Health GIS - Enabling Health Spatially

This research uses a plan of explorative study towards main roads. Therefore, the decision to determine the the spreading of public health center and the settlement transportation fee is based on classification of area scope to public health center. The method that is used is scope. Based on that, the analysis on everyone’s spatial analysis (Amri, 2003), especially spatial pattern transportation fee to Puskesmas is conducted by a in which all information obtained will be analyzed and method in which the analysis result of scope pattern to presented in the form of a map. Analyzing method that Puskesmas (public health center) showed by the is used is nearest-neighbor analysis. This method is used classification of scope area (very near, near, middle, far, to identify the spreading pattern of public health center very far) is converted into Rupiah value. by using geographical information system so that the pattern of scope area to public health center can be iden - 3. RESULT AND DISCUSSION tified as well (Amri, 2003). Depok city is located in the northern part of West Java Province which is geographically located at 6019’00” – The design of this research is explorative study on scope 60 19’00” south latitude and 106043’ – 106055’30” east area and transportation fee to public health center by longitude. Depok landscape from south to north is hilly using spatial analysis method, especially spatial pattern, lowland area with weak wave, elevation between 40-140 to identify the spreading pattern of public health center meters above the sea level, and the declivity of its slopes and the pattern of settlement scope to public health is less than 15%. center in Depok city in the form of a map. This research is conducted in administrative region of Depok city. The Figure 1 Map of Administrative Area of Depok City target of this research is all public health centers which are located in administrative region of Depok city. The 3.1 Puskesmas Spreading research was done from April until June 2008. The units of analysis are 27 dots of public health center location in Health service given by Puskesmas (public health working area of Depok city health official, highways center) is a total health service which covers curative, and main roads in administrative region of Depok city, preventif, promotive, and rehabilitative service. settlement in administrative region of Depok city. The Puskesmas location is determined based on districts and collected primary data are coordinate dots of public scope of Puskesmas working area, as well as the number health center location which are obtained through the of patients’ visits in Depok city in 2006. The number of survey done in the field by using GPS (Global Puskesmas in Depok city is 27 which cover 2 until 3 Positioning System) equipment (Abidin 2000). districts. 2.1 Analysis Method of Puskesmas Spreading Pattern Method used to explain the spreading pattern of 27 public health centers in Depok city is nearest-neighbor analysis to identify if that spreading is clustered, random, or uniform. Nearest-neighbor analysis is a quantitative method using mathematical calculation with the formula as follow (Hagget, 2001): (1) Figure 2 Distribution of Puskesmas In which Rn = spreading index of the nearest neighbor Puskesmas (public health center) existing in Depok city Dobs = average distance measured between one are Puskesmas Pancoran Mas, Puskesmas Depok Jaya, Puskesmas Rangkapan Jaya, Puskesmas Jembatan spot with another spot of its nearest Serong, Puskesmas Beji, Puskesmas Kemiri Muka, neighbor (in kilometers) Dexp = average distance obtained if all dots have random pattern (in kilometers) a = the spot density in kilometers square R = 1,00 random pattern, R > 1,00 uniform pattern, R < 1,00 clustered pattern The calculation of transportation fee for everyone to reach a public health center is determined by accessibility factor of public health center, that is, the distance of Puskesmas scope and the distance to the

Puskesmas Tanah Baru, Puskesmas Sukmajaya, Figure 4 Scope Area Pattern to Puskesmas in Depok Puskemas Abadi Jaya, Puskesmas Kalimulya, City Puskesmas Cilodong, Puskesmas Villa Pertiwi, Puskesmas Bhaktijaya, Puskesmas Pondok Sukmajaya, According to the map, the light blue color indicates are- Puskesmas Cimanggis, Puskesmas Tapos, Puskesmas as which are far from Puskesmas or areas which have di- Tugu, Puskesmas Jatijajar, Puskesmas Sukatani, stances more than 2000-3000 meters from Puskesmas Puskesmas Harjamukti, Puskemas Pasir Gunung Selatan, and have distances more than 500-1000 meters from ro- Puskesmas Sawangan, Puskesmas Pondok Petir, ads. The dark blue color indicates areas which are very Puskesmas Cinangka, Puskesmas Duren Seribu, far from Puskesmas or areas which have distances more Puskesmas Limo, Puskesmas Grogol. than 3000 meters from Puskesmas and have distances more than 1000 meters from roads. The analysis on the spreading pattern of health service facilities using nearest-neighbor analysis model results Generally, Puskesmas in Depok city are already close to in R value or index of the nearest-neighbor spreading at the settlement. This can be see from the big percentage 1,399. This means that R value > 1,00 so the pattern of of scope areas, which are close to Puskesmas. However, Puskesmas spreading in Depok city is random. if referring to the Puskesmas work guidelines, the ratio of Puskesmas should be 1 : 30.000 people, with the Figure 3 Distribution puskesmas with roads and number of population : 1.420.480 people. This is still far settlement from what is expected because the current Puskesmas ra- tio is 1 : 52.000 people. Not only does the lack of From the result of analysis on settlement, the width of Puskesmas influence the number of people’s visits to settlement (built) in Depok city is 90,24 km2 or 45,05 % Puskesmas, but it also influence Puskesmas in giving the of Depok city width. Based on the map of Puskesmas entire health service to people living around Puskesmas. spreading in Depok city settlement, it can be seen that (Puskesmas Work Guidelines, 1992). yellow color (the settlement) is widespread almost in all Depok city area. 3.2 Pattern of Puskesmas Scope Area to Settlement Figure 5 Buffer area of Puskesmas To obtain the pattern of scope area to Puskesmas, this On the map, it can be seen that there are two colors to research uses SIG model, that is, by determining buffer identify the scope areas of Puskesmas to settlement in from Puskesmas dots and buffer from the road. In terms Depok city. The dark blue color indicates areas which of Puskesmas buffer, the distances used are 0-200 meters have distances with more than or equal to 3000 meters from Puskesmas dots, >200-500 meters from Puskesmas from Puskesmas, whereas the light blue color indicates dots, >500-1000 meters from Puskesmas dots and >1000 areas which have distances with less than or equal to meters from Puskesmas dots. In terms of road buffer, the 1000 meters from Puskesmas. distances used are 0-200 meters from main roads, >200- 500 meters from main roads, >500-1000 meters from 3.3 Transportation Fee to Puskesmas main roads and >1000 meters from main roads. Based on the collected data, it can be identified that 29,14 % of the population are not so far away from

Puskesmas in Depok city or they only need 6000 rupiahs InformasiGeografis.Jurusan Geografi, to visit Puskesmas. 28,23 % of population are close to Puskesmas or they need 4000 rupiahs to visit Universitas Indonesia, Puskesmas. 16,56 % of the population are very close to Puskesmas. On the other hand, people who are far from Azwar, Azrul. 1996 Pengantar Administrasi settlement are 18,79 % or they need 8000 rupiahs to visit Puskesmas. 7,27 % are very far or they need 10.000 Kesehatan. Edisi Ke – 3 . Bina Rupa rupiahs to visit Puskesmas. 73,9 % of depok people are close to (very close, close, and medium) Puskesmas and Aksara. the cost to visit Puskesmas is Rp 2000-Rp 6000. 26,1 % are far (far and very far) from Puskesmas and the cost to Bintarto, R dan S Hadisumarno, 1987. Metode Analisa visit Puskesmas is Rp 8000-Rp 10.000. Geografi, LP3ES, Jakarta Figure 6 Estimation for Transportation Fee from Settlement to Puskesmas in Depok City Boulos, M.N.K. 2000. Health Geomatics. MIM Centre, Regarding the location, one of the factors which deter- School of Informatics, City University. mines if location is interesting to visit or not is accessi - bility level. Accessibility level is a level of ease to reach London. a location by considering the others. De Mers. 1997. Fundamentals of Geographic 4. CONCLUSION Information Systems. John Wiley & Sons, 1. Based on the pattern of Puskesmas spreading in Depok city, it can be seen that R value or Index of New York. the nearest-neighbor spreading is at 1,399. This means that R value > 1,00 so the pattern of Dinas Kesehatan Kota Depok, 2007. Profil Puskesmas spreading in Depok city is random. Kesehatan Kota Depok 2007. Dinas 2. The pattern of settlement scope to Puskesmas is as follow : Kesehatan Kota Depok, Jawa Barat a) 26,1 % of settlement in Depok city are categorized as far areas (far and very far) Haggett, P. 2001. Geography: A Global Synthesis. from Puskesmas. b) 73,9 % are categorized as near (very near, Pearson Education. England. near, medium) Puskesmas. Indonesia, Departemen Kesehatan RI, 1992. 3. Transportation fee from settlement to Puskesmas which is 2000-6000 rupiahs is 73,9 %, and 8000- Pedoman Kerja Puskesmas. Jilid I. 10.000 rupiahs is 26,1 %. Departemen Kesehatan RI, Jakarta REFERENCES Indonesia, Departemen Kesehatan RI, 2004. Sistem Abidin, Hasanuddin Z, Dr. 2000Penentuan Posisi Dengan GPS Dan Aplikasinya. PT. Kesehatan Nasional. Jakarta: 2004. Pradnya Paramita. Jakarta. Kamaluddin, Rustian. Prof. Drs. H. 2003. Ekonomi Achmadi, U.F. 2005. Manajemen Penyakit Berbasis Wilayah. Cetakan 1. Penerbit Buku Transportasi. Ghalia Indonesia. Jakarta Kompas. Jakarta. Laurini, Robert. 1992. Fundamentals of Spatial Amri, Asmarul. 2003Buku Pengenalan Dasar tentang Geografi dan Sistem Information Systems. Academic Press Limited, Nuarsa, I Wayan. 2005. Belajar Sendiri Menganalisis Data Spasial Dengan Arc View GIS 3.3 Untuk Pemula. Elex Media Komputindo. Jakarta. Prahasta, E. 2001. Konsep-konsep Dasar Sistem Informasi Geografis. Penerbit Informatika Bandung, Prahasta, E, 2002. Sistem Informasi Geografis: Tutorial ArcView, Informatika, Bandung.

ROLE OF SOCIO-CULTURAL SYSTEM IN THE EMERGENCE OF DISEASES – A CASE STUDY OF HYDERABAD M. V. Lakshmi Devi Associate Professor & Head, Department of Sociology, R.B.V.R.R.Women’s College, Hyderabad, Andhra Pradesh , India, [email protected] ABSTRACT: There has been a remarkable progress in the prevention, control and even eradication of infectious diseases with improved hygiene and development of antimicrobials and vaccines. Nonetheless, infectious diseases are a dominant public health problem even in the 21st century. The World Health Organization estimates 25% of the total 57 million annual deaths that occur worldwide are caused by microbes and this proportion is significantly higher in the developing world. The impact of the emerging and re-emerging diseases in India has been tremendous at socioeconomic and public health levels. Very recently the residents of Bholakpur area of the city of Hyderabad have severely suffered due to waterborne disease. The present study is an attempt to understand the interplay of socio-economic-political facets of emerging diseases in urban areas. Hyderabad is selected as a case for this study. The data is collected from the media reports of outbreak of disease and also from the residents of the affected area. One of the major findings of the study is that the living conditions, cultural norms of the residents, particularly, related to health and hygiene, apathy on the part of the community leaders and the residents promulgate the diseases. Effective surveillance is the key to their early containment. There is a need to develop epidemiology at the community level and improved diagnostic facilities which should be rapid, specific, simple and affordable. The strategy to combat these diseases needs a strong public health structure, effective risk communication, epidemic preparedness and rapid response. KEY WORDS: Outbreak of diseases, Cultural considerations and Community health There has been a remarkable progress in the century involve social, cultural and behavioral prevention, control and even eradication of change. Our knowledge about how social and d infectious diseases with improved hygiene and behavioral factors affect health has grown development of antimicrobials and vaccines. enormously, but effecting the individual and Nonetheless, infectious diseases are a dominant societal changes needed to reach public health public health problem even in the 21st century. goals is no easy task. The World Health Organization estimates 25% Understanding the complexities of the individual of the total 57 million annual deaths that occur requires inclusion of, rather than classification worldwide are caused by microbes and this by, ethno-cultural and contextual factors in the proportion is significantly higher in the psychological assessment and intervention developing world. The impact of the emerging process. and re-emerging diseases in India has been tremendous at socioeconomic and public health ETHNO CULTURAL CONTEXT levels. Ethno-cultural orientation is the first domain of PUBLIC HEALTH AND SOICIO- culture and contexti . Ethno cultural orientation is CULTUREAL ASPECTS a multidimensional domain that includes gauging the extent to which a person affiliates with his or Public health has always been concerned with her culture of origin and the dominant culture. the ways in which social conditions influence the This concept has also been referred to as health and well-being of communities and acculturation. People born in other states /towns human populations. The most important or villages who reside at Hyderabad for more challenges for improving health in the 21st than a visit are no doubt challenged with trying

to reconcile their beliefs, values, and little success, often due to inadequate understanding of social norms with what is understanding of people's sanitation approach. required in their new home. The availability of Sanitation approach includes the perception, feel familiar homeland foods is limited. Obedience to and practices involved in satisficing the primal the laws, education for ht children, employment, need to defecate and urinate (and their disposal). and housing- all require an active connection to, Santosh M. Avvannavar and Monto Maniiii and understanding of, the dominant culture. The traced the various approaches that diverse second domain is family environment. societies/civilizations, over time, across the Community environment is the third domain of world have had towards sanitation, and present a culture and context. This domain involves structure to articulate and understand structural aspects of the community where the determining factors. client currently lives [i.e., geographical place, social support networks, work settings, and Aims of the present study: institutional support systems]. The sociopolitical Very recently the residents of Bholakpur area of climate must also be considered in assessment of the city of Hyderabad, capital city of Andhra community environment. There is always the Pradesh state, India, have severely suffered due possibility that racism [sexism, ageism, etc.] to waterborne disease. The present study is an bias, and discrimination contribute to attempt to understand the ethno-cultural facets of community-related stress. The fourth domain of emerging diseases in urban areas. culture and context is communication style. It includes the extent to which a person is able to Data collection: send and receive accurate information as he or The data is collected from the media reports of she interacts with his or her environment. outbreak of disease and also from the residents of the affected area. CONTEXT OF THE STUDY On 5th may 2009, the news was published in the city editions of all major newspapers about the While health care services are increasingly being deaths of people at Bholakpur. Six persons, three seen as a major proximate determinant decreased of them children, died and 200 others were mortality in a population, it also seems to be the hospitalized after they consumed contaminated case that the mere provision of services does not water in Bholakpur and its adjoining areas. The lead to their better utilization. Basic health of the worst affected areas are Bholakpur, Indir-anagar, society must be fulfilled and then only people Gulshannagar, Tajirnagar, Musheerabad, will be able to utilize the health care services. Bangladesh and Lanka basthi. Prime importance is given among the basic needs of the human beings to safe drinking Conditions at these slums: water. The year 2005 marked the beginning of Residents complained that water officials did not the “International Decade for Action: Water for respond to their repeated pleas that drinking Life” and renewed effort to achieve the water was getting contaminated. The sewer Millennium Development Goal (MDG) to reduce drains have not been desilted for weeks here. by half the proportion of the world’s population Residents said water is not flushing out of their without sustainable access to safe drinking water toilets as the drains are choked. The biological and sanitation by 2015 . It has been estimated analysis of water samples from Bholakpur that diarrheal morbidity can be reduced by an revealed abnormal presence of E.coli which is average of 6-20 per cent with improvements in found in human faeces. The Institute of water supply and by 32 per cent with Preventive Medicine (IPM), the National improvements in sanitationii.Sanitation is a term Institute of Cholera and Enteric Diseases as well primarily used to characterize the safe and sound as the report by the Greater Hyderabad handling (and disposal) of human excreta — or Municipal Corporation revealed that water simply, people's approach to take-care of their contaminated with faecal matter led to diarrhoea (unavoidable) primal urge. According to the cases and the outbreak of diseases like choleraiv. recent Human Development Report 2006 Global Animal-skin trade is one of the major activities access to proper sanitation stands at of this area which creates unhygienic conditions approximately 58% with 37% being a in the area. conservative estimate both for South Asia and Residents of Bholakpur and its adjoining slums Sub-Saharan Africa. Various multi-million dollar are still at risk of getting polluted water sanitation programmes the world over have had

