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Wang L, Xu C, Hu M, Wang J, Qiao J, Chen W, Zhu Q, Wang Z. Modeling tuberculosis transmission flow in China, 2010-2012. BMC Infect Dis 2024; 24:784. [PMID: 39103752 DOI: 10.1186/s12879-024-09649-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 07/23/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND China has the third largest number of TB cases in the world, and the average annual floating population in China is more than 200 million, the increasing floating population across regions has a tremendous potential for spreading infectious diseases, however, the role of increasing massive floating population in tuberculosis transmission is yet unclear in China. METHODS 29,667 tuberculosis flow data were derived from the new smear-positive pulmonary tuberculosis cases in China. Spatial variation of TB transmission was measured by geodetector q-statistic and spatial interaction model was used to model the tuberculosis flow and the regional socioeconomic factors. RESULTS Tuberculosis transmission flow presented spatial heterogeneity. The Pearl River Delta in southern China and the Yangtze River Delta along China's east coast presented as the largest destination and concentration areas of tuberculosis inflows. Socioeconomic factors were determinants of tuberculosis flow. Some impact factors showed different spatial associations with tuberculosis transmission flow. A 10% increase in per capita GDP was associated with 10.2% in 2010 or 2.1% in 2012 decrease in tuberculosis outflows from the provinces of origin, and 1.2% in 2010 or 0.5% increase in tuberculosis inflows to the destinations and 18.9% increase in intraprovincial flow in 2012. Per capita net income of rural households and per capita disposable income of urban households were positively associated with tuberculosis flows. A 10% increase in per capita net income corresponded to 14.0% in 2010 or 3.6% in 2012 increase in outflows from the origin, 44.2% in 2010 or 12.8% increase in inflows to the destinations and 47.9% increase in intraprovincial flows in 2012. Tuberculosis incidence had positive impacts on tuberculosis flows. A 10% increase in the number of tuberculosis cases corresponded to 2.2% in 2010 or 1.1% in 2012 increase in tuberculosis inflows to the destinations, 5.2% in 2010 or 2.0% in 2012 increase in outflows from the origins, 11.5% in 2010 or 2.2% in 2012 increase in intraprovincial flows. CONCLUSIONS Tuberculosis flows had clear spatial stratified heterogeneity and spatial autocorrelation, regional socio-economic characteristics had diverse and statistically significant effects on tuberculosis flows in the origin and destination, and income factor played an important role among the determinants.
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Affiliation(s)
- Li Wang
- College of Geography and Environmental Science, Henan University, KaiFeng, 475001, China
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Henan University, Ministry of Education, KaiFeng, 475001, China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, 100101, China
| | - Maogui Hu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, 100101, China
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, 100101, China.
| | - Jiajun Qiao
- College of Geography and Environmental Science, Henan University, KaiFeng, 475001, China.
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Henan University, Ministry of Education, KaiFeng, 475001, China.
| | - Wei Chen
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Qiankun Zhu
- College of Geography and Environmental Science, Henan University, KaiFeng, 475001, China
| | - Zhipeng Wang
- College of Geography and Environmental Science, Henan University, KaiFeng, 475001, China
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Pan S, Chen L, Xin X, Li S, Zhang Y, Chen Y, Xiao S. Spatiotemporal analysis and seasonality of tuberculosis in Pudong New Area of Shanghai, China, 2014-2023. BMC Infect Dis 2024; 24:761. [PMID: 39085765 PMCID: PMC11293123 DOI: 10.1186/s12879-024-09645-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Spatiotemporal analysis is a vital method that plays an indispensable role in monitoring epidemiological changes in diseases and identifying high-risk clusters. However, there is still a blank space in the spatial and temporal distribution of tuberculosis (TB) incidence rate in Pudong New Area, Shanghai. Consequently, it is crucial to comprehend the spatiotemporal distribution of TB in this district, this will guide the prevention and control of TB in the district. METHODS Our research used Geographic Information System (GIS) visualization, spatial autocorrelation analysis, and space-time scan analysis to analyze the TB incidence reported in the Pudong New Area of Shanghai from 2014 to 2023, and described the spatiotemporal clustering and seasonal hot spot distribution of TB incidence. RESULTS From 2014 to 2023, the incidence of TB in the Pudong New Area decreased, and the mortality was at a low level. The incidence of TB in different towns/streets has declined. The spatial autocorrelation analysis revealed that the incidence of TB was spatially clustered in 2014, 2016-2018, and 2022, with the highest clusters in 2014 and 2022. The high clustering area was mainly concentrated in the northeast. The space-time scan analysis indicated that the most likely cluster was located in 12 towns/streets, with a period of 2014-2018 and a radiation radius of 15.74 km. The heat map showed that there was a correlation between TB incidence and seasonal variations. CONCLUSIONS From 2014 to 2023, the incidence of TB in the Pudong New Area of Shanghai declined, but there were spatiotemporal clusters and seasonal correlations in the incidence area. Local departments should formulate corresponding intervention measures, especially in high-clustering areas, to achieve accurate prevention and control of TB within the most effective time and scope.
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Affiliation(s)
- Shuishui Pan
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Lili Chen
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Xin Xin
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Shihong Li
- Third Branch Center, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yixing Zhang
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yichen Chen
- General Management Office , Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Shaotan Xiao
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
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Zaidi SMA, Mahfooz A, Latif A, Nawaz N, Fatima R, Rehman FU, Reza TE, Emmanuel F. Geographical targeting of active case finding for tuberculosis in Pakistan using hotspots identified by artificial intelligence software (SPOT-TB): study protocol for a pragmatic stepped wedge cluster randomised control trial. BMJ Open Respir Res 2024; 11:e002079. [PMID: 38991950 PMCID: PMC11243128 DOI: 10.1136/bmjresp-2023-002079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 06/24/2024] [Indexed: 07/13/2024] Open
Abstract
INTRODUCTION Pakistan has significantly strengthened its capacity for active case finding (ACF) for tuberculosis (TB) that is being implemented at scale in the country. However, yields of ACF have been lower than expected, raising concerns on its effectiveness in the programmatic setting. Distribution of TB in communities is likely to be spatially heterogeneous and targeting of ACF in areas with higher TB prevalence may help improve yields. The primary aim of SPOT-TB is to investigate whether a policy change to use a geographically targeted approach towards ACF supported by an artificial intelligence (AI) software, MATCH-AI, can improve yields in Pakistan. METHODS AND ANALYSIS SPOT-TB will use a pragmatic, stepped wedge cluster randomised design. A total of 30 mobile X-ray units and their field teams will be randomised to receive the intervention. Site selection for ACF in the intervention areas will be guided primarily through the use of MATCH-AI software that models subdistrict TB prevalence and identifies potential disease hotspots. Control areas will use existing approaches towards site selection that are based on staff knowledge, experience and analysis of historical data. The primary outcome measure is the difference in bacteriologically confirmed incident TB detected in the intervention relative to control areas. All remaining ACF-related procedures and algorithms will remain unaffected by this trial. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Health Services Academy, Islamabad, Pakistan (7-82/IERC-HSA/2022-52) and from the Common Management Unit for TB, HIV and Malaria, Ministry of Health Services, Regulation and Coordination, Islamabad, Pakistan (26-IRB-CMU-2023). Findings from this study will be disseminated through publications in peer-reviewed journals and stakeholder meetings in Pakistan with the implementing partners and public-sector officials. Findings will also be presented at local and international medical and public health conferences. TRIAL REGISTRATION NUMBER NCT06017843.
