Pursuing Data Modernization in Cancer Surveillance by Developing a Cloud-Based Computing Platform: Real-Time Cancer Case Collection.

Cancer surveillance is a field focused on collection of data to evaluate the burden of cancer and apply public health strategies to prevent and control cancer in the community. A key challenge facing the cancer surveillance community is the number of manual tasks required to collect cancer surveillance data, thereby resulting in possible delays in analysis and use of the information. To modernize and automate cancer data collection and reporting, the Centers for Disease Control and Prevention is planning, developing, and piloting a cancer surveillance cloud-based computing platform (CS-CBCP) with standardized electronic reporting from laboratories and health-care providers. With this system, automation of the cancer case collection process and access to real-time cancer case data can be achieved, which could not be done before. Furthermore, the COVID-19 pandemic has illustrated the importance of continuity of operations plans, and the CS-CBCP has the potential to provide such a platform suitable for remote operations of central cancer registries.

Population Heath Informatics Can Advance Interoperability: National Program of Cancer Registries Electronic Pathology Reporting Project.

PURPOSE: Given the reach, breadth, and volume of data collected from multiple clinical settings and systems, US central cancer registries (CCRs) are uniquely positioned to test and advance cancer health information exchange. This article describes a current Centers for Disease Control and Prevention (CDC) National Program of Cancer Registries (NPCR) cancer informatics data exchange initiative. METHODS: CDC is using an established cloud-based platform developed by the Association of Public Health Laboratories (APHL) for national notifiable disease reporting to enable direct transmission of standardized electronic pathology (ePath) data from laboratories to CCRs in multiple states. RESULTS: The APHL Informatics Messaging Services (AIMS) Platform provides an infrastructure to enable a large national laboratory to submit data to a single platform. State health departments receive data from the AIMS Platform through a secure portal, eliminating separate data exchange routes with each CCR. CONCLUSION: Key factors enabling ePath data exchange from laboratories to CCRs are having established cancer registry data standards and using a single platform/portal to reduce data streams. NPCR plans to expand this approach in alignment with ongoing cancer informatics efforts in clinical settings. The 50 CCRs supported by NPCR provide a variety of scenarios to develop and disseminate cancer data informatics initiatives and have tremendous potential to increase the implementation of cancer data exchange.

Using informatics to improve cancer surveillance.

OBJECTIVES: This review summarizes past and current informatics activities at the Centers for Disease Control and Prevention National Program of Cancer Registries to inform readers about efforts to improve, standardize, and automate reporting to public health cancer registries. TARGET AUDIENCE: The target audience includes cancer registry experts, informaticians, public health professionals, database specialists, computer scientists, programmers, and system developers who are interested in methods to improve public health surveillance through informatics approaches. SCOPE: This review provides background on central cancer registries and describes the efforts to standardize and automate reporting to these registries. Specific topics include standardized data exchange activities for physician and pathology reporting, software tools for cancer reporting, development of a natural language processing tool for processing unstructured clinical text, and future directions of cancer surveillance informatics.

A multi-criteria decision analysis approach to assessing malaria risk in northern South America.

BACKGROUND: Malaria control in South America has vastly improved in the past decade, leading to a decrease in the malaria burden. Despite the progress, large parts of the continent continue to be at risk of malaria transmission, especially in northern South America. The objectives of this study were to assess the risk of malaria transmission and vector exposure in northern South America using multi-criteria decision analysis. METHODS: The risk of malaria transmission and vector exposure in northern South America was assessed using multi-criteria decision analysis, in which expert opinions were taken on the key environmental and population risk factors. RESULTS: Results from our risk maps indicated areas of moderate-to-high risk along rivers in the Amazon basin, along the coasts of the Guianas, the Pacific coast of Colombia and northern Colombia, in parts of Peru and Bolivia and within the Brazilian Amazon. When validated with occurrence records for malaria, An. darlingi, An. albimanus and An. nuneztovari s.l., t-test results indicated that risk scores at occurrence locations were significantly higher (p < 0.0001) than a control group of geographically random points. CONCLUSION: In this study, we produced risk maps based on expert opinion on the spatial representation of risk of potential vector exposure and malaria transmission. The findings provide information to the public health decision maker/policy makers to give additional attention to the spatial planning of effective vector control measures. Therefore, as the region tackles the challenge of malaria elimination, prioritizing areas for interventions by using spatially accurate, high-resolution (1 km or less) risk maps may guide targeted control and help reduce the disease burden in the region.

Spatial association between malaria vector species richness and malaria in Colombia.