supply. Though the Water Board laid a new The family gave her some bread and milk and water pipeline and resumed supply, it does not have data on the number of manholes and sewer made her rest. When her condition deteriorated lines that run through numerous by-lanes. Over the years, local residents have covered on Monday morning, they rushed her to Gandhi hundreds of manholes after making them concrete and even the maps available with area Hospital where doctors declared her brought officials do not have details of these “concealed” manholes. The latest survey taken up by the deadv. Board using the Global Positioning System (GPS) has revealed that over 1,000 manholes Major findings of the study reveal that the living have been covered due to encroachment by slum dwellers. Some have laid “Shabad” stones and conditions, cultural norms of the residents, others have levelled the ground with mud. These manholes have not been cleaned or desilted for particularly, related to health and hygiene, years now. Using the GPS system, the Board officials are now locating each manhole and apathy on the part of the community leaders and reviving it. the residents promulgate the diseases. Financial situation of the respondents: In conclusion, poor planning and maintenance Most of the respondents are from lower and of the water supply system coupled with the lower-middle class having income of Rs. 3,000 cultural traditions and the insensitivity towards to Rs.5, 000 per month. Despite their financial the urban social life of both the respondents as position, they rushed to the corporate hospitals well as the officials has led to inappropriate fearing lack of facilities in government hospitals usage and over-exploitation of available and with a hope that their relatives would resources, thereby causing contamination in the recover within a couple of days. Around 300 study area. The existing guidelines need to be families from Bholakpur have sought modified. Proper measures should be reimbursement of the huge bills they paid in formulated for periodic monitoring and stricter private hospitals to get treatment for water implementation of these guidelines, and policy contamination. makers should be sensitized. Effective surveillance is the key to their early Cultural environment: containment. There is a need to develop Open air defecation, a common practice among epidemiology at the community level and villagers, may lead to contamination of the water improved diagnostic facilities which should be supply system and result in outbreaks of rapid, specific, simple and affordable. The diarrhoeal disease. When people migrate from strategy to combat these diseases needs a villages and start living at slums due their strong public health structure, effective risk economic situation, they continue their habits of communication, epidemic preparedness and open air defecation even at cities. The conditions rapid response. prevailing at the slums encourage it . the case study area is not an exception. Another belief observed among the respondents is that not taking the health complaints seriously. Complaints regarding ill health, particularly form women, will be considered as common and should not be given much importance. The interview with one of deceased‘s father clearly depicts this. Tarannum’s father, Mr Md Shamsuddin, said his daughter had complained of nausea on Sunday. “We did not take it seriously. She even had food with all of us. She started vomiting the next day and by evening was suffering.”

i Martin. William, E.Jr., Swartz-Kulstad, Jody L.; Madson, Michael [1999] psychological factors that predict the ollege adjustment of first-year undergraduate students; implications for college counselors; Journal of college Counselling, V 2 N 2 Pp121-33 Fall ii World Health Organization. Water Sanitation and Hygiene Links to Health Facts and Figures. Geneva, World Health Organization; 2004. Available from: http://www.who.int/water_sanitation_health/factsfigures2005.pdf, Accessed on November 14, 2007. iii Santosh M. Avvannavar and Monto Mani [2008] A conceptual model of people's approach to sanitation Environment. Volume, 1 February, Pages 1-12 iv Deccan Chronicle, 18th May 2009 v Deccan Chronicle, 5th May 2009

Modeling Spatial Risk for Prime-Age Adult Mortality in Vietnam Abstract Deok Ryun Kim The objective of this study is to model the geographically-related risk for gender- Mohammad Ali, specific prime-age adult (15 to <45 years) mortality in two cities of Viet Nam Vu Dinh Thiem, using a Bayesian hierarchical spatial approach. Two study sites were split in Camilo J Acosta, 500x500m cells to define neighborhoods. The number and causes of death in Lorenz von Seidlein, adults were extracted from demographic and hospital surveillance systems in Michael Favorov and each site. Individual level mortality data were aggregated by the neighborhood, John D Clemens and linked to spatial units using geographic information systems. A Poisson multiple-membership multiple-classification model estimating parameters in a Markov chain Monte Carlo simulation was employed to obtain spatially smoothed relative risk. One model was constructed without covariate (null model), and other one was with covariates (covariate model). Adult male mortality was more than twice the adult female mortality. The most frequent causes of death in adult were traffic accidents followed by drowning for male and suicide for female. Lower education of the head of household was an important risk factor for increased adult mortality. Mortality maps show that about 60% of the neighborhoods with higher mortality risk in the null model (no covariates included in the model) overlapped with neighborhoods with higher mortality risk in the covariate model. In contrast, the null model based risk areas of mortality between male and female showed little overlap. Our analysis indicates that areas of differing mortality risk exist and can be described in the context of locally important factors. Use of this technique to identify areas of increased risk will be helpful to policymakers when considering potential public health interventions to reduce preventable mortality and to adapt healthcare services accordingly.

A Spatial Decision Support system to Blood Bank Services: A Case study to private blood bank in Tumkur Abstract Prema Sudha Someone needs blood every two seconds. Much of today's medical care depends Shivakumar Swamy, on a steady supply of blood from healthy donors. People who donate blood are volunteers and are not paid for their donation. India can do with more blood B. S. Adiga and donors. Only around 45 per cent of the seven million units of blood that the Smita M. Kolhar. country needs every year are met through voluntary donation. The creation of successful blood bank policy and location of resources increasingly relies on evidence-based decision making management system. As blood bank services are rationalized, the development of tools such as graphical user interfaces (GUIs) are especially valuable as they assist decision makers in allocating resources helps the bunk in maintaining the maximum number of donors to meet the daily demand. Geographic Information System (GIS) can be used to develop GUIs that enable spatial decision-making to blood bank information system. Results: This paper explores the possibilities of using GIS to assist blood bank policy makers and a blood bank management at Tumkur city, Karnataka, India. A GUI based GIS application is created to cover three main blood bank planning issues which are distribution of blood bank demand, classification of donors and the definition of blood bank service area. Each one of these issues is covered using several GIS functions. Conclusions: Blood bank policy makers and administrators can use The GUI with little or no formal GIS training to visualize multiple resource allocation scenarios. The GUI is poised to become a critical decision-making tool especially as evidence is increasingly required for donor management issues.

Providing the Possibility of using GIS in Management Decision Making in the Health Sector Abstract Mohammad Zare Information and its major effect on strengthening the process of management Parvin Shamszadeh decision-making cause the maximum efficiency in a system. Thus, if the information makes available for managers with required speed and in a proper and Abbas Najjari way, it will help them to make correct and proper decisions. Unavailability of such conditions will cause irretrievable problems specially in the health sector. The objective of applying Geographical Information System in health management is to prevent the incidence and prevalence of different diseases through survey and analysis the way of their incidence and prevalence with regard to geographical situation and environmental conditions. In this way the proper managerial strategies will obtain for health controlling. After necessary studies and organizing expertise meetings, three districts (Farsan from Chaharmahal Bakhtiari province, Dashti from Boushehr province and Bam from Kerman province) were chosen where have ecological variety and environmental related diseases. This project was performed through contracting agreement with private sector, cooperating above mentioned districts health network and under surveillance of the Bureau of Development and Coordination of Statistical System. The data model of this project was designed in the form of geographical databank on the basis of descriptive information of health network and need assessment. The system was accountable to information needs of health system and there is the possibility of its development and improvement from many aspects. GIS, diseases, managers, prevalence, health, map, health house, village, descriptive information, geographical information, spatial information

The Analysis of Accessibility Levels and Health and Therapeutic Service Allocation with use of GIS (A Case Study Zanjan City Hospitals) Abstract Mohsen Ahadnejad and Attention to optimum distribution and allocation of common service same as Abdollah Heidari. health and therapeutic service is objective that in recently years attend by planners in different countries. One of these services is hospitals that have main and sensitive role in crisis due to disasters and so remarkable mitigation mortality. The necessity of suitable and enough distribution and also optimum allocation for easy and safe accessibility this center more clear. In this research first of all spatial distribution of hospital in case study area has been evaluated and then coverage area and accessibility levels analyzed using network analysis and exiting functions in GIS. After this analysis the area and population in out of hospital coverage is determined. Finally with use of efficacy factors in optimum allocation of hospitals using AHP model and fuzzy logic for weighting and combination of factors, suitable area for hospitals site is specified.

Technical Session - 9 Systems and Software The Investigation of Stress Factors Related to Job Finding in Educated Women & Its Relationship with their General Health Katayoon Bavandpour and Seyed Mehdi Feiz Javadian.………………………………….………..….…..186 Family Planning and Birth Regulation Applying Vital Horoscope Forms and GIS Software Mahdieh Khanmohammadi, Fatemeh Haji Ali Asgari and Nadereh Hasan Dulabi……………...............187 A GIS Model for Suitable Settlement Camp Regarding Disaster, Tehran, Iran Hassan Samadyar, Ardavan Sasani and Robab Samadyar………………………………….……………..189 Open Source Quantum GIS-Based 'Gram Panchayat QGIS' for use by Village Workers in Participatory Panchayat Development Planning and Implementation Nagesh Kolagani, C. Lakshmana Rao, Koshy Varghese, I. V. Murali Krishna, Aparna Krishnan, S. V. Ramanan and A. Ravindra……………………………………….………….…...................................194 Application of GIS in Health-Care Service Accessibility Increasation Mahdieh Khanmohammadi, Fatemeh Haji Ali Asgari and Roya Naghavi…….…………….....................197 GIS-Based Spatial and Temporal Distribution of Anopheline Vectors in Main Malaria FOCI of Iran A. A. Hanafi-Bojd, H. Vatandoost, Z. Charrahy, M. A. Oshaghi…………………………………………..200 Polyanalyst- Spatial Datamining Tool for Polio Cases Analysis K. Anuradha, P. Premchand, N. Sandhya and I. V. Murali Krishna………………………………………205

The Investigation of Stress Factors Related to Job Finding in Educated Women & Its Relationship with their General Health Abstract Katayoon Bavandpour and Today in Iran, women are 50% of manpower & more than 62% of them go to Seyed Mehdi Feiz Javadian universities yearly but only 13-15% of them will be able to find a proper job. In other word the rate of jobless index is 50% & twice the men. This has caused a great problem for women's future. Trying to find a job is not simple for especially women, regarding the problems in employing in governmental or nongovernmental organizations. Educated women in any course of study can not find a job in a short time or immediately after the graduation. So they will become involved in stress, anxiety & depression & they will lose their mental & physical health .Because stress has many harmful impacts on their mental & physical Health & will not let them to make decisions & finally choose a proper job. Many researchers have shown that those women are more anxious & experience more stress than men. So this study has been done to determine the main negative factors resulted in job finding in educated women & try to find its relationships with their general health. Hoping to decrease or remove the main problems in this way & promote their general health. 200 graduated women with different courses of studies among the whole graduated people at Kermanshah University of Medical Sciences (KUMS), were selected randomly. Data was collected by a researcher made questionnaire contained 15 questions about the necessity of consultancy services for women in universities, the ability to find a job & also the kinds of those activities which should be considered in it. And the other questionnaire was GHQ. The results were analyzed by descriptive statistical methods, using tables & graphs. It showed that there was not a meaningful relationship between demographic characteristics of statistical population & their general health. But there was a relationship between their courses & the duration of studies with stress factors.79% of them believed in improving women consultancy services at universities,60% believed in choosing proper job is not simple & they can not do it by themselves,63% of them didn't aware of those necessary activities after graduation to find a job. The results showed that educated women are more anxious about their future job situation than men. They believed that the most important factors in this field are gender discrimination in the process of employing & old beliefs about home responsibilities for women at home. They also believed that these factors do not let the women to increase their attendance in social & cultural activities. So it will cause harmful effects on their general health. Mrs. Karke Abadi in 2003 has determined that there is a positive correlation in relationship between the stress of job finding & depression. Mr. Amiri in 2004 in a study which had been carried out between 2 groups of women, one educated & the other non educated women has shown that educated women were more anxious than the other group & their health was not in a good situation. They had experienced disorders in sleeping, anxiety, headache, family problems, drinking alcohol & drug addiction. The most important strategies to reduce stress & promote general health are as follows: 1 .To educate the women to be familiar with their real responsibilities, abilities & rights in the society. 2. To decrease & remove gender discrimination . 3. To educate them life skills in order to help them to manage their home & society affairs. 4. To establish women consultancy centers for job finding at universities.