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Affiliation(s)
- Syed Mohammad Asad Zaidi
- WHO Centre for Tuberculosis Research and Innovation, Institute for Global Health, University College London, London, UK
| | - Amna Mahfooz
- Center for Global Public Health, Islamabad, Pakistan
| | | | | | - Razia Fatima
- Ministry of National Health Services Regulation and Coordination, Islamabad, Pakistan
| | | | | | - Faran Emmanuel
- Center for Global Public Health, Islamabad, Pakistan
- University of Manitoba, Winnipeg, Manitoba, Canada
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Molemans M, Kayaert L, Olislagers Q, Abrahams S, Berkowitz N, Mohr-Holland E, McKelly D, Wood R, van Leth F, Hermans S. Neighbourhood factors and tuberculosis incidence in Cape Town: A negative binomial regression and spatial analysis. Trop Med Int Health 2024; 29:599-611. [PMID: 38757387 DOI: 10.1111/tmi.14001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
OBJECTIVES Although the link between poverty and tuberculosis (TB) is widely recognised, limited studies have investigated the association between neighbourhood factors and TB incidence. Since the factors influencing different episodes of TB might be different, this study focused on the first episode of TB disease (first-episode TB). METHODS All first episodes in previously linked and geocoded TB notification data from 2007 to 2015 in Cape Town, South Africa, were aggregated at the neighbourhood level and merged with the 2011 census data. We conducted an ecological study to assess the association between neighbourhood incidence of first-episode TB and neighbourhood factors (total TB burden [all episodes] in the previous year, socioeconomic index, mean household size, mean age, and percentage males) using a negative binomial regression. We also examined the presence of hotspots in neighbourhood TB incidence with the Global Moran's I statistic and assessed spatial dependency in the association between neighbourhood factors and TB incidence using a spatial lag model. RESULTS The study included 684 neighbourhoods with a median first-episode TB incidence rate of 114 (IQR: 0-345) per 100,000 people. We found lower neighbourhood socioeconomic index (SEI), higher neighbourhood total TB burden, lower neighbourhood mean household size, and lower neighbourhood mean age were associated with increased neighbourhood first-episode TB incidence. Our findings revealed a hotspot of first-episode TB incidence in Cape Town and evidence of spatial dependency in the association between neighbourhood factors and TB incidence. CONCLUSION Neighbourhood TB burden and SEI were associated with first-episode TB incidence, and there was spatial dependency in this association. Our findings can inform targeted interventions to reduce TB in high-risk neighbourhoods, thereby reducing health disparities and promoting health equity.
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Affiliation(s)
- M Molemans
- Amsterdam UMC, Location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - L Kayaert
- Amsterdam UMC, Location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Q Olislagers
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - S Abrahams
- City Health Department, City of Cape Town, South Africa
| | - N Berkowitz
- City Health Department, City of Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - E Mohr-Holland
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - D McKelly
- Council for Scientific and Industrial Research, Smart Places, Cape Town, South Africa
| | - R Wood
- Desmond Tutu Health Foundation, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine and Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - F van Leth
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - S Hermans
- Amsterdam UMC, Location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Center for Tropical and Travel Medicine, Department of Infectious Diseases, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Institute for Immunology and Infectious Diseases, Amsterdam, The Netherlands
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Henry NJ, Zawedde-Muyanja S, Majwala RK, Turyahabwe S, Barnabas RV, Reiner RC, Moore CE, Ross JM. Mapping TB incidence across districts in Uganda to inform health program activities. IJTLD OPEN 2024; 1:223-229. [PMID: 39022779 PMCID: PMC11249603 DOI: 10.5588/ijtldopen.23.0624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/25/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Identifying spatial variation in TB burden can help national TB programs effectively allocate resources to reach and treat all people with TB. However, data limitations pose challenges for subnational TB burden estimation. METHODS We developed a small-area modeling approach using geo-positioned prevalence survey data, case notifications, and geospatial covariates to simultaneously estimate spatial variation in TB incidence and case notification completeness across districts in Uganda from 2016-2019. TB incidence was estimated using 1) cluster-level data from the national 2014-2015 TB prevalence survey transformed to incidence, and 2) case notifications adjusted for geospatial covariates of health system access. The case notification completeness surface was fit jointly using observed case notifications and estimated incidence. RESULTS Estimated pulmonary TB incidence among adults varied >10-fold across Ugandan districts in 2019. Case detection increased nationwide from 2016 to 2019, and the number of districts with case detection rates >70% quadrupled. District-level estimates of TB incidence were five times more precise than a model using TB prevalence survey data alone. CONCLUSION A joint spatial modeling approach provides useful insights for TB program operation, outlining areas where TB incidence estimates are highest and health programs should concentrate their efforts. This approach can be applied in many countries with high TB burden.
