Do You Speak Data?

Assessing animals in Kazakhstan

Trainings in QGIS software brings together specialists from both the human and animal health sectors to share expertise.

CDC Central Asia Regional Office (CDC-CAR) database analyst and information technology advisor Dilafkor Mirdjalilov speaks four languages fluently. One of those languages, he said, is “data.”

According to Mirdjalilov, “Data is the language of public health that guides interventions, informs policymakers, and helps track disease outbreaks. Data is at the core of public health.”

In Central Asia, CDC uses the Field Epidemiology Training Program (FETP) to improve local capacity in data collection and analysis, all necessary skills to understand, anticipate, and prepare for outbreaks. Since 2016, the Central Asia FETP has collaborated with Amber Dismer, a CDC health scientist in Atlanta, Georgia. Dismer leads trainings in Central Asia on geographic information systems (GIS) using the free Quantum GIS software (QGIS), allowing trainees to spatially present and analyze national public health surveillance datasets. Rooted in the science of geography, GIS helps users analyze, store, manipulate, and visualize geographic information. It helps answer questions about how location impacts diseases and guides decisions about activities to prevent, detect, and respond to disease threats.

Dismer said GIS can be widely applied in public health. “It’s used to determine where outbreaks start, identify disease patterns or clusters, and target public health surveillance efforts. GIS is invaluable.”

Map of Central Asia highlighting the countries of Kazakhstan, Uzbekistan, Kyrgyzstan, Tajikistan, and Afghanistan. Accompanying statistics show the following. Since 2016, 90 (image of footprint) FETP residents and graduates from Kazakhstan and Krygyzstan trained in GIS; 20 (image of pathogen) epidemiologists from Kazakhstan's Ministry of Health were trained in GIS; In 2017, 17 (image of footprint) FETP residents from Tajikstan and Afghanistan were trained in GIS; In 2018, 10 (Image of map marker) Uzbekistan Ministry of Health and Ministry of Agriculture specialists were trained in a One Health GIS course

TRAINING OF TRAINERS

Since 2016, Dismer has trained more than 90 FETP residents and graduates from Kazakhstan and Kyrgyzstan, and 20 epidemiologists from the Kazakhstan Ministry of Health (MOH) in GIS. In Tajikistan, with Dismer’s support, Mirdjalilov trained an additional 17 FETP residents from Tajikistan and Afghanistan in 2017. In turn, FETP residents cofacilitated a basic-level GIS course in 2018 and will lead similar trainings in Kazakhstan.

In these trainings, participants gain technical skills to present spatial data in QGIS software, learn data visualization methods, and create their own disease maps. Participants also learn various cartographic techniques that help increase collaboration and data sharing between local, national, and international partners.

The trainings bring specialists from both the human and animal health sectors together to share expertise. In 2018, Dismer and Mirdjalilov developed a One Health GIS training course in Uzbekistan and trained 10 MOH and 10 Ministry of Agriculture specialists to use datasets on priority diseases, including anthrax, brucellosis, and Crimean-Congo hemorrhagic fever.

In Kazakhstan, Dismer worked with FETP staff and residents on spatial analysis to identify hotspots of the 2018 meningitis outbreak and clusters of tuberculosis transmission in Almaty City. They informed policymakers on priority areas for targeted prevention activities, including active case finding and population screening. “Thanks to the trainings provided by CDC, QGIS mapping has also become an integral part of how the Ministry of Health describes the epidemiology of HIV in the country,” said Vladimir Kazakov, FETP graduate and monitoring and assessment specialist at Kazakhstan’s Republican Center on Prevention and Control of AIDS. In 2017, CDC’s Central Asia office provided technical support for the Republican AIDS Center to investigate an HIV outbreak in northern Kazakhstan, and, for the first time, used spatial analysis to locate hotspots of HIV transmission. Kazakov said, “The [identification of] HIV hotspots helped [us] to develop new recommendations for policymakers so they could direct resources and prevention activities where they are needed most.”

The FETP residents and graduates trained by Dismer have now joined an international community of QGIS users. With their new skills, these disease detectives help improve the region’s ability to collect accurate spatial data from disease investigations and conduct more rigorous data analysis. FETP graduates in the region are now qualified to conduct GIS trainings for others, teaching a new generation how to speak the language of data.