FAMILY PLANNING AND BIRTH REGULATION APPLYING VITAL HOROSCOPE FORMS AND GIS SOFTWARE Mahdieh Khanmohammadi, Fatemeh Haji Ali Asgari, Nadereh Hasan Dulabi Tehran University of Medical Science, Tehran, Iran, E-mail: [email protected] ABSTRACT: The Center for Community Solutions in Tehran University, Tehran is the grantee for the federal family planning funds under We provide data on 36,000 low-income patients who utilize 25 family planning clinics that are managed by eight delegate agencies. We also provide information on clinic service areas and on health and socioeconomic data. This information is used for program planning and resource allocation by health service providers and to educate and discuss family planning services with legislators in the five-county area. This paper demonstrates a methodology that Tehran University and the Iran ministry of health can easily use to geographically identify and target scarce resources to improve access to family planning and death reasons. South of Tehran was chosen as a case study for implementing the methodology, in large part because of the disparities that exist between its different subpopulations. The results highlight the potential for applying this methodology in other cities of Iran. KEY WORDS: Family planning; Birth regulation; GIS; Death reasons; Population Coverage 1. INTRODUCTION 2- Birth table according to the weight and new- born sex, mother age and maternity conditions. Today, an estimated 350 million couples worldwide (In hospital and out of Hospital) have lack of access to effective and affordable family planning. Family planning does more than help couples 3- Table of mother death because of mother age, limit their family size: It safeguards individual health maternity and pregnancy conditions and com- and rights, preserves natural resources, and can improve plications. the economic outlook for families and communities. Family planning also saves lives; up to one third of all 4- Death table based on one's age and sex maternal deaths and illness could be prevented if women 5- Table which illustrates death reasons of chil- had access to contraception. Family planning involves using various methods to control the number and timing dren below five years old. of pregnancies. A couple may use contraception to avoid 6- Table of birth regulation and family planning as pregnancy temporarily or sterilization to avoid pregnancy permanently. Abortion may be used to end an illustrated in Table 1. unwanted pregnancy when contraception has failed or not been used. Many researches are done about family Employing these tables lead to useful abstract of planning and birth regulation in health coverage. health conditions and population distribution over each However, studying the family planning in a region year in the coverage area of a health care centre. In should be geographically organized. Using the tools of addition, to improve the health conditions and anticipate GIS, census and birth statistics are mapped for areas the required equipment for the next year, these tables are under Tehran University of Medical Science coverage. used. The relative prevalence of conditions within a In each region, each health care canter, fill three pages population, and the number of people affected, are and an overall vital Horoscope information form for all shown. Some examples include families living in their costumers. After collecting vital Horoscope poverty and births to below five years. information GIS software is applied to merge it with geographical data. Each vital Horoscope table is 2. METHOD clarified in GIS for corresponding coverage area. We demonstrate Vital Horoscope form to collect 3. RESULT people vital information based on some sort of categories such as age, pregnancy, sex and death Combining the health and geographical information of reasons. Vital Horoscope is a form including several an area results in achieving the following outcomes: tables which cover the health statistics collected over a year. Some of the tables are as follow: 1- Determining the populace distribution based on people age and sex in different climate region. 1- Table of population coverage over an area based on age and sex of people. 2- Verifying population raise according to the geo- graphical areas. 3- Clarifying death distribution over the geograph- ical areas.

Table 1. birth regulation and family planning table of Vital Horoscope based on method at the end of each season in Iran. 4- Elaborating allocation of mother death as a res- Figure 2. The family planning and birth regulation ult of bad pregnancy and maternity conditions condition at Tehran University Coverage area. The color in different environmental regions. Comparing varied areas in this issue initiate how geograph- change from dark to light, the lighter color shows the ical factors influence the mother death. good condition of family planning and birth regulation 5- Achieving how the children less than five years coverage. old death is distributed over their living area which is an important aspect of progress and 4. CONCLUSION development in a community. In this paper we utilized GIS software to combine the 6- Determining distribution of trained people ecological constraint with health issues in family about family planning and diverse methods of planning, death reasons and birth regulation as a Vital birth regulation and how the population en- HORESCOPE form. The result of the study showed the largement are scattered over an area. The com- areas with lack of knowledge about contradiction and parison among varied techniques of the family good health conditions which lead to death and illnesses. regulation aspect illustrates which method of is Besides the research helped us to dedicate professional more effective in an area based on their eth- health workers in health centres which needed more nical, cultural and environmental constraints to health services. As future works first of all we can control the population growth. mention preparation of a plan to reduce the pregnant mother death and the maternity infection. Second of all, Studying and analyzing these issues help us to attain the we should consider predicting needed professional health condition in different geographical areas of Iran. human resources due to the areas' situations. Third of In addition we understand how the climate state and all, comparing the population growth over diverse populace distribution can effect the health care situation. geographical areas to anticipate the required parameters Figure 1 and Figure 2 shows the family planning and to control the populace growth comes to attention. birth regulation condition correspondent to the coverage Finally, we can analyze the people death reasons area in 2007 and 2008 consequently. As it is appear in according to the diverse areas, ethnic and environmental the following images the family regulation situation of effects and after that arrange a plan to prevent and the coverage area after geographical mapping get better control the causes. because the areas with problem is identified and the solution is found relatively.

A GIS MODEL FOR SUITABLE SETTLEMENT CAMP REGARDING DISASTER, TEHRAN, IRAN Hassan Samadyar1, Ardavan Sassani2, Robab Samadyar3 1Islamic Azad University-Roudehen Branch,Email: [email protected] 2Islamic Azad University-Science and research branch, Email: [email protected] 3Islamic Azad University-Tehran medical Branch, Email: [email protected] ABSTRACT: A GIS (Geographic Information Systems) model was developed for Tehran Province in Iran primarily for earthquake disaster and emergency activities purposes. The model served as the basis for investigating earthquake disaster vulnerability of existing settlements and identifying areas for new settlements in the Tehran Province and its counties. The set of criteria investigated in the GIS model was the following: distance from the main fault, ground acceleration, geologic basement type and terrain slope. Based on these criteria, a settlement suitability map was created, which classified the province into low, medium and high settlement suitable areas. This map was then augmented with other criteria for refinement purposes. These included the land use capability classes map of the province, the contemporary land use map derived from province integrated plan and the historical and contemporary earthquake occurrences within the region. Finally, the road network of the province derived from maps was overlaid on the settlement suitability map so that the provincial administrators could leave an evacuation zone of 200 m around the roads. This settlement suitability map is also intended to assist provincial administrators in making emergency plans for reinforcement of existing settlements in low settlement suitable regions and opening new areas for urbanization and industrialization in high settlement suitable regions. KEY WORDS: Disaster Management, Site selection, GIS, Emergency Operation Plan

in-disaster response and model in GIS environment monitoring activities, and 1.INTRODUCTION post-disaster was programmed and run reconstruction (4, 5, 6). Therefore, utilization of and then promising areas satellite remote sensing Disaster mitigation and and geographical were marked as information systems tools managing plans have been are essential in-disaster recommended sites for mitigation studies as explored and elaborated emphasized also in the emergency camp same projects (7). by many researchers. installation. The GIS (Arc 2. PROJECT AREA Earthquake mitigation and Map 9.1) is used as a The province of Tehran is managing plans do not 18,909 km2 in the North of decision support system the central plateau of Iran only mean that buildings (Figure. 1) with tool for performing site 10,343,965 inhabitants should be strengthened or (according to the most selection. recent 2006 census kept out of danger zones figures) and is Iran's most densely populated region. altogether, but that Tehran province is located The model builder tools in in the area of the mountain ArcGIS were used as a governments must have belt of Alp-Himalayas, graphical environment in which is the last and the which to develop a plans in place for dealing youngest mountainous Figure 2 – Cities and Main diagram of the multiple area in the world subjected Faults Tehran Province steps required to complete with catastrophes by to constant transformation. complex emergency tasks The movement of the (8). When the model is organizing and training faults has caused run, the Model builder disastrous earthquakes, processes the input data in the necessary personnel, with huge human and 3. METHODOLOGY the specified order and economic losses caused by generates output data making evacuation plans, the destruction of cities layers. In the made model like Ray (Tehran). Figure for emergency camping having emergency 2 shows Tehran province The decision-making prospected areas, the input cities situation. process need to combine data layers and related medical facilities and and analyze the results of parameters are variable . a number of different and can be defined by the making arrangements for surveys and studies. Thus, user when the model is to Figure 1 – Tehran human errors are be applied to other country providing food and water, Province Situation in I.R.I unavoidable during this or regional areas for the complex procedure. To detail selection of as well as other measures minimize human errors, potential sites. In the the GIS can be a powerful intermediate scales like a (1). tool for identifying Tehran province the prospective areas by ability of GIS software To mitigate disaster employing various digital allows to successfully site data layers (9). selecting for emergency damages and to facilitate cap selection sitting promising resources at rapid and effective low cost and accessible. Thus in this study the disaster response services, potential areas were selected in the provincial Keeney (2004) describes scale and the most promising areas were the role of disaster marked. preparedness including measures to predict, prevent, and respond to disasters. Mitigation is In this study ArcGIS was related to pre-activities used as an effective tool that actually eliminate or for the integral reduce the effects of a interpretation of disaster in (2). Montoya geoscientific data using and Masser (2005) computerized approach emphasize the importance (10).This approach has of studying urban been used to determine planning for mitigation prospective areas by purpose. The basis for combining various digital constructing and using a data layers in Tehran simple but comprehensive Province. decision-support tool is described by Gupta and After comprehensive Shah (1998), as the study about available data Strategy Effectiveness in the province, and Chart to evaluate different important data layer for Before the process could begin, the remaining earthquake mitigation site selection of information layers which are listed below were strategies (3).Remote emergency camp, firstly, entered into the GIS. - The faults within the sensing and geographic the available data layers study area, information management for distance from the main - Distance zones around technologies are described fault, ground acceleration, the main fault, as tools by which data can geologic basement type be collected and analyzed and terrain slope. to support pre-disaster Secondly an integration preparedness programs,

- Ground acceleration low level of intensity. maps of the province between 0 and 15° was values, further subdivided into 2 Frequency analyses provided from Iran groups, the first group for - Basement types, slopes 0 to 5° and the - Terrain slope, postulate 3 events in 100 geography organization. A other group for slopes 5°– - Land use capability 15°. years of magnitude 6 to 7 seamless mosaic was classes, - Historical earthquake on the Gutenberg – established in the GIS for occurrences within the Richter scale .Figure 3 the province from the region - Accessory to water shows the faults which are gathering map sheets. To resource - Accessory to Energy located in Tehran province old alluvial soil. All these resource - Accessories and roads and their buffer zones. formations were assigned - Some of these criteria one of the four basement were used for settlement suitability determination types (“a”, “b”, “c”, “d”). while some other criteria were used for the final The first one, “a” justification. Each step of the study is elaborated as represents massive follows: volcanic and/or unaltered metamorphic rocks and tight sandstones, which is the most settlement suitable. The next one, “b”, represents slightly altered volcanic rocks, Figure 4- Tehran province land shape Figure 3 - Faults which which is also settlement are located in Tehran province and their buffer suitable. The next one, “c” zone. represents altered volcanic 3.5 Creation of the and metamorphic rocks settlement suitability 3.1 Distance from the having restricted map (SSM) main fault (DMF) The critical distances to 3.2 Ground acceleration suitability for settlement SSM was created the main fault line were determined in five zone (GA) and finally the last one, summing up PSSG categories, according to the width and geological The earthquakes “d” represents thick assigned to each location characterization inside the fault and the distribution occurring on the Rey Fault alluvial deposits, which is by “DMF”, “GA”, “BT” of small scale fault segmentations. These were investigated using the least suitable basement and “S” criteria. However, were as follows: 1.5 km, 1.5–3 km, 3–8 km, 8–15 the historical earthquakes type for settlement each criterion was not km and 15 km. catalog for Tehran purposes. The existing equally weighted and the Province; Magnitude 7 settlement centers of the weighting for each was determined to be the Tehran Province and its criterion was determined most suitable magnitude counties were then on an empirical basis. In that should be used in an analyzed with respect to the resulting SSM, each earthquake scenario. different basement types location had a settlement Considering that ground on which they are located. suitability value differing Historical and recent acceleration (GA) is the 3.4 Terrain slope (S) between 0 and 100. These records of earthquake measure of how much and The areas suitable for values were classified into activity in Northern Iran how fast the basement is emergency camps low, medium and high indicate a prominent belt shaken during an settlement should not have settlement suitability of seismic activity earthquake, the most and a high degree of steepness. levels, (LSS, MSS, HSS), extending along the the least affected regions In order to study the slope where low, medium and southern flanks of the were determined in terms conditions within the high stand for values 0– Alborz There is a well of ground acceleration provincial land, 1:100,000 25, 30–50 and 55–100 defined of known values in case an scaled digital elevation respectively. Assigning a earthquake activity earthquake of magnitude 7 data of the province was fixed weight of 10% for extending along a line of occurs somewhere along obtained from the Iran “S”, the remaining criteria major thrust fault , which the main branch of the geography organization. (i.e., “DMF”, “GA”, and to the north of Tehran Rey fault crossing the In the form of digital “BT”) were first equally forms the structural Tehran. maps. A seamless mosaic weighted by 30%. Then, margin to the Alborz. of these maps was created the weighting of “GA” Recent studies in 3.3 Basement type (BT) in the established GIS for was gradually increased connection with the Lar Basement type the Tehran Province, as from 30% first to 50% Dam have indicated the information for the shown in Figure 4. The then to 70%, while the peak activity occurs at province was derived from slope was graded in steps other two criteria (i.e., approximately 150 years the 1:100,000 scaled of 15°. The least inclined “DMF” and “BT”) shared intervals with a relatively digital geologic formation land, having slopes equally the remaining

weight, i.e. first 20% each With this in mind there types in the study area and Tehran Province in North could train the supervised then 10% each. It was have been distinguished classification program Iran is vulnerable to employed in the observed that applying only two land use laboratory. earthquake disasters equal weights for the classifications as Five classes were because of the Rey Fault identified as follows: “DMF”, “BT” and “GA” acceptable for decision crossing the province from — Forest criteria produced an making systems: non — Grassland one side to the other. average SSM where the forested areas, which are — Water Historical records and devastating effect of “GA” agricultural or populated Indeed a final recent devastating verification trip to the could hardly be noticed. areas and grasslands. The study area revealed better earthquakes point to the than 90% accuracy using However, the weight rest of the land use areas test fields in the accessible importance of mitigation parts of the land. change in “GA” criterion were rejected, as they measures. A GIS based 4.3 Historical from 30% to 50% were covered by sparse or earthquake occurrences model of the province, (HEO) within the region drastically changed the dense forest. In order to Tehran and the including both geological neighboring provinces settlement suitability include the land use happen to be located in a and other factors, was seismological active area, results emphasizing “GA” variable in the final suffering from frequent developed for that earthquakes occurring according to an analysis, a land use grid here since ancient times. purpose, and proved very The last earthquake earthquake scenario of was created based on a occurrences within the useful both for mitigation Tehran and the magnitude 7 on the Rey land use map of 1: 50000 neighboring provinces are of earth quick prejudice .it happened in 2005. The fault. A further increase in magnitudes of last will be useful for earthquakes are 7 on the the weighting of “GA” In the project area there Gutenberg – Richter scale emergency operation plans is two land use and, some of earthquakes from 50% to 70% gave classification: could have been very for the future. destructive. exaggerated results 1- Populated area 2- Agricultural area 4.4 Other enforcement causing unduly emphasis factor Distance from the main To have accurate results fault, ground acceleration, of “GA”which was found for emergency camps basement type and terrain sitting several factors is slope criteria are the main unacceptable. Therefore, mentioned such as road ingredients in creation of a accessory, environmental SSM. Validations of SSM the second weighting 4.2 Contemporary land impacts, water availability in Tehran province against from natural resource and LUCC and CLU may be mechanism was adopted, use (CLU) distance from cities and used by provincial villages. They make the administrators for disaster which assigns 10% weight CLU map of the Tehran final purposed site more mitigation purposes, in practical. either reinforcement of to “S”, 50% weight to Province was derived structures in LSS and 5. DISCUSSIONS AND MSS regions or opening “GA” and 20% weights from Iran statics center, CONCLUSIONS new urbanization areas in HSS areas. In the SSM, a each for “DMF” and “BT” using a combination of 200 m buffer zone was considered around major criteria. While no other supervised and roads for evacuation purposes after a disaster. earthquake scenario is unsupervised techniques. realistic in this region Before a field trip was according to MTA organized to the study authorities, the resulting area, an unsupervised SSM of Figure 5 is the classification was prior output. performed and different land use types were 4. REFINEMENT OF interpreted from data THE EMERGENCY CAMPS SETTLEMENT gathering techniques. SUITABILITY MAP Each different land use was identified during the field study trip, their By using geographical SSM was refined coordinates were checked information system with according to LUCC (Land use capability classes) using GPS receivers regard emergency within the province, CLU (Contemporary land use) carried by the field crew operation plan through the derived from Iran Statics Organization and marked on these paper earthquakes, several sites maps. There were certain and purposed fields to parts of the province install and construct which could not be emergency camps are accessed either due to the purposed (figure 5), but in dense forest cover or fact this purposed site steepness of the land or must be assessed and 4.1 Land use capability unavailability of roads evaluated with technical classes (LUCC) Any potential emergency suitable for the ground and financial analysis, due caps sitting must have as little impact as possible on survey car. However, the to this fact this the the existing resources. collected ground truth data purposed site is refined by was judged sufficient to other factors such as Fuel identify basic land use transmission line, Energy

