This article is a US Government work, and, as such, is in the public domain in the United States of America.
Article first published online: 26 MAR 2007
Copyright © 2007 Wiley-Liss, Inc.
Birth Defects Research Part A: Clinical and Molecular Teratology
Volume 79, Issue 7, pages 559–564, July 2007
How to Cite
Gardner, B. R., Strickland, M. J. and Correa, A. (2007), Application of the automated spatial surveillance program to birth defects surveillance data. Birth Defects Research Part A: Clinical and Molecular Teratology, 79: 559–564. doi: 10.1002/bdra.20363
Presented at the National Environmental Public Health Tracking TRACKS 2006 meeting, August 9–11, Atlanta Georgia.
The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.
- Issue published online: 9 JUL 2007
- Article first published online: 26 MAR 2007
- Manuscript Accepted: 29 JAN 2007
- Manuscript Revised: 10 JAN 2007
- Manuscript Received: 27 OCT 2006
- automated spatial surveillance program;
- geographic information systems;
- Metropolitan Atlanta Congenital Defects Program;
- spina bifida;
- folic acid;
- spatial-temporal disease monitoring
BACKGROUND: Although many birth defects surveillance programs incorporate georeferenced records into their databases, practical methods for routine spatial surveillance are lacking. We present a macroprogram written for the software package R designed for routine exploratory spatial analysis of birth defects data, the Automated Spatial Surveillance Program (ASSP), and present an application of this program using spina bifida prevalence data for metropolitan Atlanta. METHODS: Birth defects surveillance data were collected by the Metropolitan Atlanta Congenital Defects Program. We generated ASSP maps for two groups of years that correspond roughly to the periods before (1994–1998) and after (1999–2002) folic acid fortification of flour. ASSP maps display census tract–specific spina bifida prevalence, smoothed prevalence contours, and locations of statistically elevated prevalence. We used these maps to identify areas of elevated prevalence for spina bifida. RESULTS: We identified a large area of potential concern in the years following fortification of grains and cereals with folic acid. This area overlapped census tracts containing large numbers of Hispanic residents. CONCLUSIONS: The potential utility of ASSP for spatial disease monitoring was demonstrated by the identification of areas of high prevalence of spina bifida and may warrant further study and monitoring. We intend to further develop ASSP so that it becomes practical for routine spatial monitoring of birth defects. Birth Defects Research (Part A), 2007. © 2007 Wiley-Liss, Inc.