Geographic information system-based screening for TB, HIV, and syphilis (GIS-THIS): a cross-sectional study.
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.
Type
Journal articleSubject
AdultCross-Sectional Studies
Feasibility Studies
Female
Follow-Up Studies
Geographic Information Systems
Geography
HIV Infections
Humans
Incidence
Male
Mass Screening
Middle Aged
North Carolina
Prospective Studies
Syphilis
Tuberculosis
Young Adult
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https://hdl.handle.net/10161/13902Published Version (Please cite this version)
10.1371/journal.pone.0046029Publication Info
Goswami, Neela D; Hecker, Emily J; Vickery, Carter; Ahearn, Marshall A; Cox, Gary
M; Holland, David P; ... Stout, Jason E (2012). Geographic information system-based screening for TB, HIV, and syphilis (GIS-THIS):
a cross-sectional study. PLoS One, 7(10). pp. e46029. 10.1371/journal.pone.0046029. Retrieved from https://hdl.handle.net/10161/13902.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Gary Matthew Cox
Professor of Medicine
Susanna Naggie
Professor of Medicine
Dr. Susanna Naggie completed her medical education at Johns Hopkins School of Medicine
and her internal medicine training at Duke University Medical Center (DUMC), where
she also served as a Chief Resident in Internal Medicine. She completed her Infectious
Diseases (ID) fellowship training at Duke and then joined the faculty in the Division
of ID. She is a Professor of Medicine and currently holds joint appointments at the
Duke Clinical Research Institute and at the Durham Veterans Affa
Jason Eric Stout
Professor of Medicine
My research focuses on the epidemiology, natural history, and treatment of tuberculosis
and nontuberculous mycobacterial infections. I am also interested in the impact of
HIV infection on mycobacterial infection and disease, and in examining health disparities
as they relate to infectious diseases, particularly in immigrant populations.
Alphabetical list of authors with Scholars@Duke profiles.

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