Paper Reference No.

: MWF09 PN-152 Title of the paper : The Use of GIS (Geodatabase) in Combating Dengue Fever in Indonesia Phase II Project (Study Site: The City of Yogyakarta) Name of the Presenter : Aji Putra Perdana Author (s) Affiliation : GIS and Data Management Unit Assistant of TAHIJA FOUNDATION: COMBATING DENGUE FEVER PROJECT THE CITY OF YOGYAKARTA.

Brief Biography Name : Aji Putra Perdana Alumni : Faculty of Geography Gadjah Mada University Field of Study Cartography and Remote Sensing Position : GIS and Data Management Unit Assistant of TAHIJA FOUNDATION: COMBATING DENGUE FEVER PROJECT THE CITY OF YOGYAKARTA. Before joint with the Project, i have been worked as Staff of GIS Laboratory Faculty of Geography Gadjah Mada University (November 2006 2008)

THE USE OF GIS (GEODATABASE) IN COMBATING DENGUE FEVER IN INDONESIA PHASE II PROJECT (STUDY SITE: THE CITY OF YOGYAKARTA)

Abstract Dengue control project protecting approximately 108,000 households (520,000 residents) is envisioned for the Municipality of Yogyakarta (total population ca. 3,300,000 in 2006, on targeted Aedes aegypti (L.) breeding source control using the insect growth regulator. The City of Yogyakarta is the forth largest (32.5 km2) kabupaten in DIY yet is the most densely populated (ca. 16,000 per square kilometer); this variability in density explains much of the variability in the incidence for severe dengue within the Province. At an incidence rate (IR) of 17.7 cases per 10,000, the City has twice- to three-times higher incidence than that neighboring Sleman (7.6) or Bantul (6.3). All data, distribution and prevalence of the insect growth regulator, demographics, and cases/deaths data will be tied to a geographical information system (GIS) where they can be spatially correlated and analyzed. GIS as Geodatabase plays a very important role in this project. This paper described the use of GIS (GEODATABASE) in Combating Dengue Fever in Indonesia Phase II Project (study site: The City of Yogyakarta). Key words: GIS Geodatabase, Dengue Fever, Indonesia, The City of Yogyakarta, Dengue Control Project

Introduction The word dengue is claimed by some sources to be derived from a Swahili phrase "Ka-dinga pepo" which meant to be the disease caused by evil spirit. It could be a possibility that the Spanish word dengue originated from the Swahili word dinga meaning fastidious or careful, describing the gait of a person suffering dengue fever (Jose G., 1998). Dengue fever and Dengue Hemorrhagic Fever (DHF) is an acute febrile disease, found commonly in tropical regions and can spread similar to malaria (Teng, 1997). This disease is now endemic in most tropical countries. In 2003 only 8 countries in South East Asia Region reported dengue cases. As of 2006, ten out of the eleven countries in the Region (Bangladesh, Bhutan, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and TimorLeste) reported dengue cases. Bhutan reported the first dengue outbreak in 2004. An outbreak, with a high case fatality rate (3.55%) was first reported in Timor Leste in 2005. Nepal reported dengue cases for the first time in November 2006.

The Democratic Peoples Republic of Korea is the only country in this Region of WHO that has no report of indigenous transmission of DF/DHF (WHO Regional Office for South-East Asia, 2007). Countries in SEA Region reporting Dengue in 2003 Countries in SEA Region reporting Dengue in 2007

Source: WHO SEARO Report

Figure 1. Countries in SEA Region reporting Dengue in 2003 and 2007 Since 2004 Indonesia reports the highest number of cases from the region. In 2006 57 % of the cases were reported from Indonesia alone. Thailand reported the highest number of dengue cases in the Region till 2003; from 2004 onwards Indonesia reported highest number of dengue cases in the region. In 2006 Indonesia reported 57% of the dengue cases in the region.