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Affiliation(s)
- N J Henry
- Big Data Institute, Li Ka Shing Centre for Information Discovery, University of Oxford, Oxford, UK
- Henry Spatial Analysis, Seattle, WA, USA
| | | | - R K Majwala
- Uganda Ministry of Health, National Tuberculosis and Leprosy Program, Kampala, Uganda
| | - S Turyahabwe
- Uganda Ministry of Health, National Tuberculosis and Leprosy Program, Kampala, Uganda
| | - R V Barnabas
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA
- Harvard Medical School, Cambridge, MA
| | - R C Reiner
- Department of Health Metrics Sciences, University of Washington, Seattle, WA
- Institute for Health Metrics and Evaluation, Seattle, WA, USA
| | - C E Moore
- The Centre for Neonatal and Paediatric Infection, Infection and Immunity Institute, St George's, University of London, London, UK
| | - J M Ross
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
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Khursheed S, Wazir S, Saleem MK, Majeed AI, Ahmad M, Khan QU, Jadoon A, Akbar A, Jadoon SK, Tasneem S, Saleem H, Khan MS, Alvi S. Tuberculosis prevalence and demographic characteristics of population in Azad Jammu and Kashmir (Pakistan): A retrospective study. Medicine (Baltimore) 2024; 103:e37787. [PMID: 38608068 PMCID: PMC11018243 DOI: 10.1097/md.0000000000037787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/13/2024] [Indexed: 04/14/2024] Open
Abstract
Tuberculosis (TB) remains a serious problem for public health and a leading cause of death after COVID-19 and superior to even HIV/AIDS. It is a social health issue and can cause stigma and economic loss as the person cannot perform professionally due to lethargy caused by disease. It is a retrospective study done on data from National TB program Muzaffarabad chapter. The details were noted on SPSS and analysis was done to find important demographic characteristics. The total number of patients was 3441; among which 48.76% were males. Most of them (81.11%) belonged to the Muzaffarabad division of Azad Jammu and Kahmir (AJK). The microbiologically or culture positive cases were 440. Rifampicin resistance was present in 147 cases, further categorized as high (n = 143), very high (n = 3), or true positive (n = 1) resistance. Muti drug resistance was found in 19 cases. The microscopy culture is more sensitive (AUC = 0.511) than MTB/RIF or serology (AUC = 0.502) according to ROC. The rate of positive smear results is not very satisfactory in the present study as it cannot detect dormant or latent cases. There is a need to establish more sensitive tests for detection of cases and more research to combat the disease.
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Affiliation(s)
| | - Samia Wazir
- Pakistan Institute of Medical Science, Islamabad, Pakistan
| | - Muhammad Khurram Saleem
- University Hospital, Bristol and Weston NHS Foundation Trust, Royal College of Physicians and Surgeons of Glasgow, Glasgow, UK
| | | | - Mumtaz Ahmad
- Abbas Institute of Medical Sciences, Muzaffarabad, AJK, Pakistan
| | | | - Arzu Jadoon
- Ziauddin University Hospital Karachi, Karachi, Pakistan
| | - Amna Akbar
- CHPE Health Services Academy, Islamabad, Pakistan
| | | | | | | | - Mohammad Saleem Khan
- Chief Consultant Physician/Head of Department of Medicine DHQ Teaching, Hospital Kotli AJK, Kotli, Pakistan
| | - Sarosh Alvi
- Teaching Faculty, University of Khartoum, Khartoum, Sudan
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Cuboia N, Reis-Pardal J, Pfumo-Cuboia I, Manhiça I, Mutaquiha C, Nitrogénio L, Zindoga P, Azevedo L. Spatial distribution and determinants of tuberculosis incidence in Mozambique: A nationwide Bayesian disease mapping study. Spat Spatiotemporal Epidemiol 2024; 48:100632. [PMID: 38355255 DOI: 10.1016/j.sste.2023.100632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 11/26/2023] [Accepted: 12/11/2023] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Mozambique is a high-burden country for tuberculosis (TB). International studies show that TB is a disease that tends to cluster in specific regions, and different risk factors (HIV prevalence, migration, overcrowding, poverty, house condition, temperature, altitude, undernutrition, urbanization, and inadequate access to TB diagnosis and treatment) are reported in the literature to be associated with TB incidence. Although Mozambique has a higher burden of TB, the spatial distribution, and determinants of TB incidence at the sub-national level have not been studied yet for the whole country. Therefore, we aimed to analyze the spatial distribution and determinants of tuberculosis incidence across all 154 districts of Mozambique and identify the hotspot areas. METHOD We conducted an ecological study with the district as our unit of analysis, where we included all cases of tuberculosis diagnosed in Mozambique between 2016 and 2020. We obtained the data from the Mozambique Ministry of Health and other publicly available open sources. The predictor variables were selected based on the literature review and data availability at the district level in Mozambique. The parameters were estimated through Bayesian hierarchical Poisson regression models using Markov Chain Monte Carlo simulation. RESULTS A total of 512 877 people were diagnosed with tuberculosis in Mozambique during our five-year study period. We found high variability in the spatial distribution of tuberculosis incidence across the country. Sixty-two districts out of 154 were identified as hotspot areas. The districts with the highest incidence rate were concentrated in the south and the country's central regions. In contrast, those with lower incidence rates were mainly in the north. In the multivariate analysis, we found that TB incidence was positively associated with the prevalence of HIV (RR: 1.23; 95 % CrI 1.13 to 1.34) and negatively associated with the annual average temperature (RR: 0.83; 95 % CrI 0.74 to 0.94). CONCLUSION The incidence of tuberculosis is unevenly distributed across the country. Lower average temperature and high HIV prevalence seem to increase TB incidence. Targeting interventions in higher-risk areas and strengthening collaboration between HIV and TB programs is paramount to ending tuberculosis in Mozambique, as established by the WHO's End TB strategy and the Sustainable Development Goals.
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Affiliation(s)
- Nelson Cuboia
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE), University of Porto, Porto, Portugal; Hospital Rural de Chicumbane, Limpopo, Mozambique.
| | - Joana Reis-Pardal
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE), University of Porto, Porto, Portugal
| | | | - Ivan Manhiça
- Ministry of Health, National Tuberculosis Program, Maputo, Mozambique
| | - Cláudia Mutaquiha
- Ministry of Health, National Tuberculosis Program, Maputo, Mozambique
| | - Luis Nitrogénio
- Gaza Provincial Health Directorate, Tuberculosis Program, Xai-Xai, Mozambique
| | - Pereira Zindoga
- Ministry of Health, National Tuberculosis Program, Maputo, Mozambique
| | - Luís Azevedo
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS@RISE - Center for Health Technology and Services Research (CINTESIS) & Health Research Network Associated Laboratory (RISE), University of Porto, Porto, Portugal
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Toribio JAL, Lomata K, Fullman S, Jenkins A, Borja E, Arif S, McKercher J, Blake D, Garcia A, Whittington RJ, Underwood F, Marais BJ. Assessing risks for bovine and zoonotic tuberculosis through spatial analysis and a questionnaire survey in Fiji - A pilot study. Heliyon 2023; 9:e22776. [PMID: 38125425 PMCID: PMC10730600 DOI: 10.1016/j.heliyon.2023.e22776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 11/11/2023] [Accepted: 11/19/2023] [Indexed: 12/23/2023] Open
Abstract
Mycobacterium bovis causes tuberculosis in cattle and when transmitted to humans typically causes extra-pulmonary tuberculosis (EPTB). Bovine tuberculosis (bTB) has a global distribution and is controlled in most countries to protect animal and public health. Recent studies revealed that bTB is established on dairy farms in Fiji where EPTB cases have been reported in people. The aims of this pilot investigation were to look for putative zoonotic TB (EPTB) cases in people and to evaluate practices that might contribute to the persistence and transmission of M. bovis between cattle and to humans. Existing data sets were shared between the Fiji Ministry of Agriculture and Ministry of Health and a questionnaire-based survey was implemented using One Health principles. Statistically significant co-location and close proximity of EPTB cases and bovine TB affected farms were identified. The bTB infection status of farms was significantly associated with unfenced water sources where cattle grazed. Of 247 households, 65 % shared drinking water sources with cattle and 36 % consumed raw milk without boiling, while 62 % of participants reported backyard slaughter of cattle. Several participants reported current symptoms potentially suggestive of TB (chronic cough) but the impact of smoking and history of previous TB treatment could not be evaluated. Farmers had limited understanding of the practices required to prevent bTB at farm level. Further study is recommended and should include an assessment of lifetime EPTB diagnoses, classification of farms based on more recent bTB test data and molecular typing of mycobacterial isolates from humans, cattle and the environment. A targeted awareness and education approach is required to reduce the future risk of zoonotic TB and to help ensure uptake of recommendations and practices aimed at controlling and preventing bTB.
