An approach to integrate population mobility patterns and sociocultural factors in communicable disease preparedness and response

Abstract

Complex human movement patterns driven by a range of economic, health, social, and environmental factors influence communicable disease spread. Further, cross-border movement impacts disparate public health systems of neighboring countries, making an effective response to disease importation or exportation more challenging. Despite the array of quantitative techniques and social science approaches available to analyze movement patterns, there continues to be a dearth of methods within the applied public health setting to gather and use information about community-level mobility dynamics. Population Connectivity Across Borders (PopCAB) is a rapidly-deployable toolkit to characterize multisectoral movement patterns through community engagement using focus group discussions or key informant interviews, each with participatory mapping, and apply the results to tailor preparedness and response strategies. The Togo and Benin Ministries of Health (MOH), in collaboration with the Abidjan Lagos Corridor Organization and the US Centers for Disease Control and Prevention, adapted and applied PopCAB to inform cross-border preparedness and response strategies for multinational Lassa fever outbreaks. Initially, the team implemented binational, national-level PopCAB activities in March 2017, highlighting details about a circular migration pathway across northern Togo, Benin, and Nigeria. After applying those results to respond to a cross-border Lassa fever outbreak in February 2018, the team designed an expanded PopCAB initiative in April 2018. In eight days, they trained 54 MOH staff who implemented 21 PopCAB focus group discussions in 14 cities with 224 community-level participants representing six stakeholder groups. Using the newly-identified 167 points of interest and 176 routes associated with a circular migration pathway across Togo, Benin, and Nigeria, the Togo and Benin MOH refined their cross-border information sharing and collaboration processes for Lassa fever and other communicable diseases, selected health facilities with increased community connectivity for enhanced training, and identified techniques to better integrate traditional healers in surveillance and community education strategies. They also integrated the final toolkit in national- and district-level public health preparedness plans. Integrating PopCAB in public health practice to better understand and accommodate population movement patterns can help countries mitigate the international spread of disease in support of improved global health security and International Health Regulations requirements.

Modeling marine cargo traffic to identify countries in Africa with greatest risk of invasion by Anopheles stephensi

“…stephensi surveillance efforts should focus. Several methods have been proposed in the literature for modeling human movement and one in particular, PopCAB, which is often used for communicable diseases, combined quantitative and qualitative data with geospatial information to identify points of control 34 .…”

Using marine cargo traffic to identify countries in Africa with greatest risk of invasion by Anopheles stephensi

“…stephensi surveillance efforts should focus. Several methods have been proposed in the literature for modeling human movement and one in particular, PopCAB, which is often used for communicable diseases, combined quantitative and qualitative data with geospatial information to identify points of control (Merrill et al, 2021).…”

Farmworker Mobility and COVID-19 Vaccination Strategies: Yuma County, Arizona, 2021

“…The project team, which included local health department staff with experience working with the Yuma County farmworker community and its partners, adapted the Population Connectivity Across Borders (PopCAB) 13 , 14 toolkit to collect data on farmworker mobility in and around Yuma County, Arizona, and farmworkers’ COVID-19 vaccine perceptions, enablers, and barriers. The PopCAB toolkit, 13 , 14 developed by the CDC, includes qualitative and geospatial methods such as focus group discussion (FGD) guides, key informant interviews (KIIs), surveys and participatory mapping used to evaluate population mobility, and community access to public health services among mobile populations to enable public health partners to integrate information about population mobility into programming and resource allocation decisions. The FGD guides were not piloted with local farmworkers before data collection began because we used an open-ended style of interviewing.…”