transmission line, The fruitful cooperation of 6.Luscombe, B.W., the Islamic Azad Effective wind and University-Roudehen Hassan, H.M., 1993. Branch is greatly Archeological area. After acknowledged for the Applying remote carrying out its supports refinement result the through the project. Dr. sensing technologies Nematollah Samadyar is practical map contained acknowledged for the to natural disaster financial support. Special the most suitable site for thanks are extended to and risk management: Ms. Fatemeh Samadyar emergency camps is for her most valuable implications for supports. prepared (figure 7) developmental investments. Acta Other parameters maybe Astronica 29 (10/11), added by other experts to optimize the mentioned 871–876 parameters, site options and also parameter 7.Tubitakmrcemsi weighting. Figure 6 shows the purposed sites for Bolu Project Final emergency cap installation in Tehran Province. Report, 2002. Establishment of REFRENCES Basic GIS Layers for 1.Kent, G., 2001. The Bolu Province and human right to disaster Settlement mitigation and relief. Suitability Environmental Determination (in Hazards 3, 137–138. Turkish). 2.Montoya, L., 2003. 8.Northwood Geo-data acquisition Technologies Inc. through mobile GIS and Malconi Mobile and digital video: an Ltd., 2001. Vertical urban disaster Mapper Spatial management Analysis and Display respective. Software, Version Environmental 3.0, User’s Manual. Modeling & Software pp 369. 18, 869–876. 9.Mitchell, G., 2004. 3.Montoya, L., Masser, Mapping hazard Figure 5 - The purposed I., 2005. Management from urban non-point sites for emergency camp of natural hazard risk pollution: a installation in Tehran Province in Cartago, Costa Rica. screening model to Habitat International support sustainable 29, 493–509. urban drainage 4.Metternicht, G., 2001. planning. Journal of Assessing temporal Environmental and spatial changes of Management 74, 1– salinity using fuzzy 9. logic, remote sensing 10. Alonso, W.1968, and GIS, foundations Predicting best with of an expert system. imperfect data, Ecological Modeling journal of the 144, 163–179. American institute of 5.Tralli, D.M., Blom, planners, 34:248- R.G., Zlotnicki, V., 255. Donnellan, A., Evans, D.L., 2005.Satellite remote sensing of earthquake, volcano, Figure 6 - The most flood, landslide and suitable sites for emergency camp coastal inundation installation in Tehran hazards. ISPRS Province Journal of ACKNOWLEDGEMEN TS Photogrammetry and Remote Sensing 59 (4), 195–198.

OPEN SOURCE QUANTUM GIS-BASED 'GRAM PANCHAYAT QGIS' FOR USE BY VILLAGE WORKERS IN PARTICIPATORY PANCHAYAT DEVELOPMENT PLANNING AND IMPLEMENTATION Nagesh Kolagani, C. Lakshmana Rao and Koshy Varghese, I.V. Muralikrishna, Aparna Krishnan, S. V. Ramanan and A. Ravindra Indian Institute of Technology Madras Chennai 600036, India E.Palaguttapalli panchayat, Chittoor, AP J. N. T. University, Hyderabad, India ABSTRACT: Various programs are being implemented in rural India to improve standard of living of all sections of rural society in terms of income, education, health, etc. For these programs to succeed, people's participation at every stage of planning and implementation is critical. Their participation is facilitated greatly by training and encouraging them to carry out accurate mapping and management of their panchayat resources using Global Positioning System (GPS) and Geographical Information Systems (GIS). The GPS-based spatial data of various features in the field can be tagged with their questionnaire-based attribute data and converted into GIS maps using GIS software. These maps can then be used to carry out participatory social analysis of proposed panchayat plans and their implementation. Open Source Quantum GIS-based 'Gram Panchayat QGIS' was developed for use by village workers in participatory panchayat development planning and implementation. The software is being successfully demonstrated in a few villages where it is being used by trained village workers to prepare detailed maps of panchayat development planning and implementation. It is being further improved by providing GUI in local languages and by permitting aggregation of individual village works and associated payment vouchers into national maps and reports using open source ERP software. KEY WORDS: GPS, GIS, Open Source Quantum GIS, 'Gram Panchayat QGIS', Village workers, Participatory panchayat development planning and implementation I. PARTICIPATORY PANCHAYAT DEVELOPMENT PLANNING panchayat, to people in great detail by facilitating generation AND IMPLEMENTATION and transparent maintenance of appropriate records at various levels. Various programs are being implemented in rural India to improve standard of living of all sections of rural society in II. OPEN SOURCE QUANTUM GIS SOFTWARE terms of income, education, health, etc. For these programs to succeed, people's participation at every stage of planning and GIS software is needed to convert spatial data of village implementation is critical. resources into a map and to tag these with their attribute data. Commercial GIS software is too costly for use by village Participatory panchayat development planning and workers in panchayat development planning and implementation is facilitated greatly by training and implementation. In contrast, open source GIS software such as encouraging people to carry out accurate mapping and GRASS GIS (http://grass.itc.it) and Quantum GIS management of their panchayat resources using Global (http://www.qgis.org) can be used freely in participatory Positioning System (GPS) and Geographical Information panchayat development planning and implementation. Systems (GIS). GPS is a low-cost hand held device that can be Both commercial and open source GIS software are equally used easily by people themselves to map their panchayat difficult and time consuming to use by even educated village development resources quickly and accurately (Satyaprakash workers and need substantial amount of training. However, (2003)). The GPS-based spatial data of various features in the open source GIS software makes it possible to modify it field can be tagged with their questionnaire-based attribute data substantially to simplify its GUI and customize it for use by and converted into GIS maps by the village workers using GIS village workers in participatory panchayat development software developed for this purpose (Aparna et al (2006) and planning and implementation. Nagesh et al (2008)). These GIS maps can then be used to carry out participatory social analysis of proposed panchayat development plans and their implementation. These maps make it possible to provide information, such as how money is being used within a

I.'GRAM PANCHAYAT QGIS' SOFTWARE One of the main software requirements for facilitating GIS- based participatory panchayat development planning and implementation is the ability to visually convert GPS data of various features into a map and tag questionnaire-based attribute data to these features. Open Source Quantum GIS- based 'Gram Panchayat QGIS' was developed for use by village workers in participatory panchayat development planning and implementation (fig. 1) (Nagesh et al (2009)). Fig. 4: GIS map of proposed panchayat development plan To facilitate detailed farm level intervention, as part of panchayat development development planning and implementation, elaborate data about each farm is collected using a multi page questionnaire. To facilitate its data entry, separate GUI is provided (fig. 5). Fig. 1: 'Gram Panchayat QGIS' software Fig. 5: GUI form for entering detailed farm-wise data Village workers with basic literacy can get spatial data of each The detailed farm-wise data so gathered is processed and panchayat feature, such as a farm or a stream or a household, used to automatically generate detailed reports for participatory using GPS as a set of points (known as way points). Attribute social analysis (fig. 6). data about each of these features, such as its present status and proposed development, can be collected using questionnaires. The GPS way points can be directly imported into the 'Gram Panchayat QGIS' software which connects them automatically into GIS features and tags them with attribute data as specified by the user through GUI forms (fig. 2). This removes the need for village workers to know how to import GPS data using 'Map Source' software, enter attribute data as tab-delimited text files and merge these input data files into GIS maps (Aparna et al (2006) and Nagesh et al (2008)). Fig.2: Way point connecting & attribute tagging GUI forms Fig: 6: Sample report with household-wise data The 'Gram Panchayat QGIS' software is being successfully Detailed maps of proposed panchayat development plans demonstrated in E. Palaguttapalli panchayat of Chittoor district and their implementation can be generated from this data and (A.P.) and few other villages where it is being used by trained used for participatory social analysis by people, by facilitating village workers to prepare detailed maps of panchayat visualization of spatial correlation among various factors (fig. 7 development planning and implementation (figs. 3 and 4). and 8).

Fig. 7: Village people discussing GIS maps Open source Quantum GIS-based 'Gram Panchayat QGIS' software was developed for use by village workers in Fig. 8: Map of proposed plan for social analysis participatory panchayat development planning and The 'Gram Panchayat QGIS' software is being further implementation. It is being demonstrated successfully in a few improved by providing GUI in local languages (fig. 9). villages. Making it available as free and open source GIS software is making it far more accessible to village workers. It Fig. 9: Labeling a feature using local language is also facilitating further simplifications based on client It is also being further enhanced by permitting aggregation feedback. of individual villages works and associated payment vouchers into national maps and reports using open source ERP software Local language interface and web enabling by permitting (fig. 10). drilling down from national level to each payment voucher is being attempted. It is also being extended to other villages Fig. 10: Sample payment voucher of a village level work through low-cost training programs targeting village workers. ACKNOWLEDGMENT Above work was supported by project no. 5-5/2006-TE, TDET scheme, Department of Land Resources (DoLR), Ministry of Rural Development, Government of India. We thank Dr. D. Ramakrishnaiah, Dr. R. M. Mishra, I.F.S. and Sri Chinmoy Basu, I.A.S. of DoLR for their active support and inputs. We thank Sri M. Pawan and Sri Bakka Reddy of WASSAN, Hyderabad for their participation and support in anchoring the field work. REFERENCES [1] Aparna Krishnan and Nagesh Kolagani (2006), “Application and Improvement of GIS Software in Micro-level Planning: Case Study of Participatory Water and Agro-Forestry Management in an Upland Panchayat of Chittoor District of Andhra Pradesh,” Project Completion Report no. SP/YO/011/2003, Science and Society Division, Dept. of Science and Technology, New Delhi, India, unpublished. [2] Nagesh Kolagani and Aparna Krishnan (2008), “Creating Awareness of Water Crisis and Facilitating Solutions Through GIS-based Participatory Panchayat Resource Mapping and Management,” Project Completion Report no. CO/FP/G74/2005, NCSTC, Dept. of Science and Technology, New Delhi, India, unpublished. [3] Satyaprakash (2003), “Rural mapping with community participation”, GIS@Development, June. [4] Nagesh Kolagani, Dr. C. Lakshmana Rao and Dr. Koshy Varghese (2009), “Pilot-Scale Demonstration, Evaluation and Enhancement of Open Source GIS Tools for Use by Local People in Grass Root Level Watershed Planning and Implementation,” Annual Progress Reports 2007-08 and 2008-09, Project no. 5-5/2006-TE, TDET scheme, Department of Land Resources (DoLR), Ministry of Rural Development, Government of India, unpublished.. III. CONCLUSIONS

APPLICATION OF GIS IN HEALTH-CARE SERVICE ACCESSIBILITY INCREASATION Mahdieh Khanmohammadi, Fatemeh Haji Ali Asgari and Roya Naghavi Tehran University of Medical Science, Tehran, Iran, [email protected] ABSTRACT: The Center for Community Solutions in Tehran University, is the grantee for the federal family planning funds under We provide data on 36,000 downtown living patients who utilize 54 health center that are managed by Vice Chancellor of health. We also provide information on clinic service areas and on health and socioeconomic data. This information is used for program planning and resource allocation by health service providers and to educate and discuss health services with legislators in the some county areas. This paper demonstrates a methodology that Tehran University and the Iran ministry of health can easily use to geographically identify and target scarce resources to improve access to health services easily. South of Tehran was chosen as a case study for implementing the methodology, in large part because of the disparities that exist between its different subpopulations. The results highlight the potential for applying this methodology in other cities of Iran. KEY WORDS: Health Centre; GIS; Health workers; Population Coverage; Health house 1. INTRODUCTION factors. This has helped spark greater consumer interest in improving health quality. Especially here in the The health-care network assembling was begun from environmentally-aware center of Tehran, families are looking for ways to create a healthier indoor 1977 in Iran. The health-care network establishment in environment. Iran is accomplished to transport health-care services to After collecting the health-care centre addresses we utilize GIS software to investigate and analyse the the rural and deprived areas. Besides, the other aim of problems in the area geographically. We demonstrate health house to make the people health health- care network is providing and convenient accessibility easy. We identify the health centre in our coverage area and define the areas with the lack of accessing to the major and wide health services based on health centre. We demonstrate the health house for them with very straightforward approach of work to provide the population and climate conditions. In health-care initial health services for the people in the region. In case the patients have complicated diseases or system service providing is classified and is done with difficulties they will refer to the health centre near them. turn over scheme. Service classification means offering In figure 1 as it shows we can see the Tehran University of Medical Science coverage area with the continuous and developed health assistances. A low health centre clarified on it. As it is appear some of the areas have lack of health centre and the people living level health-care centre is developed for each high class there encounter lots of problem. We provide some house centre for them to comfort them in using the health-care progressed health-care centre according to the easy services. Figure 2 illustrate the coverage area with the health centres and the health houses added to it. access of the people. If there is a need for patient to get 3. RESULT professional services, the centre should refer his/ her to Combining the health centre approach with their the higher class centre. geographical information results in achieving the following outcomes: A health house is the first rural unit of health-care 1- Determining the health-care centre distribution services in Iran. Each health house according to the based on different regions. geographical, climate, transportation and 2- Defining the allocation of health house which is needed based on the shortage. communication situation covers health services for several rustic areas. In health house there is only one health related career. The employees can start their job after passing two years corresponding courses. The duty of health workers includes general health educations, children and pregnant care, family regulation, school sanitation and student caring, dental health, providing safeties, public environment sanitation and environment renewing. 2. METHOD In a Health House, either a new construction or a renovation, all of the building materials and techniques, as well as interior decoration and design, are selected to ensure improved indoor air quality. A dramatic increase in the incidence of asthma in our coverage area over the last decade has been blamed, in part, on environmental

3 Determining distribution of trained people about ini- John Snow, “Using Geographic Information System tial level of health. Verifying the areas which have Tools to Address Disparities in Access to Family lack of health-care centre. Planning Services and Commodities in Latin America and the Caribbean”, U.S. Agency for 4 Verifying the areas which have lack of health-care International Development centre. www.deliver.jsi.com Tehran University with 95 health employees which distribute in 44 health houses covers around 118301 Sutapa Agrawal, “The Spatial Variation in Fertility and persons of rustic. This population consists of 10486 less Family Planning Scenario in India: An Understand- than 5 years old children and 22389 women which ing through GIS Approach”, International Institute of should regard the family regulation constraints. The Health Management Research (IIHMR), New Delhi. houses under Tehran University coverage are spread in 3southern areas of Tehran (Rey, Islamshahr and South of Reade JA1, 2, Soon JA1, Shoveller JA2, Hanlon NT3, Tehran). The aim of this study is to show how GIS can Kelm ME4, Johnson JL5, be used to organize the health-care network workflow. Studying and analyzing these issues help us to attain the health condition in different geographical areas of Iran. In ad- dition we understand how the climate state and populace dis- tribution can effect the health care situation. Figure 1 and Fig- ure 2 shows the family planning and birth regulation condition correspondent to the coverage area in 2007 and 2008 consequently. As it is appear in the following images the family regulation situation of the coverage area after geographical mapping get better because the areas with problem is identified and the solution is found relatively. 4. CONCLUSION In this paper we utilized GIS software to combine the ecological constraint with health issues in easy health service accessibility. The result of the study showed the areas with lack of health workers have very bad conditions which lead to death and illnesses. Besides the research helped us to dedicate professional health workers in health centres which needed more health services. As future works first of all we can mention preparation of a plan to increase the professional health worker and used them in health centres. In addition to that demonstrating more health house is a useful way to comfort people in accessing simple health services which they need. As well, we should consider prediction of needed equipment due to the areas' situations and probable sickness cases. Finally, we can merge the population growth information with the number of health-care centres to anticipate the required number of health houses. REFERENCES Kristen S. Kurland, Wilpen L. Gorr, 2008, ESRI GIS Tu- torial for Health, 2nd edition, (California: redlans). Ali Asgari F., Salmani M., 2008, Apply ARC View GIS, 1st edition, (Tehran University of Medical Science).