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Affiliation(s)
- Jenny-Ann L.M.L. Toribio
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, Australia
- Sydney Infectious Diseases Institute (Sydney ID), The University of Sydney, NSW, Australia
| | - Keresi Lomata
- Ministry of Agriculture, Koronivia Research Station, Koronivia, Republic of Fiji
| | - Sam Fullman
- Ministry of Health and Medical Services, Dinem House, 88 Amy Street, Suva, Republic of Fiji
| | - Aaron Jenkins
- Sydney Infectious Diseases Institute (Sydney ID), The University of Sydney, NSW, Australia
- Edith Cowan University, Centre for People, Place and Planet, 270 Joondalup Drive, Joondalup, WA, Australia
| | - Elva Borja
- Ministry of Agriculture, Koronivia Research Station, Koronivia, Republic of Fiji
| | - Shumaila Arif
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, Australia
| | - Jarrad McKercher
- Edith Cowan University, Centre for People, Place and Planet, 270 Joondalup Drive, Joondalup, WA, Australia
| | - David Blake
- Edith Cowan University, Centre for People, Place and Planet, 270 Joondalup Drive, Joondalup, WA, Australia
| | - Anabel Garcia
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, Australia
| | - Richard J. Whittington
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, Australia
- Sydney Infectious Diseases Institute (Sydney ID), The University of Sydney, NSW, Australia
| | - Frank Underwood
- Ministry of Health and Medical Services, Dinem House, 88 Amy Street, Suva, Republic of Fiji
| | - Ben J. Marais
- Sydney Infectious Diseases Institute (Sydney ID), The University of Sydney, NSW, Australia
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Ge Y, Wang S, Shi Q, Shi J, Tian J. Geospatial analysis of the hospitalisation rate of patients with rheumatoid arthritis in Hunan: a cross-sectional Chinese study. BMJ Open 2023; 13:e075088. [PMID: 38000823 PMCID: PMC10679990 DOI: 10.1136/bmjopen-2023-075088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 10/10/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVE Little is known about spatial variability of hospitalisation rate (HR) of patients with rheumatoid arthritis (RA) worldwide, especially in China. METHODS A cross-sectional study was conducted among patients with RA admitted to hospitals in Hunan Province. Global Moran's I and local indicators of spatial association were used to explore the geospatial pattern of the HR of patients with RA. Generalised estimating equation analysis and geographically weighted regression were used to identify the potential influencing factors of the HR of patients with RA. RESULTS There were a total of 11 599 admissions, and the average HR was 1.57 per 10 000 population in Hunan. We detected different cluster patterns of the HR among patients with RA by local indicators of spatial association. Age, ethnicity, average temperature, average temperature range, average rainfall, regions, gross domestic product per capita, and doctors and hospitals per 10 000 people were risk factors for the HR. However, only average temperature, gross domestic product per capita and hospitals per 10 000 people showed different regression coefficients on the HR in different counties. The increase in hospitals increased the probability of HR from east to west in Hunan with a positive coefficient, while temperature decreases increased the risk of HR from south to north negatively. Similarly, the growth of gross domestic product per capita decreased the probability of HR from southwest to northeast. CONCLUSION A non-random spatial distribution of the HR of patients with RA was demonstrated in Hunan, and average temperature, gross domestic product per capita and hospitals per 10 000 people showed different regression coefficients on the HR in different counties. Our study indicated that spatial and geostatistics may be useful approaches for further study among patients with RA.
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Affiliation(s)
- Yan Ge
- Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Clinical Medical Research Center for Systemic Autoimmune Diseases in Hunan Province, Changsha, Hunan, China
| | - Shiwen Wang
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Qianshan Shi
- Information Statistics Center of Health Commission of Hunan Province, Changsha, Hunan, China
| | - Jingcheng Shi
- Department of Epidemiology and Medical Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Jing Tian
- Department of Rheumatology and Immunology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Clinical Medical Research Center for Systemic Autoimmune Diseases in Hunan Province, Changsha, Hunan, China
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Ochom E, Robsky KO, Gupta AJ, Tamale A, Kungu J, Turimumahoro P, Nakasendwa S, Rwego IB, Muttamba W, Joloba M, Ssengooba W, Davis JL, Katamba A. Geographic distribution and predictors of diagnostic delays among possible TB patients in Uganda. Public Health Action 2023; 13:70-76. [PMID: 37736583 PMCID: PMC10446659 DOI: 10.5588/pha.23.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/20/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Understanding the geographic distribution and factors associated with delayed TB diagnosis may help target interventions to reduce delays and improve patient outcomes. METHODS We conducted a secondary analysis of adults undergoing TB evaluation within a public health demonstration project in Uganda. Using Global Moran's I (GMI) and Getis-Ord GI* statistics, we evaluated for residential clustering and hotspots associated with patient-related and health system-related delays. We performed multivariate logistic regression to identify individual predictors of both types of delays. RESULTS Of 996 adults undergoing TB evaluation (median age: 37 years, IQR 28-49), 333 (33%) experienced patient delays, and 568 (57%) experienced health system delays. Participants were clustered (GMI 0.47-0.64, P ⩽ 0.001) at the sub-county level, but there were no statistically significant hotspots for patient or health system delays. Married individuals were less likely to experience patient delays (OR 0.6, 95% CI 0.48-0.75; P < 0.001). Those aged 38-57 years (OR 1.2, 95% CI 1.07-1.38; P = 0.002) were more likely than those aged ⩾58 years to experience patient delays. Knowledge about TB (OR 0.8, 95% CI 0.63-0.98; P = 0.03) protected against health system delays. CONCLUSIONS We did not identify geographic hotspots for TB diagnostic delays. Instead, delays were associated with individual factors such as age, marital status and TB knowledge.
