Geographic Information System (GIS) is a system that involves an organized collection of computer hardware, software, geographical data and personnel, designed to efficiently capture, store, update, manipulate, analyze and display all forms of geographically referenced information.[1]
This study was conducted by the Field Epidemiology Training Program to assess the knowledge and attitude of health workers in Saudi Arabia toward application of GIS in malaria control, using a cross-sectional study design. The study covered different categories of health workers in malaria or Communicable Diseases Control department mainly malarious areas: Jazan, Aseer, Makkah, Al-Baha, Taif, Al-Laith and Al-Qunfudha. It also included health workers in the Communicable Diseases Control department in Riyadh. Participants in the study were physicians, laboratory specialists, health inspectors, parasitologists, and different types of technicians. Data was obtained by using a self-administered questionnaire.
The total respondents from 8 regions were 305; most were from Aseer 123, Jazan 62, Al-Laith 32, AlBaha 26, Taif 20, Riyadh 19, Makkah 13 and Al-Qunfudha 10. Their mean age was 41.8 years (SD ±9.9), and almost 40% were over 45. Saudis comprised 66.2%, Sudanese 15.1%, Egyptians 10.2%, Indians 2.3%, Syrians 2.0%, other 4.3%. Over half worked in the Communicable Disease Control departments of each region 64.9%, followed by primary health administrations 20.3%, malaria centers 8.2% and primary health care centers 6.6%. Their occupations were: Health inspectors 36.7%, technicians 18.7%, nurses 12.5%, physicians 10.2%, laboratory personnel 8.5%, health managers 4.3%, public health specialists 3.6%, and other 5.6%. Educational levels were: up to and including secondary school 27.5%, health diploma 37.70/0, university graduate or post graduate 34.8%.
Regarding knowledge of GIS and its application in Malaria control, only 118 (38.7%) used the computer in their work and only 112 (36.7%) had heard of GIS. Out of the 112 who had heard about GIS, 58 (51.8%) heard of it from colleagues, 34 (30.4%) through training courses, 29 (25.9%) from the internet, 10 (8.9%) from TV, 5 (4.5%) by self-reading and 2 (1.8%) during the Rift Valley Fever outbreak in Saudi Arabia of year 2000. Of those who had heard of GIS, 80 (71.4%) gave the correct meaning of GIS 'Geographic Information System': all Riyadh and Al-Qunfudha health workers (100%), Al-Baba 88.9%, Makkah 83.3%, Taif 75%, Al-Laith 66.7%, Aseer 62.1%, Jazan 57.1%.
Correct responses for the benefits of GIS in malaria control were: cost effectiveness 72.3%, planning 87.5%, easily obtained information 83%, reliable information 88.4%, and data covering unlimited geographical areas 40.2%. Correct responses for the requirements for application of GIS in malaria control were: computer hardware 83.9%, geographic data 75%, and specific software 69.6%.
Of the 112, 94 (83.9%) responded that GIS could be applied in health; 100 (89.3%) responded that it could be used to map malaria incidence/prevalence and determine its risk factors, of who 70% responded positively to 'Climate conditions like temperature and rain', 79% to 'Control measures', 94% to 'Location of swamps or valleys', 77% to 'Types and distribution of mosquitoes', 82% to' Distribution of cases' and only 69% to 'Population movement'. Factors thought to limit the use of GIS in malaria control are shown in figure 1.
Of 100 health workers who had heard about GPS device, only 25% gave its correct meaning 'Global Positioning System'. However, 66% answered correctly that GPS device is used for allocation of coordinates, 18% for data collection, 9% for data analysis and 7% for data entry. Comparison of knowledge of health workers in different regions about GIS and GPS and whether they had received previous training is shown in table 1.
Out of the 305 health workers in the study, 258 (84.6%) worked in malaria control. Mean working years was 10.8 (SD ±8.7), 92 (30.8%) had worked for < 5 years, 94 (30.8%) 515 years, 57 (18.7%) 16-25 years and 15 (4.9%) for > 25 years.
Two hundred thirty-six (77.4%) of the total study participants reported that they usually used geographic information in their work, 221 (72.5%) got this information from field work, 124 (40.7%) from maps and 64 (21%) from other departments. Of the total, 282 (93.1%) wanted to apply GIS in control of malaria in their work area.
Editorial note:
Malaria is a life threatening parasitic disease transmitted by mosquitoes. It is still endemic in parts of the southwest of the kingdom. The most basic application of GIS in malaria involves mapping the incidence/prevalence in geographic areas to examine the existence of any obvious pattern, and mapping their relationship with other potential risk factors such as: temperature, rainfall, land use/land cover, elevation, demographics (age and gender), population movement, climate change, breeding sites and control programmes.[1,2] It can be used to investigate associations between environmental variables such as climatic factors, particularly rainfall, temperature and humidity and the distribution of the different species responsible for malaria transmission.[3]
GIS also helps health planners devise specific and targeted methods to control the spread and transmission of malaria.[4] The application of GIS in malaria control has been implemented in several countries, such as Indonesia[2], South Africa [5] and India.[6]
The Global Positioning System (GPS), on the other hand, is a satellite-based navigation system made up of a network of 24 satellites placed into orbit by the U.S. Department of Defense. GPS was originally intended for military applications, but in the 1980s, the US government made the system available for civilian use. GPS works in any weather conditions, anywhere in the world, 24 hours a day.[7]
This study demonstrated deficiency in the knowledge of health workers of all aspects of GIS and its general applications, benefits, requirements, limitations and its application in malaria control. It also showed deficiency in knowledge of health workers regarding GPS devices and their uses for coordinates allocation. GIS is a relatively new technology to Saudi Arabia. However, inadequate data, bad reporting system and difficulty in obtaining the digital maps are factors that may limit the use of GIS in malaria control.
It is also obvious from the study findings the deficiency of training programs of both GIS and GPS, which points to the need for raising awareness of health workers by holding more training courses particularly in areas of high malaria endemicity.
References
-
1- World Health Organization. Geographic information system (GIS): mapping for epidemiological surveillance. Weekly epidemiologic record 1999;74(34): 281-85
-
2- Sipa NG, Dale P, Challenges in using the geographic information system (GIS) to understand and control malaria in Indonesia. Malaria journal 2003; 2:36.
-
3- Sweeney AW, The application of GIS in malaria control programs. In 10th Colloquium of the Spatial Information Research Centre. University of Otago, New Zealand 1998:315-19.
-
4- Environmental System Research Institute. Resurgence of the disease in the district of Purworejo, Central Java, Indonesia: investigating the distribution of malaria using GIS. March 2003.
-
5- Carrin M, Bronwyn C, Colleen F and Brian S. The use of a GIS based malaria information system for malaria research and control in South Africa. Health & Place 2002; 8(4):227-236.
-
6- Sharma VP, Srivastava A. Role of geographic information system in malaria control. Indian J Med Res 1997; 106:198-204.
-
7- GARMIN about GPS. What is GPS? [cited 2005 July 9]. Available from: http://www.qarmin.com/aboutGPS/
|
Table 1: Percentage of health workers who had heard about GIS & GPS in each region.
|
||||||||
|
Heard about GIS
|
Had training in GIS
|
Heard about GPS
|
Had training in GPS
|
|||||
|
Regions
|
No.
|
%
|
N
|
%
|
No.
|
%
|
N
|
%
|
|
Aseer (123)
|
29
|
23.6
|
6
|
4.9
|
26
|
21.1
|
4
|
3.3
|
|
Jazan (62)
|
35
|
56.5
|
11
|
17.7
|
43
|
69.4
|
11
|
17.7
|
|
Al-Laith (62)
|
3
|
9.4
|
0
|
0
|
3
|
9.4
|
1
|
3.1
|
|
Al-Baha (32)
|
9
|
34.6
|
4
|
15.4
|
3
|
11.5
|
2
|
7.7
|
|
Taif (26)
|
12
|
60
|
3
|
15
|
5
|
25
|
1
|
5
|
|
Riyadh (20)
|
13
|
68.4
|
6
|
31.6
|
12
|
63.2
|
4
|
21.1
|
|
Makkah (19)
|
6
|
46.2
|
3
|
23.1
|
4
|
30.8
|
1
|
7.7
|
|
Al-Qunfuda (10)
|
5
|
50
|
1
|
10
|
4
|
40
|
1
|
10
|