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INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD , 2009, MUKDAHAN PROVINCE, THAILAND Taha Kass-Hout, MD, MS Director, Global Public Health and Informatics

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Page 1: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

INSTEDD EVOLVE

MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUMAPRIL 2ND–3RD, 2009, MUKDAHAN PROVINCE, THAILAND

Taha Kass-Hout, MD, MSDirector, Global Public Health and Informatics

Page 2: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

SE Asia Early Warning & Response

A collaborative early warning and response space for latest health-related events in SE Asia

Page 3: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Overview

Infectious disease events represent substantial morbidity, mortality, and socio-economic impact in SE Asia

The infectious disease event reporting in SE Asia was of: Low socioeconomic disruption (83%), High socioeconomic disruption (17%); with

indicators of a: potential sociological crisis (16%), and disaster (0.6%)

Page 4: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Overview

Information Sources ProMed MBDS Veratect

From September 1, 2008 to February 27, 2009 998 near real-time reports on

46 infectious diseases that effect humans or animals Myanmar, Thailand, Laos, Cambodia, and Vietnam 220 provinces, 239 districts, and 14 cities

Page 5: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

The majority of reporting was related to possible epidemic situations. This information is available for each report in Evolve and thus represents granularity down to the lowest geographic unit presented in a given report and by disease event in SE Asia

Approximations of Epidemiological Features

Page 6: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Approximations of Epidemiological Features What diseases were reported to have

affected different age groups in SE Asia

Reports of mortal outcomes for all age groups

Which of the infectious disease events presented as single cases, apparently localized clusters

(approximation of an “outbreak”), and

apparent multiple cases in multiple locations (approximation of an “epidemic”)

Page 7: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

This information is available for each report in Evolve and thus represents granularity down to the lowest geographic unit presented in a given report and by disease event

Response

Page 8: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Response

what level of government and non-governmental organization became involved in response by disease event

Page 9: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Local Public Community Reaction There are two basic areas presented

here: reaction of the public

reaction of responders

Page 10: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Local Public Community Reaction Reaction of the public

The term ‘panic’ is not indicative of true panic but rather a proxy for social concern ‘Panic with behavior’ is where we have documented non-

routine public behavior such as panic buying, hoarding of medications, and so on, where concern has elicited non-routine action

‘Flight’ is the ultimate outcome where a community’s inhabitants abandon their community and for a period of time, social disintegration is observed. This is the end point of infectious disease event damage from a sociological perspective, where a community ceases (transiently) to be an integrated social unit engaged in routine daily activities

Evacuation due to biological events is a rare phenomenon, but one for which we maintain a baseline for what diseases in what countries provoke such a reaction

Page 11: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Local Public Community Reaction Reaction of responders

Responder anxiety, which follows the same conceptual framework as public anxiety

Here it is key to note those events where healthcare workers refuse to perform their duties or participate in response due to fear of exposure, illness, or death Responder avoidance of duties is a rare

phenomenon

Page 12: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

This information is available for each report in Evolve and thus represents granularity down to the lowest geographic unit presented in a given report and by disease event in SE Asia

Infrastructure

Page 13: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Infrastructure

The infrastructure types affected (compromised) by infectious disease events in SE Asia either due to absenteeism, contamination, work overload (i.e., response), or any combination of the above

Page 14: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

This information is available for each report in Evolve and thus represents granularity down to the lowest geographic unit presented in a given report and by disease event in SE Asia

Infectious Disease Disaster

Page 15: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Infectious Disease Disaster

The most socially disruptive events in SE Asia, by country and disease that are assessed to be potential disasters 0.6% of all disease reports in SE Asia

Page 16: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Related items (e.g., News articles) are grouped into a thread. Threads are later associated with events (hypothesized or confirmed).

Related items (e.g., News articles) are grouped into a thread. Threads are later associated with events (hypothesized or confirmed).

InSTEDD Evolve: (http://instedd.org/evolve)

Tag cloud and semantic heat

map

Tag cloud and semantic heat

map

InSTEDD Evolve

Delete/Recycle an Item

Delete/Recycle an Item

Expert-generated TagsExpert-generated Tags

RSS PublishingRSS Publishing

Delete/Recycle an Item

Delete/Recycle an Item

Save filter (by keyword, tag, topic, location, and time) and email subscription

Save filter (by keyword, tag, topic, location, and time) and email subscription

Page 17: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Our Solution

InSTEDD Evolve: (http://instedd.org/evolve)

InSTEDD Evolve

Page 18: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

InSTEDD Evolve: (http://instedd.org/evolve)

Filter feature which automatically filters content by topic of interestFilter feature which automatically filters content by topic of interest

InSTEDD Evolve

Filter feature which automatically filters content by radius

Filter feature which automatically filters content by radius

Page 19: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

InSTEDD Evolve: (http://instedd.org/evolve)

Auto-generated (machine-learning) tags. These tags are semantically

ranked (a statistical probability match). Users can further train the

classifier by accepting or rejecting a suggestion. Users can similarly train the geo-locator by simply accepting or rejecting and updating a location.

Auto-generated (machine-learning) tags. These tags are semantically

ranked (a statistical probability match). Users can further train the

classifier by accepting or rejecting a suggestion. Users can similarly train the geo-locator by simply accepting or rejecting and updating a location.

InSTEDD Evolve

Page 20: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Automatic Classification

Current classification includes: 7 syndromes 10 transmission modes > 100 infectious diseases > 180 micro-organisms > 140 symptoms > 50 chemicals

Page 21: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Information Sources BBC Outbreak News BioCaster Open Source Ontology CNN Health News EpiSpider Eurosurveillance Google Outbreak News HealthMap (Global Disease Alert Map) HEDDS Surveillance News Moreover Public Health News ProMed News (including MBDS) Veratect Corporation WDIN Disease Map Digest WHO Latest news on the avian influenza situation in humans around the

world WHO Outbreak News Y! Health Cold & Flu News

Page 22: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

InSTEDD Evolve

InSTEDD Evolve: (http://instedd.org/evolve)

Tracking the recent Avian Influenza Outbreak in Egypt (reports started to appear late January 2009). Notice the pattern of reported incidents along the Nile river.

Tracking the recent Avian Influenza Outbreak in Egypt (reports started to appear late January 2009). Notice the pattern of reported incidents along the Nile river.

Page 23: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Acknowledgment

Page 24: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Through Funding from…

Page 25: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Thank You!

Taha Kass-Hout Nicolás di Tada

Page 26: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

InSTEDD400 Hamilton Avenue, Suite 120

Palo Alto, CA 94301, USA

+1.650.353.4440

+1.877.650.4440 (toll-free in the US)

[email protected]

Thank You!

Cambodia, Photo taken by Taha Kass-Hout, October 2008

“this pic says it all- our kids are all the same- they deserve the same”, Comment by Robert Gregg on Facebook, October 2008

Page 27: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Backup Slides

Page 28: INSTEDD EVOLVE MEKONG BASIN DISEASE SURVEILLANCE (MBDS) INFORMATION COMMUNICATION AND TECHNOLOGY FORUM APRIL 2 ND –3 RD, 2009, MUKDAHAN PROVINCE, THAILAND

Evolve Architecture and Processes

Best Poster Award for Improving Public Health Investigation and Response at the Seventh Annual ISDS Conference, 2008