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Affiliation(s)
- E Ochom
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
| | - K O Robsky
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - A J Gupta
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A Tamale
- Departments of Veterinary Medicine and Animal Resources
| | - J Kungu
- Biotechnical and Biolab Sciences, and
| | - P Turimumahoro
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
| | - S Nakasendwa
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
| | - I B Rwego
- Biosecurity, Ecosystem and Veterinary Public Health, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | | | - M Joloba
- Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - W Ssengooba
- Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda
| | - J L Davis
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT
- Pulmonary, Critical Care and Sleep Medicine Section, Yale School of Medicine, New Haven, CT, USA
| | - A Katamba
- Uganda Tuberculosis Implementation Research Consortium, Kampala, Uganda
- Clinical Epidemiology Unit, Makerere University, College of Health Sciences, Kampala, Uganda
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Dias S, Castro S, Ribeiro AI, Krainski ET, Duarte R. Geographic patterns and hotspots of pediatric tuberculosis: the role of socioeconomic determinants. J Bras Pneumol 2023; 49:e20230004. [PMID: 37341241 PMCID: PMC10578936 DOI: 10.36416/1806-3756/e20230004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/24/2023] [Indexed: 06/22/2023] Open
Abstract
OBJECTIVE Children are an important demographic group for understanding overall tuberculosis epidemiology, and monitoring of childhood tuberculosis is essential for appropriate prevention. The present study sought to characterize the spatial distribution of childhood tuberculosis notification rates in continental Portugal; identify high-risk areas; and evaluate the association between childhood tuberculosis notification rates and socioeconomic deprivation. METHODS Using hierarchical Bayesian spatial models, we analyzed the geographic distribution of pediatric tuberculosis notification rates across 278 municipalities between 2016 and 2020 and determined high-risk and low-risk areas. We used the Portuguese version of the European Deprivation Index to estimate the association between childhood tuberculosis and area-level socioeconomic deprivation. RESULTS Notification rates ranged from 1.8 to 13.15 per 100,000 children under 5 years of age. We identified seven high-risk areas, the relative risk of which was significantly above the study area average. All seven high-risk areas were located in the metropolitan area of Porto or Lisbon. There was a significant relationship between socioeconomic deprivation and pediatric tuberculosis notification rates (relative risk = 1.16; Bayesian credible interval, 1.05-1.29). CONCLUSIONS Identified high-risk and socioeconomically deprived areas should constitute target areas for tuberculosis control, and these data should be integrated with other risk factors to define more precise criteria for BCG vaccination.
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Affiliation(s)
- Sara Dias
- . Hospital Pedro Hispano, Matosinhos, Portugal
| | - Sofia Castro
- . Centro Hospitalar do Baixo Vouga, Hospital Infante D. Pedro, Aveiro, Portugal
| | - Ana Isabel Ribeiro
- . EPIUnit, Instituto de Saúde Pública - ISPUP - Universidade do Porto, Porto, Portugal
- . Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional - ITR - Porto, Portugal
- . Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Elias T Krainski
- . Departamento de Estatística, Universidade Federal do Paraná - UFPR -Curitiba (PR) Brasil
- . King Abdullah University of Science and Technology - KAUST - Tuwal, Saudi Arabia
| | - Raquel Duarte
- . EPIUnit, Instituto de Saúde Pública - ISPUP - Universidade do Porto, Porto, Portugal
- . Instituto de Ciências Biomédicas Abel Salazar - ICBAS - Universidade do Porto, Porto, Portugal
- . Unidade de Investigação Clínica da ARS Norte, Porto, Portugal
- . Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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12
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Lin H, Zhang R, Wu Z, Li M, Wu J, Shen X, Yang C. Assessing the spatial heterogeneity of tuberculosis in a population with internal migration in China: a retrospective population-based study. Front Public Health 2023; 11:1155146. [PMID: 37325311 PMCID: PMC10266412 DOI: 10.3389/fpubh.2023.1155146] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/11/2023] [Indexed: 06/17/2023] Open
Abstract
Background Internal migrants pose a critical threat to eliminating Tuberculosis (TB) in many high-burden countries. Understanding the influential pattern of the internal migrant population in the incidence of tuberculosis is crucial for controlling and preventing the disease. We used epidemiological and spatial data to analyze the spatial distribution of tuberculosis and identify potential risk factors for spatial heterogeneity. Methods We conducted a population-based, retrospective study and identified all incident bacterially-positive TB cases between January 1st, 2009, and December 31st, 2016, in Shanghai, China. We used Getis-Ord Gi* statistics and spatial relative risk methods to explore spatial heterogeneity and identify regions with spatial clusters of TB cases, and then used logistic regression method to estimate individual-level risk factors for notified migrant TB and spatial clusters. A hierarchical Bayesian spatial model was used to identify the attributable location-specific factors. Results Overall, 27,383 bacterially-positive tuberculosis patients were notified for analysis, with 42.54% (11,649) of them being migrants. The age-adjusted notification rate of TB among migrants was much higher than among residents. Migrants (aOR, 1.85; 95%CI, 1.65-2.08) and active screening (aOR, 3.13; 95%CI, 2.60-3.77) contributed significantly to the formation of TB high-spatial clusters. With the hierarchical Bayesian modeling, the presence of industrial parks (RR, 1.420; 95%CI, 1.023-1.974) and migrants (RR, 1.121; 95%CI, 1.007-1.247) were the risk factors for increased TB disease at the county level. Conclusion We identified a significant spatial heterogeneity of tuberculosis in Shanghai, one of the typical megacities with massive migration. Internal migrants play an essential role in the disease burden and the spatial heterogeneity of TB in urban settings. Optimized disease control and prevention strategies, including targeted interventions based on the current epidemiological heterogeneity, warrant further evaluation to fuel the TB eradication process in urban China.
