GEOGRAPHICAL RECOGNITION

YOSRI AZWAR

Mutakhir Segitiga Epidemiologi Klasik

FAKTOR AGENS PENYEBAB

WAKTU

KELOMPOK PEJAMU ATAU POPULASI DAN KARAKTERISTIKNYA

LINGKUNGAN LINGKUNGAN PERILAKU BUDAYA FAKTOR FISIOLOGIS UNSUR EKOLOGI

Pendekatan Epidemiologi
Waktu Time Epidemiologi Deskriptif WHAT? Tempat Place Epidemiologi Analitik HOW? & WHY? Manusia Person
1. 2. 3. 4. Tren Sekular Tren Jangka Pendek Tren Siklus Tren Musiman

1. Tempat & Lingkungan Ekologis 2. Tempat & Lingkungan Fisik 3. Tempat & Lingkungan SosBud 1. 2. 3. 4. 5. Usia Jenis Kelamin Ras & Etnik Status Perkawinan & Keluarga Struktur Keluarga & Penelitian Genealogis 6. Pekerjaan 7. Pendidikan

Sejarah

1850 Dr. John Snow mengobservasi bahwa kolera lebih sering terjadi di wilayah pelabuhan daripada di pedalaman 1883 Dr. A. Hirsch mempublikasikan Handbook of Geographical and Historical Pathology yang membahas hubungan tempat dengan penyakit

Beberapa Fakta

Batas Politik, terutama batas negara menciptakan suatu wilayah yang menentukan terjadi atau tidaknya kondisi penyakit dan gangguan tertentu. Barrier Alam, di Amerika Serikat memainkan peranan yang lebih besar dalam membatasi KLB penyakit dan tempat kejadian daripada batasan politik.

5 Kriteria/ Karakteristik yang Janggal pada Variabel Tempat

1. Angka frekuensi penyakit yang tinggi dapat dilihat pada semua kelompok etnik yang mendiami suatu wilayah. 2. Angka frekuensi penyakit yang tinggi tidak tampak pada orang-orang dalam kelompok serupa yang mendiami wilayah lain. 3. Orang sehat yang masuk ke wilayah tersebut menjadi sakit dengan frekuensi yang serupa dengan penduduk asli.

5 Kriteria/ Karakteristik yang Janggal pada Variabel Tempat

4. Penduduk yang pindah tidak menunjukkan angka penyakit yang sama tingginya dengan penduduk yang tetap tinggal di wilayah tersebut. 5. Spesies selain manusia yang mendiami wilayah yang sama memperlihatkan tingkat infestasi yang serupa dengan manusia (dalam hal penyakit zoonotik).

Tempat (Places)

Tempat dan Lingkungan Ekologis

Karakter topografi, iklim dan ekologi memiliki pengaruh yang sangat besar pada aspek tempat dalam keberadaan dan penyebaran penyakit. Suhu, curah hujan, angin, air, kelembaban, dingin, panas, lama matahari bersinar dan kondisi lain mempengaruhi kemampuan patogen, khususnya bakteri, jamur dan parasit untuk bertahan di lingkungannya.

Tempat (Places)

Tempat dan Lingkungan Ekologis

Aspek ekologis dari lingkungan mempengaruhi kemampuan patogen untuk bertumbuh kembang dan disebarkan.
Berbagai aspek ekosistem yang mencakup vektor, media, reservoir dan pejamu pada beberapa jenis penyakit menular. Sampah daun, binatang dan serangga yang menularkan penyakit, semua merupakan bagian dari lingkungan ekologis suatu tempat dan penyakit.

Tempat (Places)

Tempat dan Lingkungan Fisik

Air dan udara adalah dua komponen penting dalam lingkungan fisik yang esensial untuk kelangsungan hidup manusia dan makhluk lain di muka bumi.
Mutu air minum dan udara beragam dari suatu tempat ke tempat lain dan dapat mempengaruhi kesehatan manusia. Susunan zat kimia dan mineral yang terkandung di air telah mempengaruhi kesehatan manusia yang tinggal di wilayah tertentu.

Tempat (Places)

Tempat dan Lingkungan Fisik

Air yang kaya flor seperti di Texas Barat menyebabkan gigi penduduk berbercak coklat dan kunjungan ke dokter gigi rendah, disamping itu angka penyakit jantung juga rendah. Endemic goiter (gondok) sudah lama dikaitkan dengan kadar yodium yang rendah di dalam air dan makanan di wilayah tertentu. Tempat tertentu yang menghadapi masalah pencemaran udara memiliki angka kanker paru yang tinggi.

