Assessing the Effect of Fever and Influenza like Illness on Human Movement in Iquitos Peru Öffentlichkeit

Abstract

Background: Influenza like illness is a common global disease which causes broad public health problems. It is however poorly understood in ambulatory and non-healthcare seeking populations. Movement within urban centers is also poorly understood when looking at resource poor areas, the effect of influenza like illness and fever on movement is of particular interest in understanding the spread of infections.

Objective: The purpose and aim of this study is to examine the relationship between circulatory movement in a developing urban area and what effect having a fever and experiencing an ILI may have on said movement. This study also aimed to look at the application of iButtons as a means of tracking peripheral skin temperature over time.

Methods: Participants were enrolled based on the presence of fever. Once enrolled they were followed for seven days during which time they were interviewed daily about symptoms. Participants were also given GPS and iButton data loggers to record movement and peripheral skin temperature.

Results: ANOVA testing in which random effects and mixed effects were taken account of showed no significant difference between those experiencing fever and those not experiencing fever when it came to any of the three distance measures distance (maximum distance F=0.59 p-value=0.4453, average distance F=0.82 p-value=0.3683, total number of GPS points greater than 10m from home F=1.03 p-value=0.3142). When compared to tympanic measures for participants iButton measures were found to have no statistically significant association even with random and mixed effects modeling (p-value = 0.0922).

Discussion: Though there was found to be no significant relationship between all people and who either were or were not febrile and movement, there was significance among individuals based on if they had a fever. It was also of note that many of the assumptions about non-healthcare seeking and ambulatory care populations made in more developed areas were found to be true in Iquitos, Peru. The reasons behind both the significant difference and the contradiction of assumptions are not yet fully understood as the data set was limited both by missing data and a small sample size.

Table of Contents

Introduction………………………………………………………………………………..1

Methods………..…………………………………………………………………….……..5

Results...…………………………………………………………………..................…10

Discussion………………………………………………………………..................….15

References………………………………………………………………..................….21

Tables……………………………………………………………………....................…27

Figures…………………………………………………………………...................…..35

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Stichwort	Human Movement iButton GPS Influenza Like Illness ILI Ambulatory Care Influenza Fever
Committee Chair / Thesis Advisor	Kitron, Uriel, Emory University
Committee Members	Vazquez Prokopec, Gonzalo, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs US (Federal) agency other than CDC University, college or educational institution (other than Emory)

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