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Transcript
IDO 2008 Dengue Ontology, User-Developer perspective Overview Biology Current system A decision support system as a solution What is Dengue? Really, what is Dengue? The DDSS Control Vocabulary Dengue Ontology Disease and Mosquito Cycle 1 Main mosquito vector 1 Main disease target 3 Disease manifestations 4 Virus serotypes 9 Day from egg to adult* 14 day to become infectious* * Temperature dependent http://www.entm.purdue.edu/publichealth/images/downloads/lifecycle-mosquito.jpg Merida 500 000 (estimated) DHF cases require hospitalization each year 2.5% of those affected die 2.5 billion people at risk http://en.wikipedia.org/wiki/Dengue http://www.who.int/mediacentre/factsheets/fs117/en/ Urban Area of Merida Because of the interaction of three semi-independent components the vector borne disease behave differently from communicable diseases. Total cases in 2007 Merida Potential for rapid outbreak response based on clinical syndromic surveillance What is Dengue? Disambiguation Dengue Virus is_a Pathogen Dengue Fever is_a Disease Dengue Fever is_a Diagnosis Dengue Fever Clasic is_a Manifestation Dengue Case instance_of Dengue Fever? What is Dengue? WHO Dengue fever and dengue hemorrhagic fever (DHF) are acute febrile diseases, found in the tropics and Africa, and caused by four closely related virus serotypes of the genus Flavivirus, family Flaviviridae. (Some) Health Departments What WHO Says but, it is not Dengue until it was been confirmed by the laboratory. What is Dengue? Most dengue cases are usually clinically diagnose No Pathognomonic symptom The list includes more than 50 They can drastically vary by subject and by outbreak. There are 3 WHO recognized diagnosis (manifestations) Dengue Fever a.k.a Classic Dengue Dengue Hemorrhagic Fever (Thrombocytopenia <1x 105 platelets/mm³ Dengue Shock syndrome Dengue Fever with hemorrhagic manifestations What is Dengue? What is Diagnosis? What is Disease? Disease Ontology Workshop The Ontology of Diagnosis (to be quoted as work in progress) Baltimore, MD, USA. November 7, 2006 Juan Perez Dengue was diagnosed instance-of at t1 instance-of at t1 instance-of at t1 Person Disease Diagnosing inst-of at t2 inst-of at t2 inst-of at t2 DHF was diagnosed by by PCR Pedro Juarez instance-of at t1 method inst-of at t2 PCR Person depend_on Dengue Fever depend_on Dengue Virus caused_by Symptoms Juan Perez instance-of at t1 Dengue was diagnosed by PCR Person Disease Diagnosing method inst-of at t2 Pedro Juarez DHF was diagnosed by PCR Person has_part depens_on Head has_part Symptoms gum instance-of at t instance-of at t Juan’s headache has_location Juan’s head Juan’s mialgya has_location Juan’s muscles Juan’s bleeding gums has_location Juan’s gums A well-formed diagnosis of dengue? Disease is_a? Dengue Fever instance-of at t Juan’s portion of viruses caused_by Juan’s Dengue A well-formed diagnosis of dengue? Disease is_a Dengue virus caused_by instance-of at t Dengue Fever Juan’s Dengue Realization_of Asymptomatic Dengue Fever Dengue Fever has_symptom Headache Hem. Manif. Dengue Fever Hemorrhagic Dengue Fever has_symptom Epistaxis Shock syndrome Dengue is_a Diagnosis Juan Perez Dengue was found instance-of at t1 instance-of at t1 instance-of at t1 Person Disease Finding inst-of at t2 inst-of at t2 inst-of at t2 in 320 South street #456 Pedro Juarez DHF was found in instance-of at t1 Place inst-of at t2 12 North street #123 Disease is_a Dengue virus caused_by Dengue Fever instance-of at t Juan’s Dengue located_in 320 South street #456 instance-of at t Premise instance-of at t Block located_in Block MX1235 located_in Merida instance-of at t Populated place Problems of using English Street Ni▄os Caj¬¯n and Ninos Cajon and Nignos Cajon are not Niños Cajón Add all the characters of all the lenguajes Is not just annotation. Wrong characters renders the terms useless. Jorgue Guachintón located_in Guayomin located_in Yunited Estates is not George Washington…. Juan Perez Dengue was diagnosed instance-of at t1 instance-of at t1 instance-of at t1 Person Disease Diagnosing inst-of at t2 inst-of at t2 inst-of at t2 DHF was diagnosed by by symptoms … Pedro Juarez instance-of at t1 symptoms inst-of at t2 symptoms .. A well-formed diagnosis of dengue? Juan’s Dengue instance-of at tx Headache onset has_symptom has_symptom Asymptomatic Dengue Fever Dengue Fever Low blood pressure Epistaxis Hem. Manif. Dengue Fever Hemorrhagic Dengue Fever Shock syndrome Dengue t Juan goes to the doctor Juan is hospitalized DDSS (1): System flow scheme Functional definition of Decision Support System: An interactive and adaptable system that aids the process of gathering and analyzing information, gaining new insights, generating alternatives, and making decisions Dengue Decision Support System Program Strategy & Methodology Data Collection Sampling schemes Data Entry Data format, Data entry screens Data Storage Data Retrieval SQL data warehouse Management tool Data Analysis Data Display Management tool, GIS software, Statistical packages, Modeling XHTML files, Text files, GIS software, Google Earth, Outputs: Charts, Graphs, Maps, Tables FEEDBACK TO PROGRAM STRATEGY & METHODOLOGY Interpretation (comparison with local historical data, relation to critical thresholds etc) Management Decisions DDSS (2): Essential DDSS characteristics Integrates into existing vector/dengue control programs at local/regional levels (single DDSS) or national levels (DDSS network). DDSS application packages will be made accessible in English and Spanish language versions. Self-application concept provides potential for rapid world-wide implementation. Flexible DDSS implementation to fit a wide range of resource environments. Minimum capital investment for implementation of a basic DDSS is estimated at $1,500 per location (low-end computer, basic GPS unit and software). User-friendly; designed for use by regular vector control personnel. Standardized data entry formats to facilitate compilation of data from multiple locally operated DDSS for national level analysis. DDSS (3) DDSS (5) Disease and Vector control/surveillance activities Case Reports •Control Activities •Control Activities (Reactive) • ULV Insecticide spray • Immature Control • Breeding site control Infected Count -- •Surveillance • Counts and ndexes •Control Activities (Reactive) Case Reports http://www.entm.purdue.edu/publichealth/images/downloads/lifecycle-mosquito.jpg • Breeding Sites DDSS (7): Selected outputs from DDSS-1 Documentation to support operational logistics: - Workload and cost related to different program activities. - Spatial coverage of surveillance and control activities. - Insecticide types and quantities used. Entomological data display outputs showing: - Seasonal and spatial patterns of vector abundance. - Contribution of different container types to vector production. - Effect of implemented control strategies on vector abundance. Epidemiological data display outputs showing: - Distribution of DF and DHF cases by sex and age group. - Seasonal and spatial patterns of occurrence of DF and DHF cases. - Seasonal and spatial patterns of DF and DHF incidence (if population census data are available). - Effect of implemented vector control strategies on DF and DHF incidence (based on passively collected data). Priority Area classification for vector control. GIS-backbone to support vector/dengue control (and build public health capacity). DDSS (8): Expected outcomes from DDSS-1 Evidence-based decision making and use of locally appropriate vector/dengue control program strategies and methodologies. Improved capacity for data entry, storage, retrieval, analysis and display. Better use of available resources through improved understanding of the relative costs and benefits of different surveillance and control approaches. Better targeting of limited resources for vector control to high risk areas. Improved capacity for effective emergency vector control response through more rapid flow of information between public health institutions and vector/dengue control programs. DDSS (4): Evolution of DDSS system design Past Present Future 2–tier system (GUI – Database) 2–tier system (GUI – Database) 3–tier system (GUI – Business Logic - Database) GUI: MS Visual Basic GUI: MS Visual Basic Database: Access or SQL Server Express Database: PostgreSQL with PostGIS extension VB-Java Java PostgreSQL with PostGIS extension DDSS (5): Use of open source software Google Earth PostgreSQL R Stats Pack IDO Need Logo ZedGraph Plotting Library Reporting Thank you