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Affiliation(s)
- Honghua Lin
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
| | - Rui Zhang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
| | - Zheyuan Wu
- Division of TB and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
- Shanghai Institutes of Preventive Medicine, Shanghai, China
| | - Minjuan Li
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
| | - Jiamei Wu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
| | - Xin Shen
- Division of TB and HIV/AIDS Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
- Shanghai Institutes of Preventive Medicine, Shanghai, China
| | - Chongguang Yang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, China
- School of Public Health, Yale University, New Haven, CT, United States
- Nanshan District Center for Disease Control and Prevention, Shenzhen, Guangdong Province, China
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13
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Romanyukha AA, Karkach AS, Borisov SE, Belilovsky EM, Sannikova TE. Identification of growing tuberculosis incidence clusters in a region with a decrease in tuberculosis prevalence in Moscow (2000-2019). J Glob Health 2023; 13:04052. [PMID: 37224511 DOI: 10.7189/jogh.13.04052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Background The control of tuberculosis (TB) may benefit from a prospective identification of areas where the incidence may increase in addition to the traditionally identified foci of high incidence. We aimed to identify residential areas with growing tuberculosis incidence rates and assess their significance and stability. Methods We analysed the changes in TB incidence rates using case data georeferenced with spatial granularity to apartment buildings in the territory of Moscow from 2000 to 2019. We identified sparsely distributed areas with significant increases in the incidence rate inside residential areas. We tested the stability of found growth areas to case underreporting via stochastic modelling. Results For 21 350 cases with smear- or culture-positive pulmonary TB among residents from 2000 to 2019, we identified 52 small-scale clusters of growing incidence rate responsible for 1% of all registered cases. We tested clusters of disease growth for underreporting and found them to be relatively unstable to resampling with case drop-out, but their spatial displacement was small. Territories with a stable increase in TB incidence rate were identified and compared to the rest of the city, which is characterised by a significant decrease in incidence. Conclusions Identified areas with a tendency for an increase in the TB incidence rate may be important targets for disease control services.
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Affiliation(s)
- Alexei A Romanyukha
- Marchuk Institute of Numerical Mathematics, Russian Academy of Sciences, Moscow, Russia
- Moscow State University, Moscow, Russia
| | - Arseny S Karkach
- Marchuk Institute of Numerical Mathematics, Russian Academy of Sciences, Moscow, Russia
| | - Sergey E Borisov
- Moscow Research and Clinical Center for Tuberculosis Control, Moscow Department of Public Health, Moscow, Russia
| | - Evgeny M Belilovsky
- Moscow Research and Clinical Center for Tuberculosis Control, Moscow Department of Public Health, Moscow, Russia
| | - Tatiana E Sannikova
- Marchuk Institute of Numerical Mathematics, Russian Academy of Sciences, Moscow, Russia
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Baker CR, Barilar I, de Araujo LS, Rimoin AW, Parker DM, Boyd R, Tobias JL, Moonan PK, Click ES, Finlay A, Oeltmann JE, Minin VN, Modongo C, Zetola NM, Niemann S, Shin SS. Use of High-Resolution Geospatial and Genomic Data to Characterize Recent Tuberculosis Transmission, Botswana. Emerg Infect Dis 2023; 29:977-987. [PMID: 37081530 PMCID: PMC10124643 DOI: 10.3201/eid2905.220796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Combining genomic and geospatial data can be useful for understanding Mycobacterium tuberculosis transmission in high-burden tuberculosis (TB) settings. We performed whole-genome sequencing on M. tuberculosis DNA extracted from sputum cultures from a population-based TB study conducted in Gaborone, Botswana, during 2012-2016. We determined spatial distribution of cases on the basis of shared genotypes among isolates. We considered clusters of isolates with ≤5 single-nucleotide polymorphisms identified by whole-genome sequencing to indicate recent transmission and clusters of ≥10 persons to be outbreaks. We obtained both molecular and geospatial data for 946/1,449 (65%) participants with culture-confirmed TB; 62 persons belonged to 5 outbreaks of 10-19 persons each. We detected geospatial clustering in just 2 of those 5 outbreaks, suggesting heterogeneous spatial patterns. Our findings indicate that targeted interventions applied in smaller geographic areas of high-burden TB identified using integrated genomic and geospatial data might help interrupt TB transmission during outbreaks.
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Lei Y, Wang J, Wang Y, Xu C. Geographical evolutionary pathway of global tuberculosis incidence trends. BMC Public Health 2023; 23:755. [PMID: 37095497 PMCID: PMC10123998 DOI: 10.1186/s12889-023-15553-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 03/28/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUNDS Tuberculosis (TB) remains a serious public health and human development problem, especially in developing countries. Despite the effectiveness of directly observed therapy, short course programs in reducing transmission and progression of TB, poverty reduction and socioeconomic development remain crucial factors in decreasing TB incidence. However, the geographical pathway on the planet is not yet clear. OBJECTIVES This study was to reconstruct the geographical evolutionary process of TB in 173 countries and territories from 2010 to 2019 to analyze the socioeconomic determinants that impact the global TB epidemic. In addition, the TB incidence in 2030 was predicted. METHODS This study analyses TB incidence data from 173 countries and territories between 2010 and 2019. The Geotree model would be used to reconstruct the geographical evolutionary process of TB, which provides a simplified schema for geo-visualizing the trajectories of TB incidence and their socioeconomic drivers. Additionally, to estimate the future TB incidence in 2030, a multilevel model was utilized in conjunction with the hierarchical nature of the Geotree based on a stratified heterogeneity analysis. RESULTS Global TB incidence was found to be associated with the country type and development stages. Between 2010 and 2019, the average TB incidence rate in 173 countries and territories was -27.48%, with marked spatially stratified heterogeneity by country type and development stage. Low-income and lower-middle-income countries were most vulnerable to TB. Upper-middle-income countries experienced a faster decline in TB incidence than high-income countries, and TB incidence generally decreased as the development stage increased, except for the lower-middle development stage in 2019.The highest average rate of decline in TB incidence was observed in the upper-middle development stage of high-income countries, with a reduction of 45.24%. Meanwhile, 37 high-income countries in the high development stage demonstrated an average rate of change of -13.93%. Socioeconomic determinants, including gross domestic product per capita, urbanization rate, and sociodemographic index, were found to inhibit TB incidence. Based on current trends, the predicted average global TB incidence in 2030 is 91.581 per 100,000 population. CONCLUSIONS The trajectories of the global TB incidence have been reconstructed to formulate targeted public health responses. To eliminate TB, countries at similar development stage can draw on the experiences of countries at higher development stages that are tailored to their unique characteristics. By learning from successful TB control strategies, countries can take strategic steps toward eradicating TB and improving public health outcomes.