Figure 1. The Tehran University Coverage area and health centres. Figure 2. The Tehran University Coverage area and health centres and health houses.

GIS-BASED SPATIAL AND TEMPORAL DISTRIBUTION OF ANOPHELINE VECTORS IN MAIN MALARIA FOCI OF IRAN A.A. Hanafi-Bojd1, H. Vatandoost1, Z. Charrahy2, M.A. Oshaghi1 1Department of Medical Entomology & Vector Control, School of Public Health & Institute of Health Research , Tehran University of Medical Sciences, Tehran, Iran, P.O.Box: 6446-14155 1Department of Education, Jehad-e-Daneshgahi of Tehran University, Iran ABSTRACT: Malaria continues to be a main vector-borne public health problem in Iran. It infected an annually average of 19858 people during 1998-2007. The endemic foci of the disease are mainly located in south-eastern part of the country in Sistan & Baluchestan, Kerman and Hormozgan provinces; although another focus is reported from northwest of Iran. Different studies are conducted during more than 80 years on malaria and its vectors. The last checklist of Iranian mosquitoes shows 31 Anopheles species including sibling, biological forms and genotypes, 17 out of them are reported to be included in malaria transmission. These vectors are considered as sibling, genotype and type forms. Anopheles stephensi, An.culicifacies, An.fluviatilis, An.dthali are the main vector species of south-eastern foci, while An.sacharovi and An.maculipennis are included in malaria transmission in northwest focus, and An.superpictus has wide distribution in all malaria foci of the country. Seasonal activity of Anopheline mosquitoes varies in different area due to weather condition. It shows one peak in northwest especially in summer, however, there are two peaks of activity in coastal warm and humid region in the southern part of Iran with oriental epidemiological characteristics. In this article we will present the spatial and temporal distribution of malaria vectors in Iran by GIS method. KEY WORDS: Anopheles, Malaria, Distribution, GIS, Iran 1. INTRODUCTION northeast and southwest. Limited malaria risk exists from March to November in some areas of the provinces of Malaria is one of the most important diseases transmitted Sistan-Baluchistan, Hormozgan and Kerman (tropical by Anophelinae (Diptera: Culicidae) mosquitoes to southern part); in some areas north of the Zagros humans. This disease is one of the most infectious Mountains and in western and southwestern regions diseases in Iran with more than 15000 annual cases in during the summer months. Plasmodium vivax is last decade. The most routes of malaria cases are dominant agent of malaria in Iran, while P.falciparum is immigration from Afghanistan and Pakistan to south and reported and infects about 15% of patients. south-eastern foci of the country, as well as Azerbaijan in So far 31 species from 2 subspecies (Anopheles and north-west. In these areas 7 malaria vectors are recorded: Cellia), including siblings, genotype and type forms are An.stephensi, An.culicifacies, An.fluviatilis, An.dthali and recorded in the country, 17 out of them are in complexes An.superpictus in three endemic foci of Hormozgan, or groups that introduced as malaria vectors. Sistan-Baluchistan and Kerman in southeastern and An. Iran’s climate is affected by heat, humidity and clouds, sacharovi, An. maculipennis and An. superpictus in rainfall, wind and dust, radiation and thunder, northwest focus of Iran. Anopheles stephensi is the respectively. Based on these six factors, fifteen climatic primary vector of malaria in Hormozgan Province. zones identified as follows (Fig 1): However, in Sistan and Baluchistan, where it was once 1) Southern boundary zone, 2) Hinterland's Caspian area, one of the most important vectors, An.culicifacies is 3) Central Iran area, 4) Azeri area, 5) Khuzy area, 6) predominates and play its role as the vector of malaria. In Moghani area, 7) Western Zagros region, 8) Eastern the southeastern corner of Iran, three secondary vector Zagros area, 9) Caspian littoral area, 10) South hinterland species (An. dthali Patton, An fluviatilis and area, 11) Large Sistani area, 12) Baluchi area, 13) An.superpictus) are also present (Manouchehri et al. Makoui area, 14) Small Sistani area, 15) High Zagros 1992). area (Masoodian, 2003). Each climate provides favorite So, the transmission potential is provided in these foci conditions for some Anopheles species. and indigenous transmission cycle will be established. The aim of the present study is to map the spatial Other foci with transmission potential are located in distribution of main malaria vectors in 30 provinces of 1

Iran based on reports of previous studies, and comparing 3. RESULTS AND DISCUSSION it with different climatic area. Also in the different climates, the temporal distribution of one Anopheles There are 31 Anopheles mosquito species including species may be affected by their condition. For example, siblings, genotypes and type forms in Iran, 17 out of An.superpictus is almost recorded in different zones, but them can be mentioned as malaria vectors. Table 1 shows its temporal distribution is different because of climate the distribution of Iranian Anopheline in 30 provinces. conditions, mainly affected by temperature and humidity. Different studies have introduced An.stephensi (type, So, we determined the temporal distribution of intermediate and mysorensis froms), An.superpictus, Anopheline mosquitoes in different provinces/climates. An.culicifacies (A,B), An.fluviatilis (T,V), An.maculipennis group (An. atroparvus, An. daciae, An. 2. MATERIAL AND METHODS labranchiae, An.maculipennis, An. melanoon, An. messeae, An. persiensis, sacharovi) and An.dthali as Study area: Iran is located in the Middle East, bordered confirmed malaria vectors in the country (Abaei et al. to the north by Turkmenistan, Azerbaijan, Armenia and 2007, Azari-hamidian, 2007; Azari-Hamidian et al. 2004; the Caspian Sea, the east by Afghanistan and Pakistan, Mesghali, 1961; Naddaf et al. 2003; Oshaghi et al. 2006; the south by the Persian Gulf and the Oman Sea, and the Oshaghi et al. 2004; Saebi ,1987; Sedaghat & Harbach, west by Iraq and Turkey. The centre and east of the 2005; Vatandoost et al. 2005; Yaghoobi-Ershadi et al. country is largely barren undulating desert, punctured by 2001). Also An.pulcherrimus is detected serologically qanats (irrigation canals) and green oases, but there are positive to malaria parasite(s) in Baluchistan malarious mountainous regions in the west along the Turkish and foci, southeastern of the country (Zaim et al. 1993). Iraqi borders and in the north where the Elburz Mountains rise steeply from a fertile belt around the Table 1- distribution of Anopheline mosquitoes in Iran, Caspian Sea. 2009 Data collection: The information were obtained from different sources on malaria entomology including In southern part of the country, five anopheline published papers, Ph.D. and M.Sc. thesis, documents of mosquitoes, Anopheles stephensi, An. dthali, An. Institute of Public Health and also unpublished data fluviatilis, An. superpictus and An. culicifacies (Diptera: available in library of School of Public Health, Tehran Culicidae) are known to be malaria vectors. Meanwhile University of Medical Sciences. An. maculipennis, An. sacharovi and An. superpictus are The last shape files of Iran divisions were obtained from introduced as malaria vectors of west, central and National Cartographic Center. These data prepared and northwestern foci of the disease (Fig 2). analyzed by Arc Map GIS (ESRI, 2004) for spatial In southern part of the country from west to east, the distribution mapping of the main malaria vectors in Iran weather is warm and humid and Anopheles species are and their temporal activity through the year. active during the year (Fig. 3). In other parts of Iran the 13 6 9 2 4 4 3 8 11 14 7 15 3 5 1 12 10 1 1 0K m 250K m 500K m Fig 1. Climatic zones of Iran (Masoodian, 2003) 2

Anopheline mosquitoes mainly start their activity during Anopheles culicifacies occurs mainly in Sistan & the spring, so that from June to October they can be Baluchistan, Kermen and Hormozgan provinces. This found in all provinces of their distribution range. After species was implicated as a vector of malaria in Iran that from November temperature decreases in about 20 during an epidemic at Zabol (Sistan) in 1959. Human provinces, so in January we encounter with the minimum blood index of this species in Baluchistan is reported activity of Anopheline in Iran (Fig. 3). from 1.18 to 17.72% (Zaim et al. 1993). The spatial distribution of this species is restricted to 1, 5, 7, 11, 12 Fig 2. Spatial distribution of main malaria vectors in Iran and 14 climatic zones of Iran (Fig. 3). Anopheles fluviatilis is distributed on the southern slopes Fig 3. Temporal distribution of Anophelinae mosquitoes of the Zagros chain, from southwest of Kermanshah to in Iran Baluchistan in the southeastern part of Iran. It is considered a secondary vector of malaria in most of its 4. CONCLUSION distribution area, and found at altitude from 50 meter to Anopheles stephensi is one of the main malaria vectors in 1100 meter (Eshghi et al. 1976). It is an exophilic south of Iran. Previous investigations have shown it to be species. HBI for this species is reported different in Iran the most prevalent anopheline species in the malarious with a maximum of 62.3%. Anopheles fluviatilis is area of southern Iran. This species is considered to be reported from climatic zones of 1, 5, 7, 10 and 12 (Fig. endophagous and endophilic. An. stephensi is the main 3). vector responsible for transmission of malaria to human In Iran, An. dthali has been found in southern parts of the in Persian Gulf area. Sporozoite rates of samples from Zagros chain, and coastal area of the Persian Gulf up to the southern parts of Iran were reported to be between 1410 m (Manouchehri et al. 1972). This species is a 0.2 and 1.8% (Vatandoost et al. 2006, Manouchehri et al. secondary vector in some parts of southern Iran 1976). This species is distributed in climatic zones of especially in mountainous areas of Hormozgan province. 1,5,7,10 and 12 (Fig. 3). Precipitin tests on this species, showed anthropophilic index depends on the area, varying from 1% in Izah, a sheep rearing area southwestern Iran, to 25% in Bandar Abbas in south (Vatandoost et al. 2007; Manoochehri & Rohani, 1972). An.dthali cannot be found in zones 2, 3, 4, 6, 9 and 13 (Fig. 3). Anopheles maculipennis complex has been identified as the major vector of malaria in the Caspian Sea littoral. It includes 7 species in Iran (Sedaghat and Harbach, 2005). Vatandoost et al. (2005) reported HBI of 5% for An.maculipennis in northwest of Iran. There is no report of this species in zones 5, 7, 11, 12 and 14 (Fig. 3). Anopheles sacharovi is a major vector of malaria in the central plateau of Iran and is widely distributed in central, northwest, west, southwestern and Fars province in the south of the country. It is a member of An.maculipennis complex. Little studies are conducted on the ecology of An.sacharovi. Based on survey of Yaghoobi-Ershadi et al. (2001) the host preference of this species showed 38.5% had fed on human alone and 23% on both human and dog in human dwellings, but the specimens that had fed on the animal shelters were negative for human blood. The anthropophilic index of this Anopheles has been reported between 4.2 and 30.6% from Iran in 1969 but the sources of their blood meal smears were not stated (Shahgudian, 1969). Values of 26.5% from human dwellings and 9.4% from animal shelters were observed from Eastern Azerbaijan and Khuzistan provinces of Iran during 1982–84 (Edrissian et al., 1985). This Anopheles is not recorded from climatic zones of 1, 4, 11, 12, 14 and 15 (Fig 3). Anopheles superpictus has a widespread distribution in Iran across the all climatic zones from 50 to 2000 meter 3

