Geographic information system-based screening for TB, HIV, and syphilis (GIS-THIS): a cross-sectional study.
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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.
Geographic Information Systems
Published Version (Please cite this version)10.1371/journal.pone.0046029
Publication InfoGoswami, 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.
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Gary Matthew Cox
Professor of Medicine
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.
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