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Affiliation(s)
- Yanhui Lei
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Yang Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
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16
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The application of spatial analysis to understanding the association between area-level socio-economic factors and suicide: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02441-z. [PMID: 36805762 DOI: 10.1007/s00127-023-02441-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 02/02/2023] [Indexed: 02/21/2023]
Abstract
BACKGROUND Little is known about what impact the use of different spatial methodological approaches may have on understanding the relationship between area-level socio-economic factors and suicide. METHODS In this systematic review, we searched PubMed, Embase, CINAHL and PsycInfo for original empirical studies examining the relationship between socio-economic factors and suicide with a spatial lens, published up to January 22, 2022. Data on applied spatial methods, indicators of socio-economic factors, and risk of suicide related to socio-economic factors were extracted. The protocol for this systematic review was registered with PROSPERO (CRD42021251387). RESULTS A systematic search yielded 6290 potentially relevant results; 58 studies met the inclusion criteria for review. Of the 58 included studies, more than half of the studies (n = 34; 58.6%) used methods that accounted for spatial effects in analyses of the association between socio-economic factors and suicide or examined spatial autocorrelation, while 24 (41.4%) studies applied univariate and multivariate models without considering spatial effects. Bayesian hierarchical models and spatial regression models were commonly used approaches to correct for spatial effects. The risk of suicide relating to socio-economic factors varied greatly by local areas and between studies using various socio-economic indicators. Areas with higher deprivation, higher unemployment, lower income, and lower education level were more likely to have higher suicide risk. There was no significant difference in results between studies using conventional versus spatial statistic methods. CONCLUSION An increasing number of studies have applied spatial methods, including Bayesian spatial models and spatial regression models, to explore the relationship between area-level socio-economic factors and suicide. This review of spatial studies provided further evidence that area-level socio-economic factors are generally inversely associated with suicide risk, with or without accounting for spatial autocorrelation.
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A spatial analysis of TB cases and abnormal X-rays detected through active case-finding in Karachi, Pakistan. Sci Rep 2023; 13:1336. [PMID: 36693930 PMCID: PMC9873642 DOI: 10.1038/s41598-023-28529-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 01/19/2023] [Indexed: 01/25/2023] Open
Abstract
Tuberculosis (TB) is the leading cause of avoidable deaths from an infectious disease globally and a large of number of people who develop TB each year remain undiagnosed. Active case-finding has been recommended by the World Health Organization to bridge the case-detection gap for TB in high burden countries. However, concerns remain regarding their yield and cost-effectiveness. Data from mobile chest X-ray (CXR) supported active case-finding community camps conducted in Karachi, Pakistan from July 2018 to March 2020 was retrospectively analyzed. Frequency analysis was carried out at the camp-level and outcomes of interest for the spatial analyses were mycobacterium TB positivity (MTB+) and X-ray abnormality rates. The Global Moran's I statistic was used to test for spatial autocorrelation for MTB+ and abnormal X-rays within Union Councils (UCs) in Karachi. A total of 1161 (78.1%) camps yielded no MTB+ cases, 246 (16.5%) camps yielded 1 MTB+, 52 (3.5%) camps yielded 2 MTB+ and 27 (1.8%) yielded 3 or more MTB+. A total of 79 (5.3%) camps accounted for 193 (44.0%) of MTB+ cases detected. Statistically significant clustering for MTB positivity (Global Moran's I: 0.09) and abnormal chest X-rays (Global Moran's I: 0.36) rates was identified within UCs in Karachi. Clustering of UCs with high MTB positivity were identified in Karachi West district. Statistically significant spatial variation was identified in yield of bacteriologically positive TB cases and in abnormal CXR through active case-finding in Karachi. Cost-effectiveness of active case-finding programs can be improved by identifying and focusing interventions in hotspots and avoiding locations with no known TB cases reported through routine surveillance.
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18
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Khaliq A, Ashraf U, Chaudhry MN, Shahid S, Sajid MA, Javed M. Spatial distribution and computational modeling for mapping of tuberculosis in Pakistan. J Public Health (Oxf) 2022:6842873. [DOI: 10.1093/pubmed/fdac125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 03/21/2022] [Accepted: 10/06/2022] [Indexed: 11/25/2022] Open
Abstract
Abstract
Background
Tuberculosis (TB) like many other infectious diseases has a strong relationship with climatic parameters.
Methods
The present study has been carried out on the newly diagnosed sputum smear-positive pulmonary TB cases reported to National TB Control Program across Pakistan from 2007 to 2020. In this study, spatial and temporal distribution of the disease was observed through detailed district wise mapping and clustered regions were also identified. Potential risk factors associated with this disease depending upon population and climatic variables, i.e. temperature and precipitation were also identified.
Results
Nationwide, the incidence rate of TB was observed to be rising from 7.03% to 11.91% in the years 2007–2018, which then started to decline. However, a declining trend was observed after 2018–2020. The most populous provinces, Punjab and Sindh, have reported maximum number of cases and showed a temporal association as the climatic temperature of these two provinces is higher with comparison to other provinces. Machine learning algorithms Maxent, Support Vector Machine (SVM), Environmental Distance (ED) and Climate Space Model (CSM) predict high risk of the disease with14.02%, 24.75%, 34.81% and 43.89% area, respectively.
Conclusion
SVM has a higher significant probability of prediction in the diseased area with a 1.86 partial receiver-operating characteristics (ROC) value as compared with other models.
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Affiliation(s)
- Aasia Khaliq
- Department of Life Sciences, Lahore University of Management Sciences (LUMS) , Lahore , Pakistan
| | - Uzma Ashraf
- Department of Environmental Sciences and Policy, Lahore School of Economics (LSE) , Lahore , Pakistan
| | - Muhammad N Chaudhry
- Department of Environmental Sciences and Policy, Lahore School of Economics (LSE) , Lahore , Pakistan
| | - Saher Shahid
- School of Biological Sciences (SBS), University of the Punjab , Lahore , Pakistan
| | - Muhammad A Sajid
- Foundation Department, Majan University College , Muscat 113 , Oman
| | - Maryam Javed
- Department of Environmental Sciences and Policy, Lahore School of Economics (LSE) , Lahore , Pakistan
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Brown TS, Robinson DA, Buckee CO, Mathema B. Connecting the dots: understanding how human mobility shapes TB epidemics. Trends Microbiol 2022; 30:1036-1044. [PMID: 35597716 PMCID: PMC10068677 DOI: 10.1016/j.tim.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 01/13/2023]
Abstract
Tuberculosis (TB) remains a leading infectious cause of death worldwide. Reducing TB infections and TB-related deaths rests ultimately on stopping forward transmission from infectious to susceptible individuals. Critical to this effort is understanding how human host mobility shapes the transmission and dispersal of new or existing strains of Mycobacterium tuberculosis (Mtb). Important questions remain unanswered. What kinds of mobility, over what temporal and spatial scales, facilitate TB transmission? How do human mobility patterns influence the dispersal of novel Mtb strains, including emergent drug-resistant strains? This review summarizes the current state of knowledge on mobility and TB epidemic dynamics, using examples from three topic areas, including inference of genetic and spatial clustering of infections, delineating source-sink dynamics, and mapping the dispersal of novel TB strains, to examine scientific questions and methodological issues within this topic. We also review new data sources for measuring human mobility, including mobile phone-associated movement data, and discuss important limitations on their use in TB epidemiology.
