Neighborhood Violence Impacts Disease Control and Surveillance: Case Study of Cali, Colombia from 2014 to 2016

Amy R. Krystosik, Andrew Curtis, A. Desiree LaBeaud, Diana M. Dávalos, Robinson Pacheco, Paola Buritica, Álvaro A. Álvarez, Madhav P. Bhatta, Jorge Humberto Rojas Palacios and Mark A. James
Additional contact information
Amy R. Krystosik: Department of Pediatrics, Division of Infectious Disease, Stanford University, Grant Building, S 374, 300 Pasteur Drive, Stanford, CA 94305-5208, USA
Andrew Curtis: Department of Geography, the GIS, Health & Hazards Lab, Kent State University, Kent, OH 44240, USA
A. Desiree LaBeaud: Department of Pediatrics, Division of Infectious Disease, Stanford University, Grant Building, S 374, 300 Pasteur Drive, Stanford, CA 94305-5208, USA
Diana M. Dávalos: Department of Public Health and Community Medicine, Universidad Icesi, Cali 760031, Colombia
Robinson Pacheco: Department of Public Health and Community Medicine, Universidad Icesi, Cali 760031, Colombia
Paola Buritica: Grupo de Investigación en Epidemiología y Servicios, Universidad Libre, Cali 760031, Colombia
Álvaro A. Álvarez: Caucaseco Scientific Research Center, Cali 760031, Colombia
Madhav P. Bhatta: Department of Biostatistics, Environmental Health Sciences, and Epidemiology, College of Public Health, Kent State University, Kent, OH 44240, USA
Jorge Humberto Rojas Palacios: Secretaría de Salud de Cali, Colombia, Cali 760031, Colombia
Mark A. James: Department of Biostatistics, Environmental Health Sciences, and Epidemiology, College of Public Health, Kent State University, Kent, OH 44240, USA

IJERPH, 2018, vol. 15, issue 10, 1-20

Abstract: Arboviruses are responsible for a large burden of disease globally and are thus subject to intense epidemiological scrutiny. However, a variable notably absent from most epidemiological analyses has been the impact of violence on arboviral transmission and surveillance. Violence impedes surveillance and delivery of health and preventative services and affects an individual’s health-related behaviors when survival takes priority. Moreover, low and middle-income countries bear a disproportionately high burden of violence and related health outcomes, including vector borne diseases. To better understand the epidemiology of arboviral outbreaks in Cali, Colombia, we georeferenced chikungunya (CHIKV), dengue (DENV), and Zika (ZIKV) viral cases from The National System of Surveillance in Public Health between October 2014 and April 2016. We extracted homicide data from the municipal monthly reports and kernel density of homicide distribution from IdeasPaz. Crucially, an overall higher risk of homicide is associated with increased risk of reported DENV, lower rates of acute testing, and higher rates of lab versus clinical discordance. In the context of high violence as a potential barrier to access to preventive health services, a community approach to improve health and peace should be considered.

Keywords: arboviral surveillance; neighborhood violence; clinical diagnosis; laboratory specificity; spatial clustering; community health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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