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Arafat Raouf

Extreme heat events over the past 30 years have resulted in unprecedented increase in the numbers of heat-related morbidity and mortality across the world (1-3). During the same time frame, Houston residents has experienced three of the hottest summers on record since 1889, with 2011 being the hottest summer on record (4). Therefore, preparing for extreme heat events and monitoring their effects on public health is a vital role for the Houston Department of Health and Human Services (HDHHS). Since heat-related illnesses are not a reportable condition in the state of Texas, HDHHS authorities rely on other sources to provide information on the impact of heat on the population. HDHHS is currently able to monitor emergency departments (ED) visits across the Houston metropolitan area, Harris County, and the surrounding jurisdictions by using a syndromic surveillance system called Real-time Outbreak Disease Surveillance (RODS). The RODS system collects de-identified patient data that consists of their chief complaint and basic demographics (e.g. age, sex, zip code). This study is aimed at evaluating the ability of RODS to detect heat-related illnesses during heat event of the years 2009-2012 as well as identifying the areas of Houston that had the highest incidence of heat-related morbidity.

Objective

To evaluate the ability of a syndromic surveillance system to detect heat-related illnesses during a heat wave in Houston and to identify areas in Houston that requires additional resources to prevent heat-related illnesses.

Submitted by knowledge_repo… on

The Houston Department of Health Department of Health and Human Services (HDHHS) monitors emergency departments (ED) chief complaints across the Houston metropolitan area, Harris County, and the surrounding jurisdictions by Real-time Outbreak Disease Surveillance (RODS). The influenza-like illnesses (ILI) data is collected by sentinel surveillance provider network of 12 physicians and RODS, an electronic syndromic surveillance database consisting of about 30 EDs in metropolitan Houston. Previous research indicates that there is a relationship between new HIV diagnoses and neighborhood poverty. However, there is limited research on health disparity to investigate the association between influenza-like illnesses (ILI) and social determinants of health (SDH), such as poverty.

Objective

To investigate the association between social determinants of health and influenza-like illnesses in Houston/Harris County and to identify neighborhoods for targeted surveillance or interventions.

Submitted by knowledge_repo… on

When a chemical or biological agent with public health implications is detected in the City of Houston, analysis of syndromic surveillance data is an important tool for investigating the authenticity of the alert, as well as providing information regarding the extent of contamination.

Syndromic surveillance data in Houston is currently provided by the Real-Time Outbreak Disease Surveillance, which collects and synthesizes real-time chief complaint data from 34 area hospitals, representing approximately 70% coverage of licensed ER beds in Harris County. Data collected for each complaint includes patient home and work zip codes, allowing for geographic analysis of the data in the case of a localized environmental contamination.

Historically, when alerted to a contaminant in the Houston area, the Houston Department of Health and Human Services (HDHHS) has analyzed health data for each zip code in the geographic area of interest separately, a time-intensive process.

Recognizing the need for a more accurate and timely response to an environmental alert, HDHHS proposes aggregating zip codes into zones, based on coverage of population and areas of high risk. These “Surveillance Zones” will be used to quickly reference syndromic data in the event of a chemical or biological event.

 

Objective

This paper discusses the development of zones within the City of Houston in order to more quickly and accurately reference surveillance data in the case of chemical or biological events.

Referenced File
Submitted by elamb on

Timely outbreak detection, and monitoring of morbidity and mortality among Katrina evacuees, and needs assessment for better planning and response were urgent information intensive priorities during Katrina relief efforts at Houston, and called for immediate deployment of a real-time surveillance and needs assessment system ad hoc, in order to collect and analyze relevant data at the scene. Initial requirement analysis revealed the following capabilities as essential to sustain effective response within the shelters:

• The ability to securely collect and integrate data from evacuees seeking any form of health services from all care providers (academic, volunteers, federal, NGOs and international aid organizations, etc), including demographic information, vital signs, chief complaints, disabilities, chronic conditions, current and past medications, traumas and injuries, exposure to toxic materials, clinical laboratory results, past medical history, discharge notes and diagnoses, and ability to collect free text entries for any other information (similar to a full-blown electronic medical records system).

• Proactive survey of demographic profile, physical and mental health status, as well as special needs assessment (e.g., dialysis, medications, etc) from all evacuees.

• The ability to collect uniform information, using any network-enabled device available: PCs, tablets, and handheld devices. 

• The ability to classify observations by processing sign and symptom, chief complaint, medication, and other diagnostic data (including free text entries) through ad-hoc definition of concepts such as (Gastrointestinal, Respiratory, Fever and Rash, etc). 

 

Objective

This paper presents lessons learned from leveraging Internet-based technologies and Services Oriented Architecture in providing timely, novel, and customizable solutions, just in time and for preparedness against unprecedented events such as natural disasters (e.g., Katrina) or terrorism.