Source: WHO SEARO Report

Figure 2. South East Asia Region: Reported dengue cases (1985 2006)

The control of dengue fever/dengue haemorrhagic fever (DF/DHF) in Indonesia is the responsibility of The Indonesian Ministry of Health. Strategies to control dengue, is largely through source reduction, health education and intersectoral coordination with many surveillance methods are used. Source reduction is still the main emphasis in the control of DF/DHF. A pilot project based on implementation of result from Dengue Project Phase I study site in The City of Yogyakarta had been conducted by the Tahija Foundation (Indonesia) collaborated with Gadjah Mada University. This project proposed targeted source reduction strategy/control strategy for dengue control. This strategy targets only the most epidemiological important types of breeding containers using the insect growth regulator. Distribution and monitoring of the presence the insect growth regulator data will be compiled by Data Management Unit of Dengue Project Phase II the City of Yogyakarta. This paper describes the use of GIS as Geodatabase in database management of spatial and non spatial data for dengue control project. Background The City of Yogyakarta and dengue Yogyakarta, a city of about 506-522 thousand people, is the provincial capital of the Province or Special Region (Daerah Istimewa Yogyakarta, or DIY) of Yogyakarta located in south central Java. The Province is divided into 5 administrative districts with each district divided into progressively smaller units beginning with sub-districts (Fig. 3), and these, in turn, divided into kelurahans, and further divided into rukun warga (RW, ca. 250 residences each), and finally into rukun tetangga (RT), the smallest administrative unit composed of approximately 50-80 residences.

Figure 3. Map of the Municipality of Yogyakarta

The City of Yogyakarta is the forth largest (32.5 km2) kabupaten in DIY yet is the most densely populated (ca. 16,000 per square kilometer); this variability in density explains much of the variability in the incidence for severe dengue within the Province. At an incidence rate (IR) of 17.7 cases per 10,000, the City has twice- to three-times higher incidence than that neighboring Sleman (7.6) or Bantul (6.3). Table 1. Population size, number and incidence rate (IR, per 10,000) of dengue cases by kabupaten for the Province of Yogyakarta in 2006. Kabupaten Population Yogyakarta 506,000 Sleman 826,558 Bantul 780,177 Kulonprogo 443,819 Gunung Kidul 746,457 Totals 3,303,011 Source: Focks, Dana A., 2007 Residences No. cases 105,417 888 172,200 626 162,537 493 92,462 71 155,512 106 688,127 2,184 IR 17.7 7.6 6.3 1.6 1.4 6.6

Control Method Combating Dengue Fever in Indonesia Phase II Project coverage the entire City of Yogyakarta. This project using an insect growth regulator, pyriproxyfen that prevents successful emergence of adult mosquitoes from the pupal stage. Distribution and monitoring of the insect growth regulator being conducted by 262 Pemantau DBDs, each day 20-25 houses coordinated by Operational units. Independent assessment of the prevalence of the insect growth regulator in targeted container being conducted by Quality Control Research & Serology (QCRS) Unit. This team was also conducting two main activities, namely Serology and Entomology. Based on dengue IR, serosurvey and entomologic surveys was being conducted in only 12 kelurahans, 6 in the City and 3 each in Sleman and Bantul on the basis of similar dengue incidence rates (IRs). Serology used to measure of the impact of dengue control effort. Entomologic surveys consist of pupal counts and emergence, adult aspirations, pupal/demographic surveys to determine the reduction of Ae. aegypti populations due to targeted intervention. Knowledge, attitudes, and practices (KAP) regarding targeting, the utility and safety of the insect growth regulator being conducted in sampling area.We also used case reported from Dinas Kesehatan of The Municipality of Yogyakarta to monitor the suppression of dengue cases. All project data was being compiled in Data Management Unit, which has responsibility to create and maintain the repository of all project data that is spatially explicit, conversion of paper-based data from the other Units into digital data (data entry) and also summarizing data and creating maps. In this case, GIS play role for the management of spatial and non-spatial data that will be linked and mapped, so will be helpful for analysis.

