Mapping for a disease-free world

David Addiss, image property of CWW.

Children Without Worm’s director, Dr. David Addiss, writes for GAHI about CWW’s use of GAHI maps and the critical role of mapping in disease control.

1 March 2013

As one of our valued partners, Children Without Worms (CWW) shares our goal of living in a world free of neglected tropical diseases. Working with GlaxoSmithKline and Johnson & Johnson, CWW promotes and helps implement control of soil-transmitted helminths (STH) following a four-pronged strategy: water, sanitation, hygiene and deworming (the WASHED framework). CWW’s director, Dr. David Addiss, writes for GAHI about CWW’s use of GAHI maps and the critical role of mapping in disease control.

Ever since 1854, when John Snow, the “Father of Epidemiology,” demonstrated the power of maps to identify the source of a devastating cholera outbreak, spatial representation of data has been an essential tool for the epidemiologist and a foundation to the science of public health. It seems fitting that the site of the famous Broad Street pump, which Snow’s maps linked to cholera, is just a short walk from the London School of Hygiene & Tropical Medicine, where much of the work on the Global Atlas of Helminth Infections (GAHI) is now being done. 

Our need for maps to address complex public health problems has increased in the decades following Snow’s work. GAHI’s maps for soil-transmitted helminthiasis (STH), schistosomiasis and lymphatic filariasis (LF) have significantly enhanced our understanding of the spatial distribution and epidemiology of these diseases. The simplicity of GAHI’s web-based format is undergirded by advanced statistical and mapping techniques pioneered by Prof. Simon Brooker and his team.    

Program managers often have to develop national policy and strategies regarding STH control based on very little data on prevalence and intensity. When data are available, they are usually from a few communities and therefore, difficult to generalize to the rest of the country. The GAHI maps remove a lot of the guesswork. Children Without Worms (CWW) relies on these maps to validate proposed treatment strategies presented in applications. When we share these maps with program managers, we find that they are excited to know such a resource exists. More and more, we see the GAHI maps incorporated in National Action Plans for Control and Elimination of Neglected Tropical Diseases (NTDs). 

As STH control begins to scale up globally, the promise of the World Health Assembly (WHA) resolution (WHA 54.19) to eliminate STH as a public health problem has received renewed attention. This resolution urges WHO member states to increase drug coverage among at-risk children and women and to improve access to water, sanitation, and hygiene. The ability of GAHI’s maps to elucidate complex spatial relationships will be critical for realizing the vision of WHA 4.19 and for guiding programmatic decisions. (Read an editorial on this subject from Dr. Addiss in the most recent issue of PLOS NTDs)    

The expansion of the GAHI website to include treatment coverage data on LF and access to water and sanitation will ensure that the GAHI website remains the ‘go-to place’ for information as we continue to study, plan, and implement control of NTDs. These additional features will be particularly useful in generating hypotheses that will guide STH research and control.

We at Children Without Worms are enthusiastic about the expansion of the GAHI website and grateful for the service that GAHI provides to the entire STH control community. We look forward to working together and using this valuable resource to achieve our shared goal of a world free of neglected tropical diseases.

David Addiss
Children Without Worms

The January 2013 issue of The Quarterly Dose, Children Without Worms’ newsletter, featured an article with Prof. Simon Brooker about GAHI. Prof. Brooker is a member of the STH Advisory Committee, an independent group of experts that advises CWW on the strategic and technical components of STH control.

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