Malaria transmission in Colombia is highly variable in space and time. Using a species distribution model, we mapped potential distribution of five vector species including Anopheles albimanus, Anopheles calderoni, Anopheles darlingi, Anopheles neivai, and Anopheles nuneztovari in five Departments of Colombia where malaria transmission remains problematic. We overlaid the range maps of the five species to reveal areas of sympatry and related per-pixel species richness to mean annual parasite index (API) for 2011-2014 mapped by municipality (n = 287). The relationship between mean number of vector species per municipality and API was evaluated using a Poisson regression, which revealed a highly significant relationship between species richness and API (p = 0 for Wald Chi-Square statistic). The results suggest that areas of relatively high transmission in Colombia typically contain higher number of vector species than areas with unstable transmission and that future elimination strategies should account for vector species richness.

Prospects and recommendations for risk mapping to improve strategies for effective malaria vector control interventions in Latin America.

With malaria control in Latin America firmly established in most countries and a growing number of these countries in the pre-elimination phase, malaria elimination appears feasible. A review of the literature indicates that malaria elimination in this region will be difficult without locally tailored strategies for vector control, which depend on more research on vector ecology, genetics and behavioural responses to environmental changes, such as those caused by land cover alterations, and human population movements. An essential way to bridge the knowledge gap and improve vector control is through risk mapping. Malaria risk maps based on statistical and knowledge-based modelling can elucidate the links between environmental factors and malaria vectors, explain interactions between environmental changes and vector dynamics, and provide a heuristic to demonstrate how the environment shapes malaria transmission. To increase the utility of risk mapping in guiding vector control activities, definitions of malaria risk for mapping purposes must be standardized. The maps must also possess appropriate scale and resolution in order to become essential tools in integrated vector management (IVM), so that planners can target areas in greatest need of control measures. Fully integrating risk mapping into vector control programmes will make interventions more evidence-based, making malaria elimination more attainable.

Predicting potential ranges of primary malaria vectors and malaria in northern South America based on projected changes in climate, land cover and human population.

BACKGROUND: Changes in land use and land cover (LULC) as well as climate are likely to affect the geographic distribution of malaria vectors and parasites in the coming decades. At present, malaria transmission is concentrated mainly in the Amazon basin where extensive agriculture, mining, and logging activities have resulted in changes to local and regional hydrology, massive loss of forest cover, and increased contact between malaria vectors and hosts. METHODS: Employing presence-only records, bioclimatic, topographic, hydrologic, LULC and human population data, we modeled the distribution of malaria and two of its dominant vectors, Anopheles darlingi, and Anopheles nuneztovari s.l. in northern South America using the species distribution modeling platform Maxent. RESULTS: Results from our land change modeling indicate that about 70,000 km(2) of forest land would be lost by 2050 and 78,000 km(2) by 2070 compared to 2010. The Maxent model predicted zones of relatively high habitat suitability for malaria and the vectors mainly within the Amazon and along coastlines. While areas with malaria are expected to decrease in line with current downward trends, both vectors are predicted to experience range expansions in the future. Elevation, annual precipitation and temperature were influential in all models both current and future. Human population mostly affected An. darlingi distribution while LULC changes influenced An. nuneztovari s.l. distribution. CONCLUSION: As the region tackles the challenge of malaria elimination, investigations such as this could be useful for planning and management purposes and aid in predicting and addressing potential impediments to elimination.

New baseline environmental assessment of mosquito ecology in northern Haiti during increased urbanization.

The catastrophic 2010 earthquake in Port-au-Prince, Haiti, led to the large-scale displacement of over 2.3 million people, resulting in rapid and unplanned urbanization in northern Haiti. This study evaluated the impact of this unplanned urbanization on mosquito ecology and vector-borne diseases by assessing land use and change patterns. Land-use classification and change detection were carried out on remotely sensed images of the area for 2010 and 2013. Change detection identified areas that went from agricultural, forest, or bare-land pre-earthquake to newly developed and urbanized areas post-earthquake. Areas to be sampled for mosquito larvae were subsequently identified. Mosquito collections comprised five genera and ten species, with the most abundant species being Culex quinquefasciatus 35% (304/876), Aedes albopictus 27% (238/876), and Aedes aegypti 20% (174/876). All three species were more prevalent in urbanized and newly urbanized areas. Anopheles albimanus, the predominate malaria vector, accounted for less than 1% (8/876) of the collection. A set of spectral indices derived from the recently launched Landsat 8 satellite was used as covariates in a species distribution model. The indices were used to produce probability surfaces maps depicting the likelihood of presence of the three most abundant species within 30 m pixels. Our findings suggest that the rapid urbanization following the 2010 earthquake has increased the amount of area with suitable habitats for urban mosquitoes, likely influencing mosquito ecology and posing a major risk of introducing and establishing emerging vector-borne diseases.