Geographic Information Systems (GIS) Over the past 20 years, researchers have been developing automated tools for the efficient storage, analysis, and presentation of geographic data (Aronoff 1989). This rapidly evolving technology has come to be known as "geographic information systems" (GIS). A geographic information system (GIS) is a constellation of computer hardware and software that integrates maps and graphics with a database related to a defined geographical space. A GIS can be defined as an integrated set of tools within an automated system capable of collecting, storing, handling, analyzing, and displaying geographically referenced information. Dengue control project need to be able to effectively use information, manage project information, combined with spatial dataset to build data integration for the purposes of supporting the dengue project. In this project, GIS facilitate the integration of compiled data with spatial data obtained from maps, and satellite images, digital orthophotos are used as base maps. Large amounts of information are being collected daily from Operational Unit and QCRS Unit. Conversion of paper-based data requires a fairly long time. In addition, not all of dengue data can be directly tied to a GIS. Our smallest mapping unit is villages so the tabular data must be aggregate to villages, not per house unit, except the tabular data from the entomology survey because it is use GPS measurement to get the location of visited houses. GIS with the Geodatabase provide solution in database management. In addition, when this project will be done in other places, this scheme geodatabase can be used as reference data standards that are required in the dengue control project. Geodatabase for Dengue Control Project The geodatabase is a collection of geographic datasets of various types and stored in an MDB-formatted database management system (DBMS) which is readable by Microsoft Access. A key geodatabase concept is the dataset. The geodatabase contains three primary dataset types are shown below: Feature classes: Base Map Layers; Municipality, Villages, Administrative Boundaries, River, Roads, Survey Location (GPS measurements), etc. Raster datasets: Quickbird Imagery, Ikonos Imagery, digital aerial photos Tables: Dengue Cases Report, Demographic Data, IGR Distribution and Monitoring Data, pupal counts and emergence, adult aspirations, pupal/demographic surveys, serology surveys Creating a collection of these dataset types is the first step in designing and building a geodatabase. Tables and relationships play a key role in dengue project geodatabase because all dengue project data are in tables. All data will be summarized and tied to a GIS where they can be spatially correlated and analyzed. Designing a geodatabase is a critical process that requires the necessary planning and revision to reach a design that meets an organizations requirements (Baker, 2006). The ten steps below are taken from a new (August 2004) ESRI publication Designing Geodatabases in UPDATED GIS DATABASE DESIGN: Geodatabase Model by Baker, 2006.

[Color Key: Light Blue = Conceptual Design, Orange = Logical Design, Red = Physical Design] 1. Identify the information products that will be produced with your GIS 2. Identify the key thematic layers based on your information requirements 3. Specify the scale ranges and spatial representations for each thematic layer 4. Group representations into datasets 5. Define the tabular database structure and behavior for descriptive attributes. 6. Define the spatial properties of your datasets 7. Propose a geodatabase design 8. Implement, prototype, review and refine your design 9. Design work flows for building and maintaining each layer 10. Document your design using appropriate methods The logical data groups and associated data layers shown below are based on the feature coverages listed in the project and will be used to determine the layout of data in the dengue control geodatabase. These data layers will involve and support in the project units (See Table 2 Data Required for GIS (Geodatabase)). Table 2. Data Required for GIS (Geodatabase) LOGICAL DATA GROUP DATA LAYES Quickbird Imagery Imagery Ikonos Imagery Digital Orthophotos Transportation (Roads) Base Maps Hydrography (River) Municipality Villages Administrative Boundaries Demographic Data Demographic Dengue Cases Report Dengue Cases IGR Distribution Data The Insect Growth Regulator IGR Monitoring Data IGR Verification pupal counts and emergence Serology and Entomology adult aspirations pupal/demographic surveys serology surveys GPS Measurements (Point) A general schematic of the data layers to be maintained, developed and distributed amongst the units is illustrated (See Figure 5 Users View).

Raster

Attributes (Text) - Mapping - Spatial Correlation (join and relate) - Analysis, etc

Area Line Point

Annotation
DENGUE GEODATABASE

Attributes (Text)

Tables

Attributes (Text)

DENGUE CONTROL PROJECT

Figure 5. Users View Discussion Designing a geodatabase for this project is very complex; with large datasets the database design is similar to the concept of having a good foundation when erecting a new building. Define the tabular database structure and behavior for descriptive attributes is the key. We need to identify attribute fields, specify valid values and ranges, apply subtypes to control behavior, and model relationships. If this project will be adopted by the Indonesian Ministry of Health in the nation-wide for dengue control methods, there are several main constraints of and problems with the use of GIS (Geodatabase) which will appear: Cost Costs are currently the main constraint to the use of GIS. Software is relatively expensive in relation to the budgets of dengue control programs. Adequate Training Need computing skills and GIS background or persons should be trained. GIGO (Garbage in, Garbage out) GIS is not a tool designed to increase the quality of data. Frequently, the data collected by dengue control project staff maybe is not used. GIS use could lead to a relaxation in data collection and consolidation. It is necessary to review all the steps in the information flow to guarantee quality and adequacy. Misinformation and Misinterpretation The powerful tools of GIS can easily lead to misinformation and misinterpretation, particularly by someone unfamiliar with their use. Ecological fallacies, problems of scales, and propagation of error are frequent, and should be given serious consideration (Monmonier, l99l in Bretas, Gustavo, 1995). The same problem is also true with other types of software that helped to advance our capacity to study and control dengue, such as spreadsheets. GIS is not a magical solution to all the information difficulties of dengue control, but is a powerful tool capable of transforming the way with which information is dealt.

