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Using Google Maps for Targeted Hepatitis B Interventions

Using Google Maps for Targeted Hepatitis B Interventions. LCDR Kathy Byrd, MD, MPH Brittney Baack, MPH U.S. Public Health Service ORISE Fellowship Prevention Branch, Division of Viral Hepatitis Centers for Disease Control and Prevention. Outline.

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Using Google Maps for Targeted Hepatitis B Interventions

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  1. Using Google Maps for Targeted Hepatitis B Interventions LCDR Kathy Byrd, MD, MPH Brittney Baack, MPH U.S. Public Health Service ORISE Fellowship Prevention Branch, Division of Viral Hepatitis Centers for Disease Control and Prevention

  2. Outline • Hepatitis B infection • Global burden of hepatitis B • Hepatitis B among foreign-born persons • Imported cases of hepatitis B • Overview of CDC demonstration project • Demonstration of how to use Google Maps to identify and target populations

  3. Global Hepatitis B Infection • A leading cause of infectious disease morbidity and mortality worldwide • ~ 2 billion persons have past or present hepatitis B infection • ~ 350 million people are chronically infected • ~ 620,000 die from hepatitis B annually

  4. Hepatitis B Infection • Chronic infection cirrhosis, liver failure, hepatocellular carcinoma • Development of chronic infection inversely related to age at infection • > 90% in children infected < 1 year of age • 5% in persons infected after age 5 years • Mortality • 25% of chronic infections before age 5 • 15% chronic infections age > 5 years

  5. Hepatitis B Endemicity MMWR 2008; Vol. 57 (RR 8)

  6. Hepatitis B and Foreign-born Persons in the United States • 1 million immigrants enter U.S. annually • > 60% from high or intermediate level endemic countries • Global hepatitis B vaccination programs are expanding but variable J Painter Presented at ICEID 2010

  7. Hepatitis B and Foreign-born Persons in the United States • 2008 CDC recommendation for U.S. screening of persons from endemic countries, uptake is unknown • U.S. routine infant vaccination policy does not affect imported cases MMWR 2008; Vol. 57 (RR 8) J Painter Presented at ICEID 2010

  8. Hepatitis B Incidence—United States,1980 – 2009 All birth dose (2005)

  9. Number of Imported Hepatitis B Cases, 1980-2008 J Painter Presented at ICEID 2010

  10. Estimated Number of Chronic Hepatitis B Cases among Foreign-born in the U.S Foreign born residing in the U.S. (millions) Foreign-born with CHB (thousands) 10,639,219 773,397 96,489 14,381,701 156,852 3,444,258 2,600,687 34,135 833,943 5,798 187,587 8,074 152,054 1,475,642 97,995 4,870,823 Kowdley et al. Hepatology 2012

  11. Chronic Hepatitis B among Foreign and U.S.-born Persons

  12. Chronic Hepatitis B among Foreign and U.S.-born Persons 13% of total U.S. population

  13. The Public Health Problem… • The majority of CHB in the U.S. are among foreign-born persons • Number of imported cases is increasing • ~60-70% of persons with CHB are unaware of their infection status • ~50% of those diagnosed with CHB receive appropriate care

  14. The Public Health Problem… • Mortality secondary to untreated disease is likely to be high • U.S. vaccination strategy does not affect hepatitis B importation • Elimination of hepatitis B in the U.S. requires that imported cases be addressed

  15. CDC Demonstration Project: Community-based Hepatitis B Screening among Foreign-born Populations • Identify and map foreign-born populations within the United States • Link Community-based organizations with clinical services • Conduct hepatitis B screening, vaccination and referral for care of foreign-born populations

  16. How to Identify and Target Foreign-born Populations for Hepatitis B Interventions?

  17. Google Fusion Tables

  18. Google Fusion Tables

  19. Population Estimates: U.S. Census • 2010 Census/ Historical Census • Basic demographic information, including age, gender and race/ethnicity • American Community Survey (ACS) • Collected annually • Basic demographic information • Family/ relationships, housing, education, income, health insurance, veteran status, employment, transportation, citizenship, country of birth

  20. Population Estimates: U.S. Census www.census.gov Data American FactFinder

  21. Population Estimates: American FactFinder

  22. Population Estimates: American FactFinder

  23. Population Estimates: American FactFinder

  24. Population Estimates: American FactFinder

  25. Google Fusion Tables

  26. Geographic Information: U.S. Census www.census.gov Geography TIGER

  27. Geographic Information: TIGER/Line Shapefiles • Select TIGER/Line Shapeflies & Files • Then 2010 TIGER/Line release

  28. Geographic Information: TIGER/Line Shapefiles 1 2 3

  29. Geographic Information: Converting to KML files with GeoCommons

  30. Geographic Information: Converting to KML files with GeoCommons

  31. Geographic Information: Converting to KML files with GeoCommons

  32. Google Fusion Tables

  33. Google Fusion Tables: Developing Interactive Maps www.google.com/fusiontables documents.google.com

  34. Google Fusion Tables: Developing Interactive Maps • Upload to Google Documents: • Foreign-born population estimates • Los Angeles census tract KML file • Select Create • Table (beta)

  35. Google Fusion Tables: Developing Interactive Maps • Import a new table by selecting each file from a local drive, click through to complete upload

  36. Google Fusion Tables: Developing Interactive Maps

  37. Google Fusion Tables: Developing Interactive Maps

  38. Google Fusion Tables: Developing Interactive Maps

  39. Google Fusion Tables: Developing Interactive Maps

  40. Google Fusion Tables: Developing Interactive Maps

  41. Google Fusion Tables: Developing Interactive Maps

  42. Google Fusion Tables: Developing Interactive Maps

  43. Google Maps: Asia-born Populations, LA county Source: U.S. Census Bureau, 2005-2009 ACS | Built with: Google Fusion Tables

  44. Google Fusion Tables: Developing Interactive Maps

  45. Google Fusion Tables: Developing Interactive Maps

  46. Google Maps: Asia-born Populations, LA county Source: U.S. Census Bureau, 2005-2009 ACS | Built with: Google Fusion Tables

  47. Google Maps: Community-Based Resources, LA County Source: U.S. Census Bureau, 2005-2009 ACS | Built with: Google Fusion Tables

  48. Advantages to Mapping Populations • Unlike some other populations, foreign-born persons may not necessarily be accessed through high-risk venues • Identifies where targeted populations reside and whether population is congregated

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