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Journal Description

JMIR Public Health & Surveillance (JPHS, Editor-in-chief: Travis Sanchez, Emory University/Rollins School of Public Health) is a PubMed-indexed, peer-reviewed sister journal of the Journal of Medical Internet Research (JMIR), the top cited journal in health informatics, ranked #1 by Clarivate's Journal Impact Factor. JPH is a multidisciplinary journal with a unique focus on the intersection of innovation and technology in public health, and includes topics like health communication, public health informatics, surveillance, participatory epidemiology, infodemiology and infoveillance, digital disease detection, digital public health interventions, mass media/social media campaigns, and emerging population health analysis systems and tools. 

We publish regular articles, reviews, protocols/system descriptions and viewpoint papers on all aspects of public health, with a focus on innovation and technology in public health.

Apart from publishing traditional public health research and viewpoint papers as well as reports from traditional surveillance systems, JPH was one of the first (if not the only) peer-reviewed journal which publishes papers with surveillance or pharmacovigilance data from non-traditional, unstructured big data and text sources such as social media and the Internet (infoveillance, digital disease detection), or reports on novel participatory epidemiology projects, where observations are solicited from the public.  

Among other innovations, JPH is also dedicated to support rapid open data sharing and rapid open access to surveillance and outbreak data. As one of the novel features we plan to publish rapid or even real-time surveillance reports and open data. The methods and description of the surveillance system may be peer-reviewed and published only once in detail, in a  "baseline report" (in a JMIR Res Protoc or a JMIR Public Health & Surveill paper), and authors then have the possibility to publish data and reports in frequent intervals rapidly and with only minimal additional peer-review (we call this article type "Rapid Surveillance Reports"). JMIR Publications may even work with authors/researchers and developers of selected surveillance systems on APIs for semi-automated reports (e.g. weekly reports to be automatically published in JPHS and indexed in PubMed, based on data-feeds from surveillance systems and minmal narratives and abstracts).

Furthermore, duing epidemics and public health emergencies, submissions with critical data will be processed with expedited peer-review to enable publication within days or even in real-time.

We also publish descriptions of open data resources and open source software. Where possible, we can and want to publish or even host the actual software or dataset on the journal website.

 

Recent Articles:

  • Source: The Authors/Placeit.net; Copyright: JMIR Publications; URL: http://publichealth.jmir.org/2018/3/e10234/; License: Creative Commons Attribution (CC-BY).

    Facial-Aging Mobile Apps for Smoking Prevention in Secondary Schools in Brazil: Appearance-Focused Interventional Study

    Abstract:

    Background: Most smokers start smoking during their early adolescence, often with the idea that smoking is glamorous. Interventions that harness the broad availability of mobile phones as well as adolescents' interest in their appearance may be a novel way to improve school-based prevention. A recent study conducted in Germany showed promising results. However, the transfer to other cultural contexts, effects on different genders, and implementability remains unknown. Objective: In this observational study, we aimed to test the perception and implementability of facial-aging apps to prevent smoking in secondary schools in Brazil in accordance with the theory of planned behavior and with respect to different genders. Methods: We used a free facial-aging mobile phone app (“Smokerface”) in three Brazilian secondary schools via a novel method called mirroring. The students’ altered three-dimensional selfies on mobile phones or tablets and images were “mirrored” via a projector in front of their whole grade. Using an anonymous questionnaire, we then measured on a 5-point Likert scale the perceptions of the intervention among 306 Brazilian secondary school students of both genders in the seventh grade (average age 12.97 years). A second questionnaire captured perceptions of medical students who conducted the intervention and its conduction per protocol. Results: The majority of students perceived the intervention as fun (304/306, 99.3%), claimed the intervention motivated them not to smoke (289/306, 94.4%), and stated that they learned new benefits of not smoking (300/306, 98.0%). Only a minority of students disagreed or fully disagreed that they learned new benefits of nonsmoking (4/306, 1.3%) or that they themselves were motivated not to smoke (5/306, 1.6%). All of the protocol was delivered by volunteer medical students. Conclusions: Our data indicate the potential for facial-aging interventions to reduce smoking prevalence in Brazilian secondary schools in accordance with the theory of planned behavior. Volunteer medical students enjoyed the intervention and are capable of complete implementation per protocol.

  • Clinical laboratory scientists discuss respiratory pathogen syndromic trend dvata. Source: Image created by the Authors; Copyright: The Authors; URL: http://publichealth.jmir.org/2018/3/e59/; License: Creative Commons Attribution + Noncommercial + NoDerivatives (CC-BY-NC-ND).

    Automated Real-Time Collection of Pathogen-Specific Diagnostic Data: Syndromic Infectious Disease Epidemiology

    Abstract:

    Background: Health care and public health professionals rely on accurate, real-time monitoring of infectious diseases for outbreak preparedness and response. Early detection of outbreaks is improved by systems that are comprehensive and specific with respect to the pathogen but are rapid in reporting the data. It has proven difficult to implement these requirements on a large scale while maintaining patient privacy. Objective: The aim of this study was to demonstrate the automated export, aggregation, and analysis of infectious disease diagnostic test results from clinical laboratories across the United States in a manner that protects patient confidentiality. We hypothesized that such a system could aid in monitoring the seasonal occurrence of respiratory pathogens and may have advantages with regard to scope and ease of reporting compared with existing surveillance systems. Methods: We describe a system, BioFire Syndromic Trends, for rapid disease reporting that is syndrome-based but pathogen-specific. Deidentified patient test results from the BioFire FilmArray multiplex molecular diagnostic system are sent directly to a cloud database. Summaries of these data are displayed in near real time on the Syndromic Trends public website. We studied this dataset for the prevalence, seasonality, and coinfections of the 20 respiratory pathogens detected in over 362,000 patient samples acquired as a standard-of-care testing over the last 4 years from 20 clinical laboratories in the United States. Results: The majority of pathogens show influenza-like seasonality, rhinovirus has fall and spring peaks, and adenovirus and the bacterial pathogens show constant detection over the year. The dataset can also be considered in an ecological framework; the viruses and bacteria detected by this test are parasites of a host (the human patient). Interestingly, the rate of pathogen codetections, on average 7.94% (28,741/362,101), matches predictions based on the relative abundance of organisms present. Conclusions: Syndromic Trends preserves patient privacy by removing or obfuscating patient identifiers while still collecting much useful information about the bacterial and viral pathogens that they harbor. Test results are uploaded to the database within a few hours of completion compared with delays of up to 10 days for other diagnostic-based reporting systems. This work shows that the barriers to establishing epidemiology systems are no longer scientific and technical but rather administrative, involving questions of patient privacy and data ownership. We have demonstrated here that these barriers can be overcome. This first look at the resulting data stream suggests that Syndromic Trends will be able to provide high-resolution analysis of circulating respiratory pathogens and may aid in the detection of new outbreaks.

  • Source: Flickr; Copyright: David Goehring; URL: https://www.flickr.com/photos/carbonnyc/157432201/; License: Creative Commons Attribution (CC-BY).

    Development of an Agent-Based Model to Investigate the Impact of HIV Self-Testing Programs on Men Who Have Sex With Men in Atlanta and Seattle

    Abstract:

    Background: In the United States HIV epidemic, men who have sex with men (MSM) remain the most profoundly affected group. Prevention science is increasingly being organized around HIV testing as a launch point into an HIV prevention continuum for MSM who are not living with HIV and into an HIV care continuum for MSM who are living with HIV. An increasing HIV testing frequency among MSM might decrease future HIV infections by linking men who are living with HIV to antiretroviral care, resulting in viral suppression. Distributing HIV self-test (HIVST) kits is a strategy aimed at increasing HIV testing. Our previous modeling work suggests that the impact of HIV self-tests on transmission dynamics will depend not only on the frequency of tests and testers’ behaviors but also on the epidemiological and testing characteristics of the population. Objective: The objective of our study was to develop an agent-based model to inform public health strategies for promoting safe and effective HIV self-tests to decrease the HIV incidence among MSM in Atlanta, GA, and Seattle, WA, cities representing profoundly different epidemiological settings. Methods: We adapted and extended a network- and agent-based stochastic simulation model of HIV transmission dynamics that was developed and parameterized to investigate racial disparities in HIV prevalence among MSM in Atlanta. The extension comprised several activities: adding a new set of model parameters for Seattle MSM; adding new parameters for tester types (ie, regular, risk-based, opportunistic-only, or never testers); adding parameters for simplified pre-exposure prophylaxis uptake following negative results for HIV tests; and developing a conceptual framework for the ways in which the provision of HIV self-tests might change testing behaviors. We derived city-specific parameters from previous cohort and cross-sectional studies on MSM in Atlanta and Seattle. Each simulated population comprised 10,000 MSM and targeted HIV prevalences are equivalent to 28% and 11% in Atlanta and Seattle, respectively. Results: Previous studies provided sufficient data to estimate the model parameters representing nuanced HIV testing patterns and HIV self-test distribution. We calibrated the models to simulate the epidemics representing Atlanta and Seattle, including matching the expected stable HIV prevalence. The revised model facilitated the estimation of changes in 10-year HIV incidence based on counterfactual scenarios of HIV self-test distribution strategies and their impact on testing behaviors. Conclusions: We demonstrated that the extension of an existing agent-based HIV transmission model was sufficient to simulate the HIV epidemics among MSM in Atlanta and Seattle, to accommodate a more nuanced depiction of HIV testing behaviors than previous models, and to serve as a platform to investigate how HIV self-tests might impact testing and HIV transmission patterns among MSM in Atlanta and Seattle. In our future studies, we will use the model to test how different HIV self-test distribution strategies might affect HIV incidence among MSM.

  • Source: Wikimedia Commons; Copyright: Peter van der Sluijs; URL: https://commons.wikimedia.org/wiki/File:Het_maken_van_een_selfie_Ladiesrun_2015.jpg; License: Creative Commons Attribution + ShareAlike (CC-BY-SA).

    #Healthy Selfies: Exploration of Health Topics on Instagram

    Abstract:

    Background: Social media provides a complementary source of information for public health surveillance. The dominate data source for this type of monitoring is the microblogging platform Twitter, which is convenient due to the free availability of public data. Less is known about the utility of other social media platforms, despite their popularity. Objective: This work aims to characterize the health topics that are prominently discussed in the image-sharing platform Instagram, as a step toward understanding how this data might be used for public health research. Methods: The study uses a topic modeling approach to discover topics in a dataset of 96,426 Instagram posts containing hashtags related to health. We use a polylingual topic model, initially developed for datasets in different natural languages, to model different modalities of data: hashtags, caption words, and image tags automatically extracted using a computer vision tool. Results: We identified 47 health-related topics in the data (kappa=.77), covering ten broad categories: acute illness, alternative medicine, chronic illness and pain, diet, exercise, health care & medicine, mental health, musculoskeletal health and dermatology, sleep, and substance use. The most prevalent topics were related to diet (8,293/96,426; 8.6% of posts) and exercise (7,328/96,426; 7.6% of posts). Conclusions: A large and diverse set of health topics are discussed in Instagram. The extracted image tags were generally too coarse and noisy to be used for identifying posts but were in some cases accurate for identifying images relevant to studying diet and substance use. Instagram shows potential as a source of public health information, though limitations in data collection and metadata availability may limit its use in comparison to platforms like Twitter.

  • The SIEMA Workflow Diagram with "Brass Head Bug" by Kenny Hays. Source: Image created by the Authors; Copyright: Arash Shaban-Nejad; URL: http://publichealth.jmir.org/2018/2/e10218/; License: Creative Commons Attribution (CC-BY).

    A Surveillance Infrastructure for Malaria Analytics: Provisioning Data Access and Preservation of Interoperability

    Abstract:

    Background: According to the World Health Organization, malaria surveillance is weakest in countries and regions with the highest malaria burden. A core obstacle is that the data required to perform malaria surveillance are fragmented in multiple data silos distributed across geographic regions. Furthermore, consistent integrated malaria data sources are few, and a low degree of interoperability exists between them. As a result, it is difficult to identify disease trends and to plan for effective interventions. Objective: We propose the Semantics, Interoperability, and Evolution for Malaria Analytics (SIEMA) platform for use in malaria surveillance based on semantic data federation. Using this approach, it is possible to access distributed data, extend and preserve interoperability between multiple dynamic distributed malaria sources, and facilitate detection of system changes that can interrupt mission-critical global surveillance activities. Methods: We used Semantic Automated Discovery and Integration (SADI) Semantic Web Services to enable data access and improve interoperability, and the graphical user interface-enabled semantic query engine HYDRA to implement the target queries typical of malaria programs. We implemented a custom algorithm to detect changes to community-developed terminologies, data sources, and services that are core to SIEMA. This algorithm reports to a dashboard. Valet SADI is used to mitigate the impact of changes by rebuilding affected services. Results: We developed a prototype surveillance and change management platform from a combination of third-party tools, community-developed terminologies, and custom algorithms. We illustrated a methodology and core infrastructure to facilitate interoperable access to distributed data sources using SADI Semantic Web services. This degree of access makes it possible to implement complex queries needed by our user community with minimal technical skill. We implemented a dashboard that reports on terminology changes that can render the services inactive, jeopardizing system interoperability. Using this information, end users can control and reactively rebuild services to preserve interoperability and minimize service downtime. Conclusions: We introduce a framework suitable for use in malaria surveillance that supports the creation of flexible surveillance queries across distributed data resources. The platform provides interoperable access to target data sources, is domain agnostic, and with updates to core terminological resources is readily transferable to other surveillance activities. A dashboard enables users to review changes to the infrastructure and invoke system updates. The platform significantly extends the range of functionalities offered by malaria information systems, beyond the state-of-the-art.

  • Source: Pixnio; Copyright: Pixnio; URL: https://pixnio.com/food-and-drink/woman-dinner-food-meal-diet-glass; License: Public Domain (CC0).

    Identifying Methods for Monitoring Foodborne Illness: Review of Existing Public Health Surveillance Techniques

    Abstract:

    Background: Traditional methods of monitoring foodborne illness are associated with problems of untimeliness and underreporting. In recent years, alternative data sources such as social media data have been used to monitor the incidence of disease in the population (infodemiology and infoveillance). These data sources prove timelier than traditional general practitioner data, they can help to fill the gaps in the reporting process, and they often include additional metadata that is useful for supplementary research. Objective: The aim of the study was to identify and formally analyze research papers using consumer-generated data, such as social media data or restaurant reviews, to quantify a disease or public health ailment. Studies of this nature are scarce within the food safety domain, therefore identification and understanding of transferrable methods in other health-related fields are of particular interest. Methods: Structured scoping methods were used to identify and analyze primary research papers using consumer-generated data for disease or public health surveillance. The title, abstract, and keyword fields of 5 databases were searched using predetermined search terms. A total of 5239 papers matched the search criteria, of which 145 were taken to full-text review—62 papers were deemed relevant and were subjected to data characterization and thematic analysis. Results: The majority of studies (40/62, 65%) focused on the surveillance of influenza-like illness. Only 10 studies (16%) used consumer-generated data to monitor outbreaks of foodborne illness. Twitter data (58/62, 94%) and Yelp reviews (3/62, 5%) were the most commonly used data sources. Studies reporting high correlations against baseline statistics used advanced statistical and computational approaches to calculate the incidence of disease. These include classification and regression approaches, clustering approaches, and lexicon-based approaches. Although they are computationally intensive due to the requirement of training data, studies using classification approaches reported the best performance. Conclusions: By analyzing studies in digital epidemiology, computer science, and public health, this paper has identified and analyzed methods of disease monitoring that can be transferred to foodborne disease surveillance. These methods fall into 4 main categories: basic approach, classification and regression, clustering approaches, and lexicon-based approaches. Although studies using a basic approach to calculate disease incidence generally report good performance against baseline measures, they are sensitive to chatter generated by media reports. More computationally advanced approaches are required to filter spurious messages and protect predictive systems against false alarms. Research using consumer-generated data for monitoring influenza-like illness is expansive; however, research regarding the use of restaurant reviews and social media data in the context of food safety is limited. Considering the advantages reported in this review, methods using consumer-generated data for foodborne disease surveillance warrant further investment.

  • Source: Pixabay; Copyright: StockSnap; URL: https://pixabay.com/photo-2561819/; License: Public Domain (CC0).

    Junk Food Marketing on Instagram: Content Analysis

    Abstract:

    Background: Omnipresent marketing of processed foods is a key driver of dietary choices and brand loyalty. Market data indicate a shift in food marketing expenditures to digital media, including social media. These platforms have greater potential to influence young people, given their unique peer-to-peer transmission and youths’ susceptibility to social pressures. Objective: The aim of this study was to investigate the frequency of images and videos posted by the most popular, energy-dense, nutrient-poor food and beverage brands on Instagram and the marketing strategies used in these images, including any healthy choice claims. Methods: A content analysis of 15 accounts was conducted, using 12 months of Instagram posts from March 15, 2015, to March 15, 2016. A pre-established hierarchical coding guide was used to identify the primary marketing strategy of each post. Results: Each brand used 6 to 11 different marketing strategies in their Instagram accounts; however, they often adhered to an overall theme such as athleticism or relatable consumers. There was a high level of branding, although not necessarily product information on all accounts, and there were very few health claims. Conclusions: Brands are using social media platforms such as Instagram to market their products to a growing number of consumers, using a high frequency of targeted and curated posts that manipulate consumer emotions rather than present information about their products. Policy action is needed that better reflects the current media environment. Public health bodies also need to engage with emerging media platforms and develop compelling social counter-marketing campaigns.

  • Source: Image created by the Authors; Copyright: The Authors; URL: http://publichealth.jmir.org/2018/2/e56/; License: Creative Commons Attribution + ShareAlike (CC-BY-SA).

    Accurately Inferring Compliance to Five Major Food Guidelines Through Simplified Surveys: Applying Data Mining to the UK National Diet and Nutrition Survey

    Abstract:

    Background: National surveys in public health nutrition commonly record the weight of every food consumed by an individual. However, if the goal is to identify whether individuals are in compliance with the 5 main national nutritional guidelines (sodium, saturated fats, sugars, fruit and vegetables, and fats), much less information may be needed. A previous study showed that tracking only 2.89% of all foods (113/3911) was sufficient to accurately identify compliance. Further reducing the data needs could lower participation burden, thus decreasing the costs for monitoring national compliance with key guidelines. Objective: This study aimed to assess whether national public health nutrition surveys can be further simplified by only recording whether a food was consumed, rather than having to weigh it. Methods: Our dataset came from a generalized sample of inhabitants in the United Kingdom, more specifically from the National Diet and Nutrition Survey 2008-2012. After simplifying food consumptions to a binary value (1 if an individual consumed a food and 0 otherwise), we built and optimized decision trees to find whether the foods could accurately predict compliance with the major 5 nutritional guidelines. Results: When using decision trees of a similar size to previous studies (ie, involving as many foods), we were able to correctly infer compliance for the 5 guidelines with an average accuracy of 80.1%. This is an average increase of 2.5 percentage points over a previous study, showing that further simplifying the surveys can actually yield more robust estimates. When we allowed the new decision trees to use slightly more foods than in previous studies, we were able to optimize the performance with an average increase of 3.1 percentage points. Conclusions: Although one may expect a further simplification of surveys to decrease accuracy, our study found that public health dietary surveys can be simplified (from accurately weighing items to simply checking whether they were consumed) while improving accuracy. One possibility is that the simplification reduced noise and made it easier for patterns to emerge. Using simplified surveys will allow to monitor public health nutrition in a more cost-effective manner and possibly decrease the number of errors as participation burden is reduced.

  • Source: Flickr; Copyright: Ecig Click; URL: https://www.flickr.com/photos/ecigclick/15495836602; License: Creative Commons Attribution + Noncommercial (CC-BY-NC).

    New Tobacco and Tobacco-Related Products: Early Detection of Product Development, Marketing Strategies, and Consumer Interest

    Abstract:

    Background: A wide variety of new tobacco and tobacco-related products have emerged on the market in recent years. Objective: To understand their potential implications for public health and to guide tobacco control efforts, we have used an infoveillance approach to identify new tobacco and tobacco-related products. Methods: Our search for tobacco(-related) products consists of several tailored search profiles using combinations of keywords such as “e-cigarette” and “new” to extract information from almost 9000 preselected sources such as websites of online shops, tobacco manufacturers, and news sites. Results: Developments in e-cigarette design characteristics show a trend toward customization by possibilities to adjust temperature and airflow, and by the large variety of flavors of e-liquids. Additionally, more e-cigarettes are equipped with personalized accessories, such as mobile phones, applications, and Bluetooth. Waterpipe products follow the trend toward electronic vaping. Various heat-not-burn products were reintroduced to the market. Conclusions: Our search for tobacco(-related) products was specific and timely, though advances in product development require ongoing optimization of the search strategy. Our results show a trend toward products resembling tobacco cigarettes vaporizers that can be adapted to the consumers’ needs. Our search for tobacco(-related) products could aid in the assessment of the likelihood of new products to gain market share, as a possible health risk or as an indicator for the need on independent and reliable information of the product to the general public.

  • Source: Health.mil; Copyright: US Navy (Marie Montez); URL: https://health.mil/News/Articles/2017/06/28/Sexually-transmitted-infections-By-any-other-name-theyre-preventable; License: Public Domain (CC0).

    Opportunities for Enhanced Strategic Use of Surveys, Medical Records, and Program Data for HIV Surveillance of Key Populations: Scoping Review

    Abstract:

    Background: Normative guidelines from the World Health Organization recommend tracking strategic information indicators among key populations. Monitoring progress in the global response to the HIV epidemic uses indicators put forward by the Joint United Nations Programme on HIV/AIDS. These include the 90-90-90 targets that require a realignment of surveillance data, routinely collected program data, and medical record data, which historically have developed separately. Objective: The aim of this study was to describe current challenges for monitoring HIV-related strategic information indicators among key populations ((men who have sex with men [MSM], people in prisons and other closed settings, people who inject drugs, sex workers, and transgender people) and identify future opportunities to enhance the use of surveillance data, programmatic data, and medical record data to describe the HIV epidemic among key populations and measure the coverage of HIV prevention, care, and treatment programs. Methods: To provide a historical perspective, we completed a scoping review of the expansion of HIV surveillance among key populations over the past three decades. To describe current efforts, we conducted a review of the literature to identify published examples of SI indicator estimates among key populations. To describe anticipated challenges and future opportunities to improve measurement of strategic information indicators, particularly from routine program and health data, we consulted participants of the Third Global HIV Surveillance Meeting in Bangkok, where the 2015 World Health Organization strategic information guidelines were launched. Results: There remains suboptimal alignment of surveillance and programmatic data, as well as routinely collected medical records to facilitate the reporting of the 90-90-90 indicators for HIV among key populations. Studies (n=3) with estimates of all three 90-90-90 indicators rely on cross-sectional survey data. Programmatic data and medical record data continue to be insufficiently robust to provide estimates of the 90-90-90 targets for key populations. Conclusions: Current reliance on more active data collection processes, including key population-specific surveys, remains warranted until the quality and validity of passively collected routine program and medical record data for key populations is optimized.

  • HIV-prevention seminar with Sub Saharan African migrants in Spain (2007). Source: Image created by the authors; Copyright: The authors; License: Creative Commons Attribution + Noncommercial + NoDerivatives (CC-BY-NC-ND).

    Overcoming Barriers to HIV Prevention and Healthcare Among Sub-Saharan African Migrants in Spain

    Abstract:

  • Source: Nellis Air Force Base (Jake Carter); Copyright: US Air Force; URL: http://www.nellis.af.mil/News/Photos/igphoto/2001063097/; License: Public Domain (CC0).

    Causality Patterns for Detecting Adverse Drug Reactions From Social Media: Text Mining Approach

    Abstract:

    Background: Detecting adverse drug reactions (ADRs) is an important task that has direct implications for the use of that drug. If we can detect previously unknown ADRs as quickly as possible, then this information can be provided to the regulators, pharmaceutical companies, and health care organizations, thereby potentially reducing drug-related morbidity and saving lives of many patients. A promising approach for detecting ADRs is to use social media platforms such as Twitter and Facebook. A high level of correlation between a drug name and an event may be an indication of a potential adverse reaction associated with that drug. Although numerous association measures have been proposed by the signal detection community for identifying ADRs, these measures are limited in that they detect correlations but often ignore causality. Objective: This study aimed to propose a causality measure that can detect an adverse reaction that is caused by a drug rather than merely being a correlated signal. Methods: To the best of our knowledge, this was the first causality-sensitive approach for detecting ADRs from social media. Specifically, the relationship between a drug and an event was represented using a set of automatically extracted lexical patterns. We then learned the weights for the extracted lexical patterns that indicate their reliability for expressing an adverse reaction of a given drug. Results: Our proposed method obtains an ADR detection accuracy of 74% on a large-scale manually annotated dataset of tweets, covering a standard set of drugs and adverse reactions. Conclusions: By using lexical patterns, we can accurately detect the causality between drugs and adverse reaction–related events.

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  • Wet Markets and Food Safety: TripAdvisor for Improved Global Digital Surveillance?

    Date Submitted: Jul 3, 2018

    Open Peer Review Period: Jul 9, 2018 - Jul 23, 2018

    Background: Wet markets are critical for food security and sustainable development in their respective regions but are also associated with health risks. Due to their cultural significance, they attra...

    Background: Wet markets are critical for food security and sustainable development in their respective regions but are also associated with health risks. Due to their cultural significance, they attract numerous visitors and generate tourist-geared information on the Web (i.e. on social networks as TripAdvisor). These unexploited data can be used to create an internationally-comprehensive wet market inventory to support epidemiological surveillance and control in these settings, which to our knowledge, does not yet exist. Objective: Using social network data, we aim to: assess the level of wet markets’ touristic importance online; produce the first distribution map of wet markets of touristic interest; and identify common diseases facing visitors in these settings. Methods: TripAdvisor was selected as the data source of this study following an analysis of food markets’ touristic relevance on the web. A web scraping tool (ParseHub) was used to extract wet market names, locations, and reviews from TripAdvisor. The latter were analyzed and when possible, assigned GeoSentinel diagnosis codes. This syndromic information was overlaid onto a mapping of wet market locations. Results: 89 of the first 150 Google Search results (59.3%) for “wet market” (July 2017) were tourism-related. Of the 1,090 hits on TripAdvisor for this keyword, 393 (36%) were confirmed wet markets; syndromic information was available for 57 of these (14.5%). The confirmed wet markets were heterogeneously distributed: Asia concentrated 246 (62.6%) of them, Europe 76 (19.3%), North America 31 (7.9%), Oceania 20 (5.1%), Africa 12 (3.1%), and South America 8 (2.0%). Analysis of reviews corresponding to these wet markets revealed the most frequently occurring disease among visitors was food poisoning, accounting for 51 of 95 diagnoses (54%). This proved most prevalent among those visiting South American markets (18 of 51 food poisoning incidents [35%]) but less for Asian markets (6 of 51 food poisoning incidents [12%]) when normalizing for wet market number. Conclusions: To our knowledge, this study is first to map the global distribution of wet markets of touristic importance and adverse health events experienced by their visitors, highlighting the potential of social network data in global epidemiological surveillance.

  • A Systematic Review and Framework of Cluster Detection Mechanisms in Syndromic Surveillance: Towards Developing a Prototype of Cluster Detection Mechanism for EDMON System.

    Date Submitted: Jul 6, 2018

    Open Peer Review Period: Jul 9, 2018 - Jul 23, 2018

    Background: Time lag in detecting disease outbreaks remains a threat to global health security. Currently, our research team is working towards a system called EDMON, which uses blood glucose level an...

    Background: Time lag in detecting disease outbreaks remains a threat to global health security. Currently, our research team is working towards a system called EDMON, which uses blood glucose level and other supporting parameters from people with type 1 diabetes, as indicator variables for outbreak detection. In the right mix of cluster detection, big data from self-management of diabetes, internet availability and the prevailing pervasiveness of devices, it is feasible and efficient to detect infectious disease outbreak as early as the incubation stage by using the vulnerability of diabetes patients as a sensor. Therefore, this paper aims to pinpoint the state of the art cluster detection mechanism towards developing an efficient framework and prototype to be used in EDMON and other similar syndromic surveillance systems. Various challenges such as user mobility, privacy and confidentiality, geographical location estimation and other factors have been considered. Objective: The general objective of this studies is to pinpoint the state of the art cluster detection mechanism towards developing an efficient framework and prototype to be used in EDMON and other similar syndromic surveillance systems. Various challenges such as user mobility, privacy and confidentiality, geographical location estimation and other factors have been considered. Methods: To this end, we conducted a systematic review exploring different online scholarly databases. Considering peer reviewed journals and articles, literatures search was conducted between January and March 2018. Results: Relevant literature were identified using the title, keywords, and abstracts as a preliminary filter with the inclusion criteria and a full text review were done for literature that were found to be relevant. A total of 28 articles were included in the study. The result indicates that various clustering and aberration detection algorithms have been developed and tested up to the task. A framework for cluster detection mechanism in EDMON and other similar syndromic surveillance systems have been developed. Conclusions: The study revealed Space-Time Permutation Scan Statistics as the most implemented algorithm. The uniqueness and efficiency of STPSS is that its baseline or expected count is based on its detected cases within a defined geographical distance (cylinder radius) and temporal window (cylinder height). This approach provides significant trend of baseline data while avoiding inclusion of historical data that is irrelevant to the current period. Guided with results from the review, a framework for syndromic surveillance has been developed. Privacy preserving policies and high computational power requirement were found challenging since it restrict usage of specific locations for syndromic surveillance.

  • Social Networking Site for Suicide Database in Bangladesh

    Date Submitted: Jun 12, 2018

    Open Peer Review Period: Jun 20, 2018 - Aug 15, 2018

    The use of social networking sites has exponentially increased in the recent years and the increment was most noticeable among the youth. However, suicide is the second leading cause of death among th...

    The use of social networking sites has exponentially increased in the recent years and the increment was most noticeable among the youth. However, suicide is the second leading cause of death among this group and they are the most active group in the different social networking sites. They share their thoughts, photos, opinions and news including the news of suicide. Whenever, they came to know the death of a friend or follower they share the news express their grief. In addition they also show their condolence to the death of the relative or friends of Facebook friends Moreover, all the television channels and newspapers share their information and news in Facebook, Tweeter and other social media from where we can collect information. Bangladesh is a Muslim developing country in South East Asia that lacks any national suicide database due a number of sociocultural, religious and political factors. As a result, the existing the data on suicide in the country shows about 20 fold variation in different reports. However, the country can develop national suicide database by extracting the information shared in the Facebook and verifying each incidents from different Facebook users. This idea can solve a long lasting problem in many developing low and middle income countries.

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