Conclusion The concept of geodatabase design is complex and requires a substantial amount of work to tie GIS products, middle ware and relational databases together. To effectively implement a GIS using the geodatabase approach, a solid database design must be put in place. A database design must include data that will benefit the organization the most and identify what data can and will be stored. The database design process must take into account current business processes, the project goals and the ultimate plan for streamlining these existing functions. A discussion with the Principle Investigator is very important to do by the data management unit to be able to determine and define the tabular database will be built in a geodatabase. Designing and building geodatabase is a part of building spatial data infrastructure. Spatial Data Infrastructure (SDI) is the geospatial data, metadata, human resources, standards, policies, and the tools required to acquire, process, distribute, use, maintain and preserve spatial data. If this dengue control project can build useful geodatabase for dengue control and will be applied nationally, it will build SDI in Indonesia for public health, particularly the control of dengue fever/dengue haemorrhagic fever (DF/DHF). Acknowledgements This paper is derived from experience in implementation of Research and Pilot Project in Yogyakarta to control dengue haemorrhagic fever in Indonesia. Preparation of paper, presentation and participation in the Conference is possible by support from the Tahija Foundation of Jakarta, Indonesia and The Claire and Scobie MacKinnon Trust of Melbourne, Australia. We would like to express our sincere thanks to Focks, Dana A. Infectious Disease Analysis, LLC. PO Box 12852, Gainesville, FL 32604, USA., Aprillya, Sukma Tin. Project Manager, and Ardiansyah, Hilmi. Team Leader Data Management Unit. Yayasan Tahija. Project Dengue for reviewing this manuscript. Reference Aronoff, S. 1989. Geographical information systems. Management perspective. WDL Publications, Canada. Alharthy, Abdulatif. 2007.Role of GIS in Dengue Control Management Strategy at Jeddah Municipality. Jeddah Municipality, Jeddah, Saudi Arabia. (http://saudigis.org/FCKFiles/File/33_E_AbdullatifAlharthy_KSA.pdf) Baker Jr., Michael. 2006. UPDATED GIS DATABASE DESIGN: Geodatabase Model. CITY OF SUFFOLK, VIRGINIA. Virginia Beach, Virginia

[BAKOSURTANAL] Badan Koordinasi Survei dan Pemetaan Nasional. 2004. Pedoman Penyelenggaraan Infrastruktur Data Spasial Nasional (IDSN) Versi 1. Badan Koordinasi Survey dan Pemetaan Nasional, Cibinong. Bretas, Gustavo. 1995. CASE STUDIES FROM THE SOUTH 8. GIS for the study and control of malaria in GIS FOR HEALTH AND THE ENVIRONMENT. Edited by Don de Savigny and Pandu Wijeyaratne. The International Development Research Centre (IDRC), Ottawa, Canada. Focks, Dana A. 2007. Combating Dengue Fever in Indonesia Phase II Project Description. Tahija Foundation. Garson GD, Biggs RS. 1992. Analytic mapping and geographic databases. Series: Quantitative applications in the Social Sciences. Sage University Papers. Sage Publications, Newbury Park. Masser I. 2005. GIS Worlds Creating Spatial Data Infrastructures. California Redlands: ESRI Press. Ten Boon Teng, 1997. Control of Dengue Fever/Dengue Haemorrhagic Fever in Singapore. Dengue Bulletin, vol 21. (http://www.searo.who.int/EN/Section10/Section332/Section519_2383.htm) WHO SEARO. 2007. Dengue/DHF - Situation of Dengue/ Dengue Haemorrhagic Fever in South-East Asia Region (http://www.searo.who.int/EN/Section10/Section332_1098.htm)