Resting and energy reserves of Aedes albopictus collected in common landscaping vegetation in St. Augustine, Florida.

The resting behavior of Aedes albopictus was evaluated by aspirating diurnal resting mosquitoes from common landscape vegetation in residential communities in St. Augustine, FL. Energy reserves of the resting mosquitoes were analyzed to determine if there was a correlation between mosquito resting habitat and energy accumulation. Six species of plants were selected and 9 collections of resting mosquitoes were aspirated from each plant using a modified John W. Hock backpack aspirator during June and July 2012. Eight mosquito species were collected, with Ae. albopictus representing 74% of the overall collection. The number of Ae. albopictus collected varied significantly with the species of vegetation. When comparing the vegetation and abundance of resting mosquitoes, the highest percentages of Ae. albopictus were collected resting on Ruellia brittoniana (Mexican petunia), Asplenium platyneuron (fern), Gibasis geniculate (Tahitian bridal veil), followed by Plumba goauriculata (plumbago), Setcreasea pallida (purple heart), and Hibiscus tiliaceus (hibiscus). There were significant differences in lipid and glycogen accumulation based on type of vegetation Ae. albopictus was found resting in. Resting mosquitoes' sugar reserves were not influenced by species of vegetation. However, there was an overall correlation between vegetation that serves as a resting habitat and energy reserve accumulation. The results of our study demonstrate the potential to target specific vegetation for control of diurnal resting mosquitoes.

Evaluation of a new formulation of permethrin applied by water-based thermal fogger against Aedes albopictus in residential communities in St. Augustine, Florida.

The efficacy of a new water-based formulation containing 30% permethrin and 30% piperonyl butoxide against laboratory and field populations of Aedes albopictus was evaluated in the laboratory, in semifield experiments, and in residential communities in St. Augustine, FL. In laboratory bottle bioassay, 3 doses (3.18 g/ml, 2.26 g/ml, and 1.59 g/ml) of the permethrin product resulted in 100% mortality of adult mosquitoes in 1 h. In semifield experiments, the insecticide sprayed by the water-based thermal fogger at 381.5 ml/min application rate caused 99% mortality of caged mosquitoes. At 24 h posttreatment in the residential communities, there was 79% and 83% reduction of the natural population (numbers) of adult Ae. albopictus and all adult mosquito species collected in BioGent (BG) sentinel traps baited with a BG lure in the 3 test sites, respectively. There was also a 79% reduction in the number of Ae. albopictus eggs collected in ovitrap used in the treated sites. The reductions were significant for adult Ae. albopictus and all mosquito species at 1 wk posttreatment, but no significant reduction was observed at 2-3 wk posttreatment. These findings demonstrate the effectiveness of the new water-based permethrin product against Ae. albopictus populations in residential communities.

Evaluation of boric acid sugar baits against Aedes albopictus (Diptera: Culicidae) in tropical environments.

Attractive toxic sugar bait (active ingredient, 1% boric acid) was evaluated against Aedes albopictus Skuse populations in the laboratory, semi-field trials, and field trials in residential communities in St. Augustine, Florida. Laboratory evaluations of boric acid sugar baits applied to the plant Pentas lanceolata (Rubiaceae) demonstrated 100 and 92% mortality of A. albopictus at day 7 and 14, respectively. A semi-field study evaluating the bait application to the upperside or topside of leaves resulted in no significant difference on mortality (P>0.05). Overall combined top and bottom boric acid sugar bait application mortality at day 7 was 95% based on leaf bioassays. Field application of the boric acid sugar baits significantly (P<0.05) decreased adult A. albopictus populations up to day 21 post-treatment compared to the pre-treatment population numbers. A significant reduction in oviposition was demonstrated both at day 7 and 14 post-application (P=0.001) as monitored by ovitraps. Attractive toxic sugar bait application in tropical environments demonstrated efficacy, persistence, and feasibility in controlling A. albopictus populations.

How much vector control is needed to achieve malaria elimination?

Roll Back Malaria's ambitious goals for global malaria reduction by 2015 represent a dilemma for National Malaria Control Programs (NMCPs) that are still far from malaria elimination. Current vector control efforts by NMCPs generally fall short of their potential, leaving many NMCPs wondering how much vector control it will take to achieve malaria elimination. We believe the answer is detailed in the relationships between the entomological inoculation rate (EIR) and four epidemiological measures of malaria in humans. To achieve adequate vector control, NMCPs must evaluate EIRs to identify problematic foci of transmission and reduce annual EIRs to less than one infectious bite per person.