Determination of true patient origin through motorcycle mapping: design and implementation of a community-defined geographic infrastructure surveillance tool in rural Sierra Leone.

BACKGROUND: Village-level geographic infrastructure data are often insufficient in low-resource settings, despite accurate patient origin determination being essential for surveillance and outbreak management. We detail a novel and seemingly reliable method for the determination of true patient origin with proof of concept in rural Sierra Leone. METHODS: Potential villages (n=2263), identified within a 7800 km2 hospital catchment area from satellite imagery, were accessed by motorcycle and surveyed in person, capturing village name and community-defined section/chiefdom/district. RESULTS: A survey established 1740 inhabited villages and a village of origin determination tool (gazetteer) was produced. Recording the district/chiefdom/section/village at hospital registration allowed Global Positioning System patient origin determination in 2277/2344 (97.1%) attendances. CONCLUSIONS: Our proof of concept reports a substantial and sustained record of true patient origin in a low-resource setting.

A regulatory code for neurogenic gene expression in the Drosophila embryo.

Bioinformatics methods have identified enhancers that mediate restricted expression in the Drosophila embryo. However, only a small fraction of the predicted enhancers actually work when tested in vivo. In the present study, co-regulated neurogenic enhancers that are activated by intermediate levels of the Dorsal regulatory gradient are shown to contain several shared sequence motifs. These motifs permitted the identification of new neurogenic enhancers with high precision: five out of seven predicted enhancers direct restricted expression within ventral regions of the neurogenic ectoderm. Mutations in some of the shared motifs disrupt enhancer function, and evidence is presented that the Twist and Su(H) regulatory proteins are essential for the specification of the ventral neurogenic ectoderm prior to gastrulation. The regulatory model of neurogenic gene expression defined in this study permitted the identification of a neurogenic enhancer in the distant Anopheles genome. We discuss the prospects for deciphering regulatory codes that link primary DNA sequence information with predicted patterns of gene expression.