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Affiliation(s)
- Tyler S Brown
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Infectious Diseases Division, Massachusetts General Hospital, Boston, MA, USA
| | - D Ashley Robinson
- Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Caroline O Buckee
- Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Barun Mathema
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
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Zheng J, Shen G, Hu S, Han X, Zhu S, Liu J, He R, Zhang N, Hsieh CW, Xue H, Zhang B, Shen Y, Mao Y, Zhu B. Small-scale spatiotemporal epidemiology of notifiable infectious diseases in China: a systematic review. BMC Infect Dis 2022; 22:723. [PMID: 36064333 PMCID: PMC9442567 DOI: 10.1186/s12879-022-07669-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/03/2022] [Indexed: 11/20/2022] Open
Abstract
Background The prevalence of infectious diseases remains one of the major challenges faced by the Chinese health sector. Policymakers have a tremendous interest in investigating the spatiotemporal epidemiology of infectious diseases. We aimed to review the small-scale (city level, county level, or below) spatiotemporal epidemiology of notifiable infectious diseases in China through a systematic review, thus summarizing the evidence to facilitate more effective prevention and control of the diseases. Methods We searched four English language databases (PubMed, EMBASE, Cochrane Library, and Web of Science) and three Chinese databases (CNKI, WanFang, and SinoMed), for studies published between January 1, 2004 (the year in which China’s Internet-based disease reporting system was established) and December 31, 2021. Eligible works were small-scale spatial or spatiotemporal studies focusing on at least one notifiable infectious disease, with the entire territory of mainland China as the study area. Two independent reviewers completed the review process based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results A total of 18,195 articles were identified, with 71 eligible for inclusion, focusing on 22 diseases. Thirty-one studies (43.66%) were analyzed using city-level data, 34 (47.89%) were analyzed using county-level data, and six (8.45%) used community or individual data. Approximately four-fifths (80.28%) of the studies visualized incidence using rate maps. Of these, 76.06% employed various spatial clustering methods to explore the spatial variations in the burden, with Moran’s I statistic being the most common. Of the studies, 40.85% explored risk factors, in which the geographically weighted regression model was the most commonly used method. Climate, socioeconomic factors, and population density were the three most considered factors. Conclusions Small-scale spatiotemporal epidemiology has been applied in studies on notifiable infectious diseases in China, involving spatiotemporal distribution and risk factors. Health authorities should improve prevention strategies and clarify the direction of future work in the field of infectious disease research in China. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07669-9.
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Affiliation(s)
- Junyao Zheng
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China.,School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Guoquan Shen
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Siqi Hu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Xinxin Han
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, China
| | - Siyu Zhu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Jinlin Liu
- School of Public Policy and Administration, Northwestern Polytechnical University, Xi'an, China
| | - Rongxin He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Ning Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.,MRC Centre for Global Infectious Disease Analysis and the Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College, London, UK
| | - Chih-Wei Hsieh
- Department of Public Policy, City University of Hong Kong, Hong Kong, China
| | - Hao Xue
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA
| | - Bo Zhang
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Yue Shen
- Laboratory for Urban Future, School of Urban Planning and Design, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Bin Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, China.
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21
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Investigating Spatial Patterns of Pulmonary Tuberculosis and Main Related Factors in Bandar Lampung, Indonesia Using Geographically Weighted Poisson Regression. Trop Med Infect Dis 2022; 7:tropicalmed7090212. [PMID: 36136622 PMCID: PMC9502094 DOI: 10.3390/tropicalmed7090212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/15/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Tuberculosis (TB) is a highly infectious disease, representing one of the major causes of death worldwide. Sustainable Development Goal 3.3 implies a serious decrease in the incidence of TB cases. Hence, this study applied a spatial analysis approach to investigate patterns of pulmonary TB cases and its drivers in Bandar Lampung (Indonesia). Our study examined seven variables: the growth rate of pulmonary TB, population, distance to the city center, industrial area, green open space, built area, and slum area using geographically weighted Poisson regression (GWPR). The GWPR model demonstrated excellent results with an R2 and adjusted R2 of 0.96 and 0.94, respectively. In this case, the growth rate of pulmonary TB and population were statistically significant variables. Spatial pattern analysis of sub-districts revealed that those of Panjang and Kedaton were driven by high pulmonary TB growth rate and population, whereas that of Sukabumi was driven by the accumulation of high levels of industrial area, built area, and slums. For these reasons, we suggest that local policymakers implement a variety of infectious disease prevention and control strategies based on the spatial variation of pulmonary TB rate and its influencing factors in each sub-district.
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22
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Li H, Ge M, Zhang M. Spatio-temporal distribution of tuberculosis and the effects of environmental factors in China. BMC Infect Dis 2022; 22:565. [PMID: 35733132 PMCID: PMC9215012 DOI: 10.1186/s12879-022-07539-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background Although the World Health Organization reports that the incidence of tuberculosis in China is decreasing every year, the burden of tuberculosis in China is still very heavy. Understanding the spatial and temporal distribution pattern of tuberculosis in China and its influencing environmental factors will provide effective reference for the prevention and treatment of tuberculosis. Methods Data of TB incidence from 2010 to 2017 were collected. Time series and global spatial autocorrelation were used to analyze the temporal and spatial distribution pattern of tuberculosis incidence in China, Geodetector and Geographically Weighted Regression model were used to analyze the environmental factors affecting the TB incidence. Results In addition to 2007 and 2008, the TB incidence decreased in general. TB has a strong spatial aggregation. Cities in Northwest China have been showing a trend of high-value aggregation. In recent years, the center of gravity of high-value aggregation area in South China has moved further south. Temperature, humidity, precipitation, PM10, PM2.5, O3, NO2 and SO2 have impacts on TB incidence, and in different regions, the environmental factors show regional differences. Conclusions Residents should pay more attention to the risk of developing TB caused by climate change and air pollutant exposure. Increased efforts should be placed on areas with high-value clustering in future public resource configurations.
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Affiliation(s)
- Hao Li
- Institute of Healthy Geography, School of Geography and Tourism, Shaanxi Normal University, Xi'an, 710119, China.,College of Resources and Environmental Science, Ningxia University, Yinchuan, 750021, China
| | - Miao Ge
- Institute of Healthy Geography, School of Geography and Tourism, Shaanxi Normal University, Xi'an, 710119, China.
| | - Mingxin Zhang
- College of Resources and Environmental Science, Ningxia University, Yinchuan, 750021, China
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23
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Guerra SS, Seixas E, Ribeiro AI, Duarte R. Tell me where you went, I may tell who you infected. J Bras Pneumol 2022; 48:e20220099. [PