Geographic Information System and tools of spatial analysis in a pneumococcal vaccine trial

Tanskanen, Antti; Nillos, Leilani T.; Lehtinen, Antti; Nohynek, Hanna; Sanvictores, Diozele; Simões, Eric A F; Tallo, Veronica; Lucero, Marilla

doi:10.1186/1756-0500-5-51

Cited by 7 publications

(5 citation statements)

References 13 publications

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“…Only 142 children were partially vaccinated (e.g., received <3 doses) and these children were included in the intent-to-treat (ITT) analyses, but not the per-protocol (PP) results that we present here. The geographic location of each child's household of residence was collected using handheld GPS (24). We linked these geographic data to the study population in a geographic information system (GIS).…”

Section: Methodsmentioning

confidence: 99%

Distance to health services affects local-level vaccine efficacy for pneumococcal conjugate vaccine (PCV) among rural Filipino children

Root

Lucero

Nohynek

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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Pneumococcal conjugate vaccines (PCVs) have demonstrated efficacy against childhood pneumococcal disease in several regions globally. We demonstrate how spatial epidemiological analysis of a PCV trial can assist in developing vaccination strategies that target specific geographic subpopulations at greater risk for pneumococcal pneumonia. We conducted a secondary analysis of a randomized, placebo-controlled, double-blind vaccine trial that examined the efficacy of an 11-valent PCV among children less than 2 y of age in Bohol, Philippines. Trial data were linked to the residential location of each participant using a geographic information system. We use spatial interpolation methods to create smoothed surface maps of vaccination rates and local-level vaccine efficacy across the study area. We then measure the relationship between distance to the main study hospital and local-level vaccine efficacy, controlling for ecological factors, using spatial autoregressive models with spatial autoregressive disturbances. We find a significant amount of spatial variation in vaccination rates across the study area. For the primary study endpoint vaccine efficacy increased with distance from the main study hospital from −14% for children living less than 1.5 km from Bohol Regional Hospital (BRH) to 55% for children living greater than 8.5 km from BRH. Spatial regression models indicated that after adjustment for ecological factors, distance to the main study hospital was positively related to vaccine efficacy, increasing at a rate of 4.5% per kilometer distance. Because areas with poor access to care have significantly higher VE, targeted vaccination of children in these areas might allow for a more effective implementation of global programs.spatial epidemiology | spatial analysis | targeted intervention | randomized controlled trial | GIS

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Section: Methodsmentioning

confidence: 99%

Distance to health services affects local-level vaccine efficacy for pneumococcal conjugate vaccine (PCV) among rural Filipino children

Root

Lucero

Nohynek

et al. 2014

Proc. Natl. Acad. Sci. U.S.A.

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“…Data management team personnel, particularly the statisticians, were still available part time until 2009, when the main trial results were published [ 3 ]. An additional study of the geographic locations of children’s homes and services in the study area took place in years 2008–2009 with core members of the data management team [ 10 ]. Because of the skills that had been acquired, the local data management team was able to apply to this and other new research projects that had hired them.…”

Section: Discussionmentioning

confidence: 99%

The data management of a phase III efficacy trial of an 11-valent pneumococcal conjugate vaccine and related satellite studies conducted in the Philippines

et al. 2012

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BackgroundA large phase III placebo-controlled, randomized efficacy trial of an investigational 11-valent pneumococcal conjugate vaccine against pneumonia in children less than 2 years of age was conducted in the Philippines from July 2000 to December 2004. Clinical data from 12,194 children who were given either study vaccine or placebo was collected from birth up to two years of age for the occurrence of radiologically proven pneumonia as the primary endpoint, and for clinical pneumonia and invasive pneumococcal disease as the secondary endpoints. Several tertiary endpoints were also explored. Along the core trial, several satellite studies on herd immunity, cost-effectiveness of the study vaccine, acute otitis media, and wheezing were conducted.ResultsWe describe here in detail how the relevant clinical records were managed and how quality control procedures were implemented to ensure that valid data were obtained respectively for the core trial and for the satellite studies. We discuss how the task was achieved, what the challenges were and what might have been done differently.ConclusionsThere were several factors that made the task of data management doable and efficient. First, a pre-trial data management system was available. Secondly, local committed statisticians, programmers and support staff were available and partly familiar to clinical trials. Thirdly, the personnel had undergone training during trial and grew with the task they were supposed to do. Thus the knowledge needed to develop and operate clinical data system was fully transferred to local staff.Trial registrationCurrent Controlled Trials ISRCTN62323832

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“…The geographic location of each child's household of residence, along with other demographic information, was collected with geographic positioning systems (GPS) by trained health personnel from November 2008 to June 2009 . The birthplace for 383 children could not be found.…”

Section: Methodsmentioning

confidence: 99%

Disease mapping for informing targeted health interventions: childhood pneumonia in Bohol, Philippines

Thomas

Anthamatten

Root

et al. 2015

Tropical Med Int Health

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Abstractbackground Acute lower respiratory tract infections (ALRI) are the leading cause of childhood mortality worldwide. Currently, most developing countries assign resources at a district level, and yet District Medical Officers have few tools for directing targeted interventions to high mortality or morbidity areas. Mapping of ALRI at the local level can guide more efficient allocation of resources, coordination of efforts and targeted interventions, which are particularly relevant for health management in resource-scarce settings.methods An efficacy study of 11-valent pneumococcal vaccine was conducted in six municipalities in the Bohol Province of central Philippines from July 2000 to December 2004. Geocoded under-five pneumonia cases (using WHO classifications) were mapped to create spatial patterns of pneumonia at the local health unit (barangay) level.results There were 2951 children with WHO-defined clinical pneumonia, of whom 1074 were severe or very severely ill, 278 were radiographic, and 219 were hypoxaemic. While most children with pneumonia were from urban barangays, there was a disproportionately higher distribution of severe/very severe pneumonia in rural barangays and the most severe hypoxaemic children were concentrated in the northern barangays most distant from the regional hospital.conclusions Mapping of ALRI at the local administrative health level can be performed relatively simply. If these principles are applied to routinely collected IMCI classification of disease at the district level in developing countries, such efforts can form the basis for directing public health and healthcare delivery efforts in a targeted manner.

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Geographic Information System and tools of spatial analysis in a pneumococcal vaccine trial

Cited by 7 publications

References 13 publications

Distance to health services affects local-level vaccine efficacy for pneumococcal conjugate vaccine (PCV) among rural Filipino children

Distance to health services affects local-level vaccine efficacy for pneumococcal conjugate vaccine (PCV) among rural Filipino children

The data management of a phase III efficacy trial of an 11-valent pneumococcal conjugate vaccine and related satellite studies conducted in the Philippines

Disease mapping for informing targeted health interventions: childhood pneumonia in Bohol, Philippines

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