(Fig 3). This species has exophagous and endophilic A survey is suggested to find the correlation between behavior and occurs in the greatest numbers in human different climatology factors and distribution of dwellings and cattle sheds. It was found to have HBI of Anopheline mosquitoes in Iran. 11.4% in Iran (Edrissian et al., 1985). Oshaghi et al. (2007) found two distinct morphological forms (A and B) ACKNOWLEGEMENTS of this species were found sympatric in all areas of their study in Iran. This species is responsible for malaria The authors are grateful to personnel of library of School transmission in central plateau of Iran with a sporozoite of Public Health, Tehran University of Medical Sciences, rate of 4.7% (Manouchehri 1985). especially Mr. Davoodi for his kind assistance in preparing some references. The project is financially REFERENCES supported by the Tehran University of Medical Sciences. 1. Abai, M.R., Azari-Hamidian, S., Ladonni, H., Southern Iran. Annals of Tropical Medicine and Hakimi, M., Mashhadi-Esmail, K., Sheikhzadeh, Parasitology, 69(3), 393-397. K., Kousha, A., and Vatandoost, H., 2007, 11. Manoochehri, A.V., Ghiasseddin A.M., and Fauna and Checklist of Mosquitoes (Diptera: Shaghudian E.R., 1972, Anopheles dthali Culicidae) of East Azerbaijan Province, Patton, 1905, a new secondary vector in Northwestern Iran. Iranian Journal of southern Iran. Annals of Tropical Medicine and Arthropod-Borne Diseases, 1(2), 27-33. Parasitology, 66(4), 537-538. 12. Masoodian, A., 2003, Climatic regions of Iran. 2. Azari-Hamidian, S., 2007, Checklist of Iranian Journal of Geography and Development, 1(2), mosquitoes (Diptera: Culicidae). Journal of 171-185. (In Farsi with English Abstract) Vector Ecology, 32(2), 235-242. 13. Mesghali, A., 1961, Detailed report on the distribution of mosquitoes of the genus 3. Azari-Hamidian, S., Joeafshani, M.A., Rassaei, Anopheles in Iran. Publication of Parasitology A.R., Mosslem, M., and Moussavi-Eivanaki, E., and Malarialogy, Tehran, 846 pp. (in Persian) 2004, Mosquito fauna of the genus Anopheles 14. Naddaf, S.R., Oshaghi, M.A., Vatandoost, H., (Diptera: Culicidae) in Guilan province. and Asmar, M., 2003, Molecular characterization Modarres journal of Medical Sciences (In Farsi of the Anopheles fluviatilis species complex in with English Abstract), 6(2), 11-22. Iran. WHO Eastern Mediterranean Health Journal, 9(3), 257-265. 4. Edrissian, G.H., Manouchehri, A.V., and Hafizi, 15. Oshaghi, M.A., Shemshad, Kh., Yaghobi- A., 1985. Application of an enzyme-linked Ershadi, M.R., Pedramb, M., Vatandoost, H., immunosorbent assay (ELISA) for Abaie M.R., Akbarzadeh, K., Mohtarami, F., determination of human blood index in 2007, Genetic structure of the malaria vector anopheline mosquitoes collected in Iran. Anopheles superpictus in Iran using Journal of American Mosquito Control mitochondrial cytochrome oxidase (COI and Association, 1(3), 349–352. COII) and morphologic markers\" A new species complex? Acta Tropica, 101, 241-248. 5. Eshghi, N., Motabar, M., Javadian, E., and 16. Oshaghi, M.A., Yaghoobi, F., Vatandoost, H., Manoutcheri, A.V., 1976, Biological features of Abaei, M.R., and Akbarzadeh, K., 2006, Anopheles fluviatilis and its role in the Anopheles stephensi biological forms; transmission of malaria in Iran. Tropical and geographical distribution and malaria Geographical Medicine, 28, 41-44. transmission in malarious regions of Iran. Pakistan Journal of Biological Sciences, 9(2), 6. ESRI (2004) ArcGIS 9.1. Redlands: ESRI. 294-298. 7. Manouchehri, A.V., Zaim, M., and Emadi, 17. Oshaghi, M.A., Taghilo, B., Moradi, M.T., and Vatandoost, H.. 2004, Mosquitoes of Anopheles A.M., 1992, A review of malaria in Iran, 1957- culicifacies complex, species A and B in 1990. Journal of American Mosquito Control Baluchistan using mtDNA PCR- RFLP assay: Association. 8, 381-385. the first report of species B from Iran. Journal 8. Manouchehri, A.V., 1985, A review on the of Hakim (In Farsi with English Abstract), 7, ecology of malaria vectors in Iran. Publications 35-41. of School of Public Health, Tehran University 18. Saebi, M.E., 1987, Morphological study on of Medical Sciences, 77, 24. anopheline larvae and their distribution in Iran 9. Manouchehri, A.V., Javadian, E., Eshghi, N., [PhD dissertation]. School of Public Health, and Motabar, M., 1976, Ecology of Anopheles Tehran University of Medical Sciences, Tehran, stephensi Liston in southern Iran. Tropical and Iran [In Persian]. Geographical Medicine, 28, 228-232. 10. Manoochehri, and Rohani, F., 1975, Notes on the ecology of Anopheles dthali Patton in 4

19. Shahgudian, E.R., 1969. Biological and in the malarious area of Hormozgan province, Bionomic Features of Malaria Vectors in Iran southern Iran. Acta Tropica, 97(2), 196–203. and their role and importance. Publications of 23. Vatandoost, H., Abdoljabari Boonab, R., Abai, Institute of Public Health Research, Tehran M.R., Oshaghi, M.A., Rassi, Y., Gholizadeh, S., University, Iran. 1667, 6–7. Mashhadi-Esmail, K., Kousah, A., Haghi, M., and Gorghani, M., 2005, Entomological survey 20. Sedaghat, M.M., and Harbach, R.E., 2005, An in Kalibar, a resurgent malaria focus in east- annotated checklist of the Anopheles mosquitoes Azerbaijan, Iran. Pakistan Journal of Biological (Diptera: Culicidae) in Iran. Journal of Vector Sciences, 8(10), 1466-1471. Ecology, 30: 272-276. 24. Yaghoobi-Ershadi, M.R., Namazi, J., and Piazak, N., 2001, Bionomics of Anopheles 21. Vatandoost, H., Shahi, M., Hanafi-Bojd, A.A., sacharovi in Ardebil Province, northwestern Abai, M.R., Oshaghi, M.A., and Rafii, F., 2007, Iran during a larval control program. Acta Ecology of Anopheles dthali Patton in Bandar Tropica, 78, 207- 215. Abbas District, Hormozgan Province, Southern 25. Zaim, M., Subbarao, S.K., Manouchehri, A.V., Iran. Iranian Journal of Arthropod-Borne and Cochrane, A.H., 1993, Role of Anopheles Diseases, 1(1), 21-27 culicifacies and An.pulcherrimus in malaria transmission in Ghassreghand (Baluchistan), 22. Vatandoost, H., Oshaghi, M.A., Abai, M.R., Iran. Journal of the American Mosquito Shahi, M., Yaghoobi, F., Baghaii, M., Hanafi- Association, 9(1), 23-26. Bojd, A.A., Zamani, G., and Townson, H., 2006, Bionomics of Anopheles stephensi Liston 5



POLYANALYST- SPATIAL DATAMINING TOOL FOR POLIO CASES ANALYSIS K. Anuradha1, P. Premchand2, N. Sandhya3, I. V. Murali Krishna4 1Professor & Head Department of CSE GRIET 2University College of Engineering,OU 3Associate professor Department of CSE GRIET 4Retd. Director,IST JNTU Hyderabad, India ABSTRACT: Poliomyelitis is an acute communicable disease caused by poliovirus types 1, 2 and 3, transmitted through person- to-person contact. Given the progress already made towards the goal of global eradication of poliomyelitis (polio), the risk of paralytic poliomyelitis is changing in many geographical areas. Yet its existence is seen in some areas. There is need of some techniques to identify its proximity. Data Mining is defined as the process of discovering significant and potentially useful patterns in large volumes of data. It is the exploration and analysis, by automatic or semi- automatic means, of large quantities of data in order to achieve Knowledge Discovery in Databases (KDD). The study reported in this paper is concerned primarily with thematic information related to the occurrences of polio cases across the world. In this study the database has been mined using the PolyAnalyst software package. The application of data mining techniques helps the decision maker to take some influential measures. The specific application of PolyAnalyst gave a clear scope to classify the regions across the world where polio cases are reported using data mining’s clustering technique. Clustering is a classical problem of grouping data points into several clusters, such that the intra-distance within clusters is minimized whereas the inter-distance between clusters is maximized. KEY WORDS: Poliomyelitis, Data Mining, PolyAnalyst, Clustering, Line chart, Histogram. 1. INTRODUCTION in their data warehouses. Data mining tools predict future trends and behaviors, allowing businesses to Poliomyelitis, often called polio or infantile make proactive, knowledge-driven decisions. The paralysis, is an acute viral infectious disease spread automated, prospective analyses offered by data from person to person, primarily via the fecal-oral mining move beyond the analyses of past events route. Poliomyelitis is caused by infection with a provided by retrospective tools typical of decision member of the genus Enterovirus known as support systems. poliovirus (PV). The global eradication of poliomyelitis is a public health effort to eliminate all Importance of spatial data mining: cases of poliomyelitis (polio) infection. There are two Spatial data mining, i.e., mining knowledge types of polio vaccine: trivalent oral polio vaccine (tOPV), given through mouth, and inactivated polio from large amounts of spatial data, is a highly vaccine (IPV), given as an injection. Post-polio demanding field because huge amounts of spatial syndrome (PPS) is a condition that affects polio data have been collected in various applications, survivors years after recovery from an initial acute ranging from remote sensing, to geographical attack of the poliomyelitis virus. information systems (GIS), computer cartography, environmental assessment and planning, etc[2]. 2. DATA MINING Recent studies on data mining have extended its scope from relational and transactional databases to Data mining, the extraction of hidden spatial databases. Spatial data carries topological and/ predictive information from large databases, is a or distance information and it is often organized by powerful technology with great potential to help spatial indexing structures and accessed by spatial companies focus on the most important information access methods. These distinct features of a spatial database pose challenges and bring opportunities for

mining information from spatial data. In this study paralysis varies from part of a limb to quadriplegia the data base has been mined using the PolyAnalyst and respiratory failure.The acute flaccid paralysis is software package. defined as: 3. POLYANALYST Acute: rapid progression of paralysis from onset to maximum paralysis PolyAnalyst is a powerful multi-strategy data mining system that implements a broad variety of Flaccid: loss of muscle tone, “floppy” – as opposed mutually complementing methods for the automatic to spastic or rigid data analysis. PolyAnalyst automatically finds dependencies and laws hidden in data, presenting Paralysis: weakness, loss of voluntary movement them explicitly in the form of rules and algorithms. The system builds empirical models of an Any case meeting this definition undergoes a investigated object or phenomenon based on the raw thorough investigation to determine if the paralysis is data. PolyAnalyst works with data extracted from flat caused by polio. files or relational databases, and can work with numerical (floating-point), integer, yes/no (binary), Data taken: date, and discrete (categorical or string) variables.  Using this data and PolyAnalyst’s suite of analytical The study here considers the last 14 years polio cases algorithms, relationships in the data can be discovered, predictions made, and the data classified reported in various parts of the world (1996-2009). and organized.  Data is categorized as per 6 regions. The PolyAnalyst Workspace:  African region(AFR) The polyAnalyst’s workspace primarily consists of projects, attributes, datasets, graphs,  Region of Americas(AMR) reports. The first step in running an analysis with PolyAnalyst is to create a new project. When an  South east Asia(SEA) exploration engine completes its task, the primary output is a report.  European region(EUR) 4. MATERIALS AND METHODS  Eastern Mediterranean Prior to the introduction of a vaccine in 1955, polio region(EMR) infection was common. A global eradication programme has reduced the number of reported polio  Western pacific region(WPR) cases worldwide by more than 99% since the mid- 1980s. Most infections are asymptomatic, less than Under each region the countries wherein the polio 1% result in acute flaccid paralysis. The extent of cases are reported are listed. In the dataset countries form the rows whereas the columns are  afp( acute flaccid paralysis) cases reported  non-polio afp rate  afp cases with adequate specimens %  total confirmed polio cases  wild virus confirmed polio cases

An example of the dataset prepared for this study is in the figure shown below. Besides this region wise occurances: (for each year) Problem formulation: decision maker-the government or any other Study objective concerned body to draw some important conclusions The analysis of polio cases reported helps the and make influential decisions like enhancing the eradication measures. In this study an experimental attempt is made for analyzing the proximity of polio

occurances in various countries regionwise and the Clustering is useful in data mining for variations in these trends is observed. finding anomalous records, subsets of similar records, and significant features determining Approach similarity. Clustering is used in a variety of applications, such as finding groups of similar The overall objective is to make an analytical customers for targeted marketing, identifying solution that a decision maker can easily use and get insurance fraud, and document classification. The results. The development approach consists of a performance is linear from the number of records, series of steps: number of clusters, number of columns and from the number of iterations required. -Preprocess data so that the most relevant result can be generated quickly. Line chart: -Analyze pattern and co-occurrence of identified PolyAnalyst’s line chart displays trends in a 2D concept coordinate plot, where the data points are connected by lines. This type of chart is used to explain the -Develop an automated solution variance of one or more attributes in relation to another attribute. Multiple Y axes on a single X axis 1) Preprocessing Data can be displayed. Typically, the line chart can be used to display a trend. The Line Chart can be helpful A decision maker first analyses the historical in visualizing the relationship between two or more data of the past. This stage comprises identifying, continuous variables, or to communicate results in a collecting, filtering, aggregating data into a format summarized, non-tabular form. required by the data models. Histogram: 2) Problem solving A histogram is a frequency graph, generally Using data mining techniques we can displayed as a two dimensional vertical bar chart. It is analyze generate reports, graphs and charts of used to view a distribution. It can be created based on historical data. any dataset. 3) Overview of Application Using Polyanalyst in When Properties | clustering is selected, it the study prompts to select which attributes to be used as input to the clustering algorithm. Only these attributes will Data mining technique is applied in this be used to compare records to one another to study to analyze the similarities in occurance of polio determine similarity. The number of clusters that the cases in various regions. Clustering algorithm is algorithm should attempt to identify can be set. applied here to observe these trends. Past data is taken into consideration and behavior of the output is The Output: studied. The data set contains the occurrences of polio cases in various countries. The data was Clustering is performed on the dataset based categorized as per years and regions as mentioned on the polio cases reported, polio cases confirmed. earlier. The output comprises the clusters with each cluster numbered. The clusters formed exhibit minimum 5. RESULTS AND DISCUSSIONS inter cluster similarity and maximum intra cluster similarity. Support and confidence of each single Reports: cluster is calculated to show the concurrent occurrence. Each cluster contains the countries that Reports are the main asset of this study. These exhibit similarity in number of polio cases reports give valuable information regarding the goal. confirmed. This output facilitates the decision maker The Data Mining Technique used here for generating to concentrate on particular countries and enhance the the reports is clustering technique. Besides this, the preventive strategies such as to augment polio PolyAnalyst’s graphical representation techniques- vaccination in the observed countries. line chart and histogram are used. Clustering:

When clustering is performed on 2009 dataset based on afp cases reported, 4 clusters are found and when done based on total cases confirmed 4 clusters are found. From the formed clusters of total cases confirmed, it is observed that polio cases are seen in 18 countries. Nigeria(289), India(40),Sudan(33) etc., are excerpts from the observations made. The graphical representation of polio cases reported and total polio cases confirmed region wise is made using histogram as shown. The variations in total polio cases confirmed yearwise can be shown by line chart below.

The number of cases confirmed in South East Asian region is more than the other regions. The similar representation can be made for other regions. 6. CONCLUSION: Data mining facilitates to extract required REFERENCES knowledge from huge datasets. The specific application of PolyAnalyst gave a clear scope for 1. http://en.wikipedia.org/wiki/Polio observing the distribution of polio cases in various countries. The use of Clustering technique helped to 2. Data taken from identify the similarities in this distribution. Besides this, trend along the years can be observed. http://www.who.int/immunization_mon The observations made help us to enhance itoring/en/diseases/poliomyelitis/ the polio eradication measures. The most important step in eradication of polio is interruption of endemic case_count.cfm transmission of poliovirus. Stopping polio transmission has been pursued through a combination 3. http://www.directessays.com of routine immunization, supplementary immunization campaigns and surveillance of possible 4. http://www.einstein.edu/ outbreaks. polioandmobility This study drags attention towards particular countries where the eradication measures are to be 5. Jiawei Han, Micheline Kamber, Data much enhanced so that polio can be washed out completely. mining: concepts and techniques. 6. Pang-Ning Tan, Michael Steinbach, Vipin Kumar, Introduction to Data Mining. 7. D. J. Hand, Heikki Mannila, Padhraic Smyth, Principles of Data Mining. 8. http://www.geocities.com 9. Pieter Adriaans, Dolf Zantinge, Data Mining. 10. Arun K. Pujari , Data Mining Techniques.