Tempat (Places)

Tempat dan Lingkungan Sosial & Budaya Cara masyarakat atau kelompok populasi menggunakan makanan, air, zat kimia dan perilaku mereka dalam sanitasi, higiene dan kesehatan perorangan memiliki pengaruh yang sangat besar pada status kesehatan populasi. Kepercayaan yang berkaitan dengan kesehatan, tradisi, interaksi sosial dan kebudayaan juga dapat mempengaruhi perkembangan dan penyebaran penyakit.

Geographical Recognition
GLOBAL HEALTH ATLAS

Geographical Recognition
GLOBAL HEALTH ATLAS
WHO has launched the first global online atlas of infectious diseases, a new tool for infectious disease surveillance and control which builds on the features of the HealthMapper. Over 300 indicators for more than 20 infectious diseases of major public health concern are included in the database. In a single electronic platform, the Atlas is bringing together for analysis and comparison standardized data and statistics for individual diseases and indicators at country, regional, and global levels. The analysis and interpretation of data are further supported through information on demography, socioeconomic conditions, and environmental factors. In so doing, the Atlas specifically acknowledges the broad range of determinants that influence patterns of infectious disease transmission. Maps are used to display data on the prevalence of individual diseases, the location of at-risk populations and vector habitats, and patterns of antimicrobial drug resistance. Such maps offer easy visualization of conditions ranging from the number of villages infected with guinea worm disease, through the monitoring of polio surveillance in a selected country, to the status of resistance to chloroquine throughout the African continent.

Geographical Recognition
CASE MAP

Geographical Recognition
HEALTH MAPPER

Geographical Recognition
HEALTH MAPPER
The HealthMapper is a surveillance and mapping application, developed by WHO, that aims to address critical surveillance information needs across infectious disease programmes at national and global levels. The HealthMapper is a user-friendly data management and mapping system customized specifically for public health users. The system facilitates data standardization, collection and updating of data on epidemiology and on interventions and provides immediate visualization of data in the form of maps, tables and charts. The HealthMapper also packages a database of core baseline geographic, demographic and health information, including the location of communities, health care and education facilities, accessibility by road, access to safe water and demography. The system is currently in operation to support a range of infectious diseases in over 60 countries in all regions of WHO. Key infectious disease programmes currently using the system include Roll Back Malaria, Lymphatic filariasis Elimination, Buruli Ulcer, Guinea worm Eradication, Onchocerciasis Control Programme, and Polio Eradication. In 2003, the system supported the implementation surveillance of HIV/AIDS/STIs (sexually transmitted infections), Tuberculosis, Control of Communicable Diseases in Complex Emergency Situations, Outbreak Alert and Response and Integrated Management of Childhood Illnesses.

Geographical Recognition
GEOGRAPHICAL INFORMATION SYSTEM (GIS)
The Public Health Mapping and GIS programme is developing tools and applications to respond to critical information needs of infectious disease and public health programmes. These tools are based on recent advances in GIS technologies, mapping and remote field data collection tools such as hand-held global positioning systems, mobile mapping units and Internet connectivity. Geographical mapping of disease events dates back to the first maps used by Dr. John Snow in 1859 to trace the origin of a cholera outbreak in London, England. Simple maps have been used since then to follow disease spread, identify sources, determine target areas and assess epidemic risk. Mapping of events not only facilitates epidemiological analysis but is also effective for advocacy, informing the pubic and generating action by decisionmakers. It enables decision-makers to easily assess where populations are in relation to specific problems (disease and health events) and in relation to available resources (health and social services, water supply and education). Scarce public health resources can be more rationally planned and targeted to those communities most in need.

Geographical Recognition
GLOBAL POSITIONING SYSTEM (GPS)
The remote field data collection tools
In support of remote field data collection activities, WHO has been routinely using Global Positioning Systems (GPS) to map and track infectious diseases at community levels. GPS are now routinely used by village outreach teams for onchocerciasis, guinea worm, African Trypanosomiasis (sleeping sickness), lymphatic filariasis among others. Increasingly such systems are being used during the investigations of disease outbreaks for rapid mapping of cases and deaths and within the context of complex emergency situations they are being used for mapping internally displaced persons, refugee camps and rapid epidemiological assessments. With the arrival of palm sized computers and associated mapping software, it is now feasible to collect and map data in the field, offering exciting opportunities for real-time surveillance data capture, analysis and transfer even in area where communication infrastructures are poorly developed. WHO aims to pioneer these new tools and software in the field to serve not only as support to the surveillance requirements of eradication and control programmes but also as early alert systems for the detection, verification and response to outbreaks of new and previously unknown diseases.