Referenced File
Submitted by elamb on

Disease surveillance provides essential information for control and response planning1. Emergency Room (ER) syndromic surveillance data can help to identify changes in disease incidence and affected group thereby providing valuable additional time for public health interventions1. The current study explored the relationship between ER syndromic surveillance data and influenza notification to the Houston Department of Health and Human services (HDHHS).

Referenced File
Submitted by elamb on

In 2011, injury by firearms accounted for 32,351 deaths (10.4 deaths per 100,000 population) in the United States. This rate was higher than any infectious or parasitic disease (the highest being 2.5 for both viral hepatitis and HIV disease). Furthermore, death by gunshots accounted for over half of all suicides and over two-thirds of all homicides in the US. Despite the disproportionate media coverage of mass shootings and assault weapon violence, the vast majority of these deaths are attributable to non-mass shootings and to handguns. Though a contentious issue in the United States, understanding this cause of death is vital to confronting the issue locally and nationally. Traditionally, death certificates, crime data, cross-sectional studies, and retrospective studies have most commonly been utilized in this endeavor; however, the collection of real-time emergency department (ED) visit information presents a unique opportunity to track gunrelated injuries to supplement our current understanding of this issue. The Houston Department of Health and Human Services (HDHHS) has been receiving this information for over a decade from EDs in the greater-Houston area, and the department is currently connected to 32 of the largest EDs in the area. The current study aims to enhance the understanding of gunshot-related injuries in the Houston area and present a model for utilizing RODS information for this purpose.

Objective

To introduce a model to track gunshot-related injuries, describe gun-related injuries in Houston, and investigate the association between gun-related injuries and social determinants of health using syndromic surveillance data.

Submitted by teresa.hamby@d… on

Since November 2014, the Houston Health Department has been receiving antimicrobial resistance information for Streptococcus pneumoniae from a safety net hospital via electronic laboratory reporting (ELR). Antimicrobial characteristics and vaccination rates of pneumococcal disease are of public health interest due to potential implications in treatment and prevention. Ten states participate in the CDC’s Active Bacterial Core surveillance (ABCs) program. Texas, which represents a different and diverse demographic compared to other states, is not an ABCs participating state. No studies have compared local antimicrobial susceptibility percentages to those of the ABCs. The aim of this study is to 1) report the antimicrobial susceptibility of S. pneumoniae in a local cohort, 2) characterize the demographics of the cohort including the use of pneumococcal vaccine, and 3) compare antimicrobial susceptibility percentages of the local cohort to the 2013 ABCs program.

Objective

Our objective is to report the antimicrobial susceptibilities of Streptococcus pneumoniae received from a local safety net hospital via electronic laboratory reporting (ELR), and compare susceptibility percentages with those of the Centers for Disease Control and Prevention’s Active Bacterial Core surveillance (ABCs) program.

Submitted by Magou on

Approximately 2.7 million Americans live with chronic HCV, with roughly 30,000 new cases in 2013. Fortunately, recent clinical trials have shown great advances using interferon-free, oral direct-acting antivirals, with cure rates over 95% . But only a few people have been treated, and most are unaware of the infection. This presents an opportunity for public health to address unmet needs, but most jurisdictions have limited surveillance and prevention efforts. Leveraging HCV surveillance, this analysis presents a cost-effective method to improve situational awareness and guide prevention efforts in Houston.

Objective

To describe the use of Hepatitis C Virus (HCV) viral load (VL) results and geospatial analysis to guide prevention efforts.

Submitted by teresa.hamby@d… on

Flu Near You allows individuals to volunteer to be a sentinel node of the syndromic surveillance (SyS) network. The platform has the potential to provide insight into the spread of influenza-like illness (ILI). CDC’s ILINet is the gold standard for tracking ILI at the national level, but does not track into the local level. Local health departments (LHD) frequently express a need for granular data specific to their jurisdictions. FNY attempts to meet this need by collecting and sharing data at the zip code level. Knowing how well FNY data correlates to ILINet data will give local health departments an important tool to communicate the arrival of influenza to their jurisdiction. However, there is significant skepticism at the quality of FNY data as compared to validated datasets.

Objective

Our objective is to provide evidence for the data quality of Flu Near You (FNY) by evaluating the national and Houston datasets against CDC ILI data.

Submitted by teresa.hamby@d… on

Internet based technologies are becoming quite prominent among today’s generation due to its easy accessibility through computer or phone devices. Internet’s relative anonymity leads high risk groups to find it easier to meet sexual partners with similar characteristics through dating sites like Grindr, Jack’D, Adams4Adams etc. and mainstream social networking sites like Facebook, Twitter, or Instagram. According to various studies, young MSMs prefer to use dating sites and social networking sites more as a source to meet sexual partners than older MSMs.

Objective

To assess the usage of dating sites and social networking sites for finding sexual partners among newly diagnosed HIV positive MSMs in Harris County in 2014

Submitted by teresa.hamby@d… on
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