11. http://www.thearling.com/text/dmwhite/ 13. Daniel T. Larose, Data Mining Methods dmwhite.html and Models. 12. http://www.amazon.com/Data-Mining- Techniques

Poster Session Student Examination by the use of GIS Software Fatemeh Haji Ali Asgari, Zahra Bigom Aghamiri……………………………………212 A Space-Time Permutation Scan Statistic for Diarrhea Outbreak Detection in Chiang Mai, Thailand Nakarin Chaikaew, Nitin Kumar Tripathi and Marc Souris…………………………216 Mapping Distribution and Relocation Areas in Dengue Endemic Area East Jakarta Municipality Artha Prabawa…………………………………………………………………………220 Mapping Greenhouse Gases to Alleviate the Impact on Human Health Uday Dnyandeo Pimple, Nitin Kumar Tripathi, Seishiro Kibe and Md. Zakir Hossian…………………………………………………………………225 Geospatial Overview of Swine Flu Outbreak in Mid 2009 Siriwan Hassarangsee and Nitin Kumar Tripathi………………………………………104

STUDENT EXAMINATION BY THE USE OF GIS SOFTWARE Fatemeh Haji Ali Asgari, Zahra Bigom Aghamiri Tehran University of Medical Science, Tehran, Iran, [email protected] ABSTRACT: What we mean by Screening Examination is to discover a defect or disease by the use of quick and scientific tests, examinations, and other methods among people who seem to be healthy on the surface. The health personnel have the Health ID as their tool during the screening and even medical examinations; the result of all health and medical tests will be inscribed on pages 7 and 11 of the Health ID. By the use of this method, some diseases and defects - e.g. growth disorders, hearing and sight problems, oral infections, goiter, anemia, behavior disorders, spinal scoliosis, etc. – are being traced among the students, annually. Screening examinations, consist of: A) Measuring students’ height and weight. B) Performing oral tests. C) Performing spinal tests. D) Discovering nutrition problems. E) Performing tests on skin, hair, and nails. F) Performing tests on eyesight. G) Performing hearing tests. H) Discovering behavior and mental disorders. I) Examining students’ educational readiness (which will be carried-out by psychology experts). KEY WORDS: Examining; height and weight; GIS; Discovering behavior; Performing 1. INTRODUCTION either loss of weight, or weight growth being stopped. The cases therefore, need to be sent to the physician. The growth rate in girls, speeds up from the age of 10 or Furthermore, discussing the matter with the parents, and 11, and reaches the maximum rate at the age of 12. In finding the root of the problem by studying these boys, on the other hand, the growth rate speeds up from students’ health records, social, economical, and cultural the age of 12 to 13 and reaches the maximum at 14 situation of their families (parents’ education, family’s years. income, parents’ occupation, eating habits, etc.) could The best method to inform us of the growth status of be helpful as well. students, is measuring their height and weight. By doing this, various indexes are determined, the most important 1.1.1 Students’ Growth Monitoring of which is the index of weight for height and the index of height for age. 2. Measuring Weight and Height The index of weight for height is the indication of ones One other important index in students’ growth being over- or under-weight and determines the nutrition monitoring is the BMI. We need to measure students’ status of the case student. weight and height, and then by the use of following This index is sensitive to factors as malnutrition and formula we can find the BMI: disease; getting under-weight according to ones’ height can occur in a very short time. The defect, however, BMI= Weight (Kilograms)/Height (Meter). could be compensated in a short time, also. If the growth curve of the students is between percentile BMI is used for comparing and contrasting the students’ 5 to 85, they are overweight, and if it is higher than the bodily status with the standard. This index categorizes upper curve (percentile 95 and more) they could be students into four classes: considered heavy and therefore, need to be sent to the 1. Under-weight, or thin (less than 18.5). health and recovery center for further examinations. 2. Normal weight (18.5- 25). If the growth curve of the students is lower than the 3. Over-weight (25- 30). bottom curve (percentile 5) – which is the most common 4. Heavy (more than 30). status in our country – or if the curve is descending, BMI is determined according to the students’ age. even if the meeting points of height and weight measures are higher then the bottom curve, it indicates

Studying the changes in weight according to height is so the student should be sent to the health center. If the simple; when decreased, it indicates mal-nutrition, or meeting point of height is between the third and ninety- mal-nutrition along with infection, and when increased, seventh percentiles, this case is considered normal, it indicates overweight. without any specific problems. It is important to have in Height index according to the age, shows the mind that if in every measurement session, a student’s background of one’s nutrition, and is mostly used to status on the graph ascends the previous sessions’ status, study the nutrition status of children in one society. this case needs further attention and examinations, as Students’ weight and height is measured once a year, in well. the first and the third grade of elementary school, the first grade of middle school, and the first grade in high A) Performing Oral Examinations school and the growth process is drawn separately for girls and boys. In the age of 7 to 12, children’s permanent The best method to determine whether the growth teeth, replace the so-called milk teeth. If the permanent process is normal in students or not, is the usual teeth are damaged, there will be no replacements. There- measurement of their height and weight, and its fore, taking care of the permanent teeth is of a great im- comparison and contrast to the standard. portance. 3. HOW TO MEASURE HEIGHT AND WEIGHT According to the Health ID, every 7 to 12 years old child, needs to be orally examined at least once a 1. Check the scale by the use of the control-scale, before year. This makes it essential that oral examinations too, you start the measuring, or after the scale is being be included in the annual school tests. moved. 3.1 How to Perform an Oral Examination 2. While measuring the weight, students need to have on the least amount of clothes possible and no shoes. 1. The students sit on chairs. You stand in front of them and ask them to open up their mouth. Use a small torch 3. Students must be properly standing on the scale and to light up the oral cavity. you, need to be standing in front of the scale when 2. To be able to examine all the teeth and the gum, you reading the results. need to be organized, e.g. you can start from the chewing part of the teeth and move towards the frontal 4. For measuring the height, students need to take off parts, and then to the back and gum. their shoes and stand with their head straight, in a way 3. When examining each side of the mouth, ask the that their heels, back of the legs, hips, back of shoulders, patients to move their tongue to the opposite side. Use a and head be stuck to the height-measuring tool. tongue depressor to move the chicks away from the gum. 5. If the scale lacks the height-measuring tool, an ordi- 4. When examining the frontal part of the teeth, or the nary tape-measure could be fixed on the wall in a way gum, use a tongue depressor to move away the lips and that it is totally perpendicular to the floor. Ask students inner chicks. to stand with their back of their head, back, hips, and 5. Pay attention to the remains of food. If they exist, it heels in touch with the wall. Put a ruler, or a sheet of pa - shows that the students do not brush their teeth per on the students’ head, and read the number on the correctly. meeting point of it with the tape-measure. Remember to 6. Examine every side of every tooth. Pay attention to pay enough attention to the status of students’ head, germs and cavities, from small light or dark brown stain, legs, and hair, other than the ruler’s status. to holes. 7. Pay careful attention to all the parts of gum, so that An important index in children’s growth monitoring is you could notice if there is an inflammation. the index of height according to age, which is the 8. Pull out the tongue with clean gauze and examine the indicator of nutrition status i.e. mal-nutrition, in the mouth, beneath the tongue, inside the chicks, and lips so past. For this purpose, students’ height needs to be that you could notice if there is an injury, tumor, or any contrasted to the standard height of students of their other abnormal symptom. own age. 4. Spinal Examinations In the graph of height according to age also, three curves As you know, there are 33 vertebrae in the spinal are marked (percentile 3, 50, and 97). If the student’s canal. If we look at it from one side, there are four status is lower than the third percentile curve, or higher curvatures in it. One, a curve to the front, in the area than percentile 97 curve, it is usually considered of neck, the second one, to the back, and in the back abnormal and indicates that the case student needs area, next one, to the front in the waist area, and the further examinations. In order to solve the problem, last one, to the back, in the area of pelvis i.e. sacrum parents must be informed about better nutrition plans or and coccyx.

If there is a change in one of these curvatures, other - Students must stand across from the board, with 6 curvatures will compensate the damage by changing. meters of distance. This way, the body will not lose its balance. - One of the eyes must be covered by a pad or by Common Defects in Students’ Spinal Canal student’s hand in a way that there is no pressure on the eye. 1. Kyphosis: Unnatural and excessive curvature to the back, of the spinal canal in the back area. If this state - Ask the student to read the letter you choose on the becomes more severe, it could put the lungs under board, or tell the direction of letter E. pressure and cause respiratory disorders. People with this infection, tend to get fatigue and nervous very often. The other eye must be examined, in a same way. At last, both eyes should be examined. 2. Lordosis: Excessive curvature to the front, of the spinal canal in the waist area, which causes excessive The examination board has 10 rows (from 2/10 to 11/10) curvature of the spinal canal to the back. and letters in different directions must be used while examining. 3. Spinal scoliosis: Spinal canal can be deviated to one Send the student to the health and recovery center when: side, left or right. This, eventually, will cause changes to 1. Each eye has a sight less than 0.9. the ribs and chest and leads to respiratory disorders, 2. One eye’s sight is more than 0.1 different from the problems in the blood circulation, backaches or various others’. nervous pains. 3. The sight of both eyes together, is less than 10/10. The students must be sent to health and medical centers E) Hearing Examinations in case of any of the three disorders, above mentioned. - Ears must be examined with audiometric tools, or by the whispering tests. In a case that a hearing-measure- B) Discovering Nutrition Problems ment tool is not available, whispering tests are per- Of the most common sequences of nutrition defects in formed. school years, are anemia and goiter: 5. Behavior and Mental Disorders - To diagnose anemia, you need to check inner lips and bottom eyelids. These parts are red in color, when The most common disorders of this kind in school ages normal. They will be pink or close to white, in case of are: anemia. 1. Chewing nails. - To diagnose goiter, examine the thyroid gland, which 2. Stammering: Pause while speaking, repeating words cannot be seen, if normal. in a way that it continues for a long time; to diagnose this disorder, ask students to speak fast. C) Performing Skin, Hair, and Nail Examina- tions 3. Urinary incontinence: happens at least 3 times a month and twice a week, at night or day; to diagnose Examining these parts of body requires following this, you need to talk to the parents or the teacher. conditions: 4. Depression and seclusion: not taking part in group - Examination must be performed in a separate room activities, fatigue, lack of concentration, headache, with enough light. sleeping disorders, etc. 5. Quarrelsomeness: with classmates at school, and with - Attention must be paid to any unnatural symptom like family members at home. pimples, hives, itchiness, rash, etc. If suspected to have any of the above disorders, the - Hair must be luxuriant, limpid, and no sign of students need to be sent to a physician. pediculosis must be seen. 6. Educational Readiness - Nails must be examined according to their shape and color. Attention must be paid to any unnatural symptom. Examining educational talents of the students, is per- formed by psychology experts. D) Eyesight Examinations - Fix the examination board (E) to an appropriate place, 7. METHOD according to height of the students. The best option, in regards to the light, is that the board be placed across BMI= Weight (Kilograms)/Height (Meter). from the window and students stand with their back to the window.

BMI is used for comparing and contrasting the Edited Books students’ bodily status with the standard. This index cat- Strum, B., 1981, The atmospheric correction of remotely egorizes students into four classes: sensed data and the qualitative determination of sus- 1. Under-weight, or thin (less than 18.5). pended matter in marine water surface layers. In Re- 2. Normal weight (18.5- 25). mote Sensing in Oceanography and Meteorology, 3. Over-weight (25- 30). edited by A. P. Cracknell (Chichester: Ellis Hor- 4. Heavy (more than 30). wood). BMI is determined according to the students’ age References from websites: Nakhapakorn, K., 2005. Proceeding on the Health GIS symposium “Analysis of Spatial Factors affecting dengue epidemics using GIS”, Bangkok, Thailand. http://www.j-geoinfo.net/HealthGIS/HG001.html 7.1 Acknowledgements (optional) Acknowledgements of support for the project/paper/author are welcome. Figure 1 :zone of iran-tehran Tehran university Figure2. The Graph of Height According to Age REFERENCES Journal Dale, P.E.R., Chandica, A.L., and Evans, M., 1996, Us- ing image substraction and classification to evaluate change in subtropical intertidal wetlands. Interna- tional Journal of Remote Sensing, 17, 703-719. Books Barret, E.C., and Curtis, L. F., 1992, Introduction to En- vironmental Remote Sensing, 3rd edition, (London: Chapman and Hall).

A SPACE-TIME PERMUTATION SCAN STATISTIC FOR DIARRHEA OUTBREAK DETECTION IN CHIANG MAI, THAILAND 1Nakarin Chaikaew, 2Nitin Kumar Tripathi and 3Marc Souris Remote Sensing and GIS FoS, Asian Institute of Technology, Klongluang, Pathumthani, Thailand, 12120 E-mail: [email protected], [email protected] and [email protected] ABSTRACT The aim of this study was to identify the local diarrhea cluster alarms (diarrhea outbreaks) in Chiang Mai province, Thailand. The data of village locations and the daily diarrhea patients less than five years of age during 2001-2006 were collected to support the purpose. The space-time permutation scan statistic was used to determine whether the diarrhea clusters occurred by chance in space and time. In the study, the detected diarrhea outbreaks were observed at statistically significant levels (p ≤ 0.001), and were found in the difference place and time of the study area. KEY WORDS: GIS, Diarrhea outbreak, Space-time permutation scan statistic, Chiang Mai 1. INTRODUCTION The attempt to apply the spatial statistical methods and GIS for identifying the disease outbreaks in In Thailand, diarrhea has been a major public health Thailand has become the important tool in problem for many years. The Bureau of Epidemiology, epidemiological studies. This study describes the space– Ministry of Public Health, estimated nearly 1 million time analysis to detect diarrhea outbreaks when cases every year (in the period 2001-2005: 1,020,377, available signal (i.e. number of cases) for a particular 1,055,393, 966,760, 1,161,877 and 1,142,581 area is being monitored. The daily notification data from respectively, with corresponding deaths: 176, 160, 124, 2001-2006 of Chiang Mai was analysed to determine 93 and 77). In 2006, the diarrhea incidence was local clustering of cases (the village outbreak estimated to be 1,245,022 cases and 9 deaths, with the identification) by using space-time permutation scan highest incidences occurring in Chiang Mai, Chiang Rai, statistic (Kuldorff et al., 2004). Khon Kaen and Roi Et provinces, all in the northern and north-eastern region of Thailand. Diarrhea is most 2. METHODD commonly caused by gastrointestinal infections (bacterial, viral and parasitic organisms). The infection 2.1 Data sources is spread through contaminated food or drinking-water, or from person to person as a result of poor hygiene Relevant data for Chiang Mai province were classified (WHO, 2005). The disease incidence in children under to six different geographic data sets (Table 1). The daily five years of age was also reported high (FAO, 2004). diarrhea patients less than five years of age at village level were obtained from the Chiang Mai Provincial Chiang Mai is the second-largest province of Public Health Office (CMPHO). The spatial data related Thailand, located in the north of the country with to the village location were collected from The Geo- geographical location at 18°47'N and 98°59'E (Figure Informatics and Space Technology Centre (Northern 1). The incidence of diarrhea in Chiang Mai has Region) (GISTC), Thailand. All these data were fluctuated every year and marks high variability at incorporated into a geographic information system district, sub-district and village levels. Socio- (GIS). demographic, environmental and sanitation, and climate factors are thought to be related to the outbreak of Table 1. Summary of the data sets diarrhea (i.e. the occurrence of a large number of diarrhea cases in a restricted geographical area over a Age Spatial Locations Year Total short period of time) (FAO, 2004; Pande et al., 2008). The burden of diarrhea is well described in this area as resolution (n) cases (n) mandatory reporting of the patient cases, which is recorded from the Chiang Mai Provincial Public Health < 5yr Villages 1,532 2001 18,979 Office (CMPHO). All confirmed diarrhea cases are entered into a computerized public health surveillance < 5yr Villages 1,897 2002 26,904 system of CMPHO. < 5yr Villages 1,941 2003 29,743 < 5yr Villages 1,923 2004 38,087 < 5yr Villages 1,983 2005 38,481 < 5yr Villages 2,003 2006 32,863 Source. Chiang Mai Provincial Public Health Office

Figure 1: Chiang Mai province 2.2 Data analysis of the outbreak is set to be a circle with a 5.2 km radius (mean disperse distance of villages), and the maximum Space-time permutation scan statistic (Kulldorff, 1977) temporal length is set to 7 days. To ensure sufficient is used to identify diarrhea outbreaks by considering statistical power, the number of Monte Carlo both spatial and temporal aspects of the signal. This is replications is set to 999, and outbreaks with statistical done by modifying the scanning window so that instead significance of p ≤ 0.001 are reported. of circles across space, cylinders are tested, with time presenting as height of the cylinder. The spatial statistic 3. RESULT is implemented in the SaTScan software (Kulldorff, 2003). A space–time retrospective analysis is used, in For the space-time retrospective analysis, top ten signals order to include all confirmed cases during the week. from 45 detections with p ≤ 0.001 are listed in Table 1 For the analysis, the upper limit on the geographical size and depicted the map in Figure 2, 3 and 4. Table 2. Top ten outbreaks from 1 January 2001 to 31 December 2006 Loca- Date Villages in signal Observed cased Expected cased Relative risk tion 5-11 Feb 2001 1 32 0.42 76.45 30 Apr - 6 May 2001 1 26 0.52 49.97 C1 16-22 Jan 2006 23 35 2.18 16.07 A1 19-25 Feb 2001 1 17 0.43 39.80 B1 1-7 Jan 2001 1 11 0.07 163.50 A2 1-7 Jan 2001 3 11 0.15 74.32 C2 7-13 Jan 2002 3 11 0.19 57.30 C3 23-29 Jan 2006 2 24 2.48 9.70 A3 14-20 Mar 2005 1 15 0.70 21.30 B2 4-10 Dec 2006 3 6 0.01 439.63 B3 C4

In the northern of Chiang Mai (zone A), the most 2002 and San Pa Tong district (B9) in 2003 (Figure 3 and outbreak signals were concentrated within the urban 5). areas of Fang and Mae Ai districts at the beginning of rainy season (May-June) for the years 2001, 2003 and The strongest signal of list (C1) was on 5-11 February 2004 (Figure 2 and 5). The highest outbreak of this zone 2001, locating in southern zone (zone C) of Chiang Mai (A1) was on 30 April - 6 May 2001, there had 26 (Hot district). This signal had 32 cases observed over 7 observed cases, when 0.52 were expected theoretically days when 0.42 were expected (relative risk = 76.45). (relative risk = 49.97). All most signals were distributed around the highland in Om Koi district at the end of cool season (January- February) to the beginning of hot season (March-April) (Figure 4 and 5). Figure 2: Diarrhea outbreaks in zone A Figure 4: Diarrhea outbreaks in zone C 4. CONCLUSION Using space-time permutation scan statistic in GIS, we explored the outbreaks of diarrhea in Chiang Mai from 2001 to 2006. The study exhibits that statistic methods and tools can be useful for diarrhea surveillance for public health officials. It demonstrates that using existing health data, space-time analysis and GIS can provide an opportunity to specify the health burden from diarrhea within infected areas. To implement specific and geographically appropriate risk-reduction programs for public health officers, the use of such space-time analysis and tools should become an integral component in the epidemiologic description and risk assessment of diarrhea.. Figure 3: Diarrhea outbreaks in zone B ACKNOWLEDGMENT In the middle zone (zone B), the strongest signal (B1) Special thanks to the Chiang Mai Provincial Public was on 16-22 January 2006 (the end of cool season), Health Office and Geo-Informatics and Space covering 23 villages around the highland in the west Technology Centre (Northern Region) for providing (Mae Cheam district). The signal had 35 observed cases data. when 2.18 were expected (relative risk = 16.07). On the other hand, the outbreaks occurred in the end of rainy season (August-October), there were concentrated within the urban area of San Kamphaeng district (B11) in

Total cases Zone cases 600 200 500 Diarrhea cases (Total) 180 Areas with signals (Zone A) 400 Areas with signals (Zone B) 160 Areas with signals (Zone C) 140 120 300 100 C2 C3 80 200 C1 A8 B9 A10 B1 60 100 A2 A11 B3 B2 40 A1 A3 B11 20 0 C4 0 1 Jan 01 1 Mar 01 1 May 01 1 Jul 01 1 Sep 01 1 Nov 01 1 Jan 02 1 Mar 02 1 May 02 1 Jul 02 1 Sep 02 1 Nov 02 1 Jan 03 1 Mar 03 1 May 03 1 Jul 03 1 Sep 03 1 Nov 03 1 Jan 04 1 Mar 04 1 May 04 1 Jul 04 1 Sep 04 1 Nov 04 1 Jan 05 1 Mar 05 1 May 05 1 Jul 05 1 Sep 05 1 Nov 05 1 Jan 06 1 Mar 06 1 May 06 1 Jul 06 1 Sep 06 1 Nov 06 Figure 4. The weekly temporal pattern of emergency diarrhea cases in Chiang Mai province, January 1, 2001 to December 31, 2006. REFERENCES World Health Organization, 2005. The treatment of diar- rhoea. http://whqlibdoc.who.int/publications/2005/ Bureau of Epidemiology, 2006. Situation of diarrheal 9241593180.pdf diseases. Bangkok: Department of Disease Control, Ministry of Public Health. Chiang Mai Province Official Site, 2006. http://www. chiangmai.go.th/meet_file/intro2.pdf ChiangMai Provincial Public Health Office, 2006. ht- tps:// 61.19.145.134/cmpho_web/epe_web/ Food and Agriculture Organization of the United Na- tions, 2004. Foodborne diseases: situation of diar- rheal diseases in Thailand. In FAO/WHO Regional Conference on Food Safety for Asia and the Pacific. Kulldorff, M.., 1997. A spatial scan statistic. Communi- cations in Statistics: Theory and Methods, 26, 1481- 1496. Kulldorff, M., 2003. SaTScan: Software for the spatial and space–time scan statistics, version 4.0 [computer program]. http://www.satscan.org Kulldorff, M,, Zhang, Z., Hartman, J., Heffernan, R., Huang, L., Mostashari, F., 2004. Benchmark data and power calculations for evaluating disease out- break detection methods. Morbidity and Mortality Weekly Report, 53, 144-151. Pande, S., Keyzer, M.A., Arouna, A., Sonneveld, B.G.J.S., 2008. Addressing diarrhea prevalence in the West African Middle Belt: social and geographic dimensions in a case study for Benin. International Journal of Health Geographics, 7, 17.

Third International Conference on HealthGIS 2009 July 24-26, 2009, Hyderabad, India MAPPING DISTRIBUTION AND RELOCATION AREAS IN DENGUE ENDEMIC AREA EAST JAKARTA MUNCIPALITY Artha Prabawa Faculty of Public Health University of Indonesia, [email protected] ABSTRACT: The development of diseases incidence in spatial domain has been parallel by the development of methods where time implicity included in the analysis. This extension can take a variety of form depending on how the sampling of the process in time is made. For example, at one extreme, a month of prevalence DHF patient may be known as well as the residential location, whereas at another, only the count of cases within a small area tract within a time period will be available. In addition , many other forms of time-based information may arise, duration of period of epidemic, longitudinal case history intervention or other prevention for DHF epidemic. It has been taken effort of prevention and Dengue Haemorrhagic Fever Surveillance and Fogging Epidemic Area, however the DHF incident trend is increasing as well as the number of the contangious DHF area. This study area was in East Jakarta for the year 2002 with prevalence DHF patient spatio temporal datain the year 1996 – 2001 and patient environment data in endemic area in the year 2002. The spatio temporal data DHF patient in endemic area for identify characteristic about epidemic cyclic and characteristic for home environment DHF patient residential. Geographic Quantitative Methods and Geographic Information System use in this study for collecting, processing and analysis data. The study found Some characteristic for DHF cyclic in endemic area and home environment characteristic for DHF patient residential. The DHF cyclical characteristic epidemic distribution found in three years cyclic for the year 1996 – 1998 and 1999 – 2001. For the home environment DHF patient residential the study found some characteristic like in environment factor, Socio-economic factor and life style factor. The study in East Jakarta is consist of preliminary research in spatial epidemiology especially for DHF epidemic, but it will not be carried out in this research because of the time limitation and hopefully the study can be used for spatial epidemiology in health intervention in other endemic DHF epidemic area. KEY WORDS: Dengue Haemorrhagic Fever, Characteristic, Endemic, Epidemic, Spatial Distribution, Environment, Geographic Information System. 1. INTRODUCTION style changes on public because dynamic economic circumstance change very fast. Health status is a comprehensive description for quality of public live, that is from environment condition or In Indonesia and Jakarta Province Dengue Fever is public social condition. That is have the impact to human endemic epidemic diseases cause insect as third large health. If Heath status is bad cause to bad productivity mortality causes after food borne diseases (Cholera, (leod Gordis, 1996). Environment is a place for human typus, dysentery). Jakarta province Dengue activity to interact with others and environment is a place Haemorrhagic fever(DHF) Incident rate have first level in for daily human stay in. Environment meaning such as a Indonesia 145.19/100,000 person year 1998/1999 physical environment, biological environment and (Indonesian health Profile, Health Dept. Rep. of socioeconomic environment. Environment have Indonesia, 1999). contribution to public health problem as a direct cause for spreading communicable diseases but environment is Changing in situation and condition of residential is a infinite media of disease spread. The Differentiate influence factor in geographic distribution pattern for between healthy environment and unhealthy environment dengue fever epidemic in Jakarta province endemic area is clear to see if the indicator for differentiate as a especially east Jakarta Municipality. The great dengue physical view from clean environment condition. fever incident coming in 1998 and decrease in 1999 but the decreased still never come to incident number in year Trend of diseases cause arthropode borne infection very 1997, that mean the incident in year 1999 still high. significant Increase in morbidity rate or case fatality rate Intervention with fogging and abate cannot reduced (CFR) from year 1995 until 1998 and that following with significantly. In general, the Health Service District II a large geographic area distribution number increased cannot implement the DHF Health Intervention (Indonesian Health Data Survey in 1995 - 1998) . The optimally. increase of number spread geographic area that meaning clearly is fact to evident base for geographic transition Geographic Information System (GIS) can show the area for endemic diseases and following havening life distribution and moving area relocation the dengue fever

outbreaks with visual description using map. The GIS This methods can made time series a number of dengue technology need a spatial data from location like name of fever case map in ten sub district from 1996 until 2001. place, address, climate data and some data with spatial From that map the pattern of relocation will identify with characteristic. Diseases mapping can explained us about some model, three month movement relocation pattern, some interaction like diseases between geographic semester movement relocation pattern, one year factor. Geographic factor is season, rainfall, wind speed, movement relocation pattern and Five years movement and others geographic factor in endemic area. The relocation pattern. Determine the direction movement residential in east Jakarta have some characteristic like relocation using the outbreaks time in each epidemic High Density population, over crowded and water location and a number of incident increase per times drainage. That is a perfect place for dengue fever vector series cycle, that is comparability with prevalens in life and breeding, mosquito is a dengue fever diseases endemic area. The spatial form pattern on map was the vector can life and breeding in that area. Mosquito genus movement relocation having direction product four as a dengue fever vector is aedes aegepty and aedes spatial form pattern. That is 1.Zigzag line pattern, 2.Poly Albopictus. line pattern, 3. Ring polygon pattern, 4. Radial spread pattern (Artha, 2002). The figure 3 below described that 2. THE PROBLEM spatial pattern. The problem for research is a geographic distribution The research using data secondary from health district characteristic an pattern in endemic dengue epidemic area office annual report about dengue fever cases in 1996 base on CFR health district office reported in east Jakarta until 2001 on ten sub district in East Jakarta Municipality. municipality as a research area. The table 1 to contain dengue fever cases data distribution in ten East Jakarta sub district. The annual The objective data develop mapping for years relocation movement, this can get the years dengue relocation movement The objective research is for identification characteristic pattern model and distribution pattern in ten years. about epidemic cyclic and characteristic for home environment DHF patient residential. Monthly dengue data cases in ten district abstraction to mapping for monthly dengue relocation movement map. Research Area Data from January , February, March, in year 2000 and January, February, March,on year 2001 in table 2 below This study area was in East Jakarta for the year 2002 with (next page). prevalence Dengue Haemorrhagic fever (DHF) patient Spatio temporal data in the year 1996 – 2001 and patient January until march data using because that in rainy environment data in endemic area in the year 2002. East season in Java Island, and in that season is breeding time Jakarta have ten sub district and the location in Java for aedes aegepty and aedes albopictus, floods and much Island north territory exactly from 106o44’35’’E until water pool every where without controlling can be 106o58’10’’E and 06o10’35’’S until 06o23’42’’S. Java breeding places for that mosquitos. Island borderer with Java Ocean in North and India Ocean in South. East Jakarta have 4 Million citizen in ten 4. RESULTS sub district (2009). East Jakarta have tropical climate and 2 season a year, dry and rainy. Jakarta is Centre Dengue Haemorrhagic fever(DHF) data abtraction to six Government of Indonesian Republic. map in 1996 until 2001 (see figure 4 below) and maps show some sub district with higher dengue cases in that’s 3. METHODS years. Maps position arrange base on time series from left to right in 3 years set that is first row year 1996 to 1998 The research using Geographic Information System and below in second row year 1999 to 2001. Table 3 methods. The GIS methods is mapping and data described the higher cases in each location and arrange abstraction spatial data to digital map with Arc-View 3.2 . with ascending from 1996 to 2001. Map show in figure on series position for described associative analysis in geographic, associative analysis 5. DISCUSSIONS explained about relocation area for dengue fever epidemic relocation pattern in endemic area and The map show in figure 4 as series from 1996 until 2001 distribution pattern. The spatial data overlay with some with dengue fever cases in ten sub district at East Jakarta. variable on map. The research using secondary data from Changing the location with higher cases in each year has Health Service District II annual report from 1996 until indication relocation movement center of dengue 2001 and primarily data with rapid survey in residential epidemic (see figure 4 from left to right up map a.1996 area for collected some variable to completed relational until c. 1998 and map d. 1999 until f. 2001 below). The over layer map. DHF cyclical characteristic epidemic distribution found in three years cyclic for the year 996 – 1998 and 1999 – 2001. According to spatial pattern model in methods, the