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- Title
Geographic Information System-based Screening for TB, HIV, and Syphilis (GIS-THIS): A Cross-Sectional Study.
- Authors
Goswami, Neela D.; Hecker, Emily J.; Vickery, Carter; Ahearn, Marshall A.; Cox, Gary M.; Holland, David P.; Naggie, Susanna; Piedrahita, Carla; Mosher, Ann; Torres, Yvonne; Norton, Brianna L.; Suchindran, Sujit; Park, Paul H.; Turner, Debbie; Stout, Jason E.
- 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.
- Subjects
GEOGRAPHIC information systems; TUBERCULOSIS; SYPHILIS; HIV; CROSS-sectional method; COCAINE
- Publication
PLoS ONE, 2012, Vol 7, Issue 10, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0046029