in early case detection programs more effectively to decrease CDD and also disability in a new leprosy case.
Tine Huyse - Royal Museum for Central Africa, Mbarara University of Science and Technology, Université de Kinshasa - Uganda, Democratic Republic of the Congo
Proposal: Citizen science for mapping snail-borne diseases: a community-based approach to revolutionize snail control in Uganda and DR Congo
Snail-borne diseases such as schistosomiasis and fasciolosis pose a significant public and veterinary health burden, particularly in Africa. Since drug treatment alone does not suffice to control these diseases, the World Health Organization recommends including snail control and community involvement. However, the lack of snail experts and snail distribution data hampers the design and implementation of targeted control measures. Moreover, snail control will simultaneously tackle animal diseases transmitted by the same or related snail species, aligning with the One Health approach.
To tackle these challenges, we propose a groundbreaking approach using citizen science (CS) to bridge this gap by involving community members in snail monitoring. Two CS networks in Uganda and the Democratic Republic of Congo have collected weekly snail data and information on water-related activities at 76 fixed-water contact sites between 2020-2023. This data will be used to identify potential transmission sites. However, to identify actual transmission sites, we now want to combine field-friendly environmental (e)DNA sampling with loop-mediated isothermal amplification (LAMP) to measure parasite transmission in real-time (eLAMP)
In the Action Towards Reducing Aquatic snail-borne Parasitic diseases (ATRAP) initiative, we developed a robust validation protocol to ensure accurate spatial and temporal mapping. We showed through advanced comparative analyses that CS-collected and expert data substantially agree regarding the presence or absence of snails at a given site (Tumusiime et al, submitted). In addition, the CS model is about eight times cheaper than the conventional expert monitoring. Now we want to use snail and eLAMP data to develop advanced distribution models that predict the presence of snails/parasites based on environmental conditions obtained from novel remote sensing products and state-of-the art COSMO-CLM simulations. The raw data will be used to generate real-time risk maps, while fine-scaled spatio-temporal modelling will provide future forecasting of snail/parasite presence considering extreme hydrological events and long-term environmental fluctuations driven by climate change.
We aim to create an open-access platform to maximize data accessibility. This citizen science approach has been shown to generate unprecedented snail datasets regarding spatiotemporal resolution and coverage. Incorporating eLAMP has the potential to turn it into a powerful early warning system for disease risk. Our earlier work has shown that citizen participation empowers communities and increases knowledge of snail-borne diseases and their control and prevention. We therefore argue that this community-based approach presents a highly innovative and sustainable addition to classical surveillance programs, or even a replacement in remote areas. Finally, this project has a huge potential for upscaling to other regions in Africa and beyond.
Ximena Illarramendi - Fiocruz - Brazil
Proposal: Interactive map for visual exploration and analysis of NTDs
Geographical distribution of neglected tropical diseases (NTDs) is diverse, according to social and environmental determinants, as well as the degree of endemicity. Understanding patterns of transmission, dispersal, and epidemiological indicators is essential for disease control. Visualization tools facilitate understanding and communication with the public but also aid informed decisions. Disease distribution is usually represented by means of choropleth maps which are limited to representing a single data variable in shaded or colored divided geographical areas. This type of map restricts the variables to the geographical space with loss of proportions related to population density, thus generating biased visual information. We propose a visualization tool that addresses the complex data used in NTDs control to aid the health professional and manager understand and communicate the epidemiology of NTDs.
We will use health secondary data to create a visualization tool of Dorling maps, allowing the selection and exploration of multiple variables and municipalities. Each municipality will be represented by a circle with a radius that provides its population. Various interaction facilities will be implemented in order to provide greater dynamism in exploration. Among the NTDs, leprosy and American cutaneous leishmaniasis affect the skin. In Brazil, these diseases are compulsory reported to the National Health System. The data is freely available by the National System for Information on Compulsory Reported Diseases (SINAN), provided by the Brazilian Ministry of Health. The Map visualization will summarize the profile of each municipality by plotting five variables aggregated per year: Human Development Index, health facilities, disease epidemiologic and operational indicators. The value of one of these variables will be shown on the color scale on the map for a given year.
The visualizations will help the user, mainly municipal and state levels health managers to take evidence-based decisions. The maps will be also freely accessible to journalists, academics, and NGOs representatives, to explore the situation in cities selected from the 5,570 Brazilian municipalities. The maps will be implemented using the Observable online development platform. Various interaction facilities will be also implemented. The Map view will use data stored directly on the project's server with no need for special back-end support. The visualization will be available for access by computer and will allow the download of selected data and maps.
The selection and exploration of multiple variables in a single map will enable health authorities to monitor leprosy and leishmaniasis indicators, aiding decision making and supporting health policies. The tool can be customized to include other NTDs and countries. Creating a visual space where administrative and clinical health databases can be viewed in a single map opens a new avenue for analysis and the generation of novel insights regarding the control of NTDs.