Division of Infectious Diseases and Geographic Medicine, School of Medicine, Stanford University, Stanford, California, USA.
Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal.
Clin Infect Dis. 2020 Dec 1;71(Suppl 3):S239-S247. doi: 10.1093/cid/ciaa1310.
Implementation of population-based surveys is resource intensive and logistically demanding, especially in areas with rapidly changing demographics and incomplete or no enumeration of the underlying population and their residences. To remove the need for pre-enumeration and to simplify field logistics for the population healthcare utilization survey used for the Surveillance for Enteric Fever in Asia Project in Nepal, we incorporated a geographic information system-based geosurvey and field mapping system into a single-stage cluster sampling approach.
A survey was administered to ascertain healthcare-seeking behavior in individuals with recent suspected enteric fever. Catchment areas were based on residential addresses of enteric fever patients using study facilities; clusters were randomly selected from digitally created grids using available satellite images and all households within clusters were offered enrollment. A tablet-compatible geosurvey and mapping system that allowed for data-syncing and use in areas without cellular data was created using the ArcGIS suite of software.
Between January 2017 and November 2018, we surveyed 25 521 households in Nepal (16 769 in urban Kathmandu and 8752 in periurban Kavrepalanchok), representing 84 202 individuals. Overall, the survey participation rate was 90.9%, with geographic heterogeneity in participation rates within each catchment area. Areas with higher average household wealth had lower participation rates.
A geographic information system-based geosurvey and field mapping system allowed creation of a virtual household map at the same time as survey administration, enabling a single-stage cluster sampling method to assess healthcare utilization in Nepal for the Surveillance for Enteric Fever in Asia Project . This system removed the need for pre-enumeration of households in sampling areas, simplified logistics and could be replicated in future community surveys.
基于人群的调查实施需要耗费大量资源，并且在人口结构快速变化、基础人群及其住所的登记不完整或不存在的地区，还需要耗费大量的后勤资源。为了消除预登记的需求，并简化亚洲肠热病监测项目在尼泊尔进行的人群医疗保健利用调查的现场后勤工作，我们将基于地理信息系统的地理调查和现场绘图系统纳入了单阶段聚类抽样方法。
我们进行了一项调查，以确定最近疑似肠热病患者的医疗保健寻求行为。集水区是基于肠热病患者的居住地址使用研究设施确定的；从可用的卫星图像创建的数字网格中随机选择聚类，并且向聚类中的所有家庭提供入组机会。使用 ArcGIS 软件套件创建了一个与平板电脑兼容的地理调查和绘图系统，允许在没有蜂窝数据的地区进行数据同步和使用。
在 2017 年 1 月至 2018 年 11 月期间，我们在尼泊尔调查了 25521 户家庭（其中 16769 户在城市加德满都，8752 户在城郊卡瓦普巴乔克），代表了 84202 个人。总体而言，调查参与率为 90.9%，每个集水区的参与率存在地理差异。平均家庭财富较高的地区参与率较低。
基于地理信息系统的地理调查和现场绘图系统允许在进行调查的同时创建虚拟家庭地图，从而实现了单阶段聚类抽样方法，用于评估亚洲肠热病监测项目在尼泊尔的医疗保健利用情况。该系统消除了抽样地区家庭预登记的需求，简化了后勤工作，并且可以在未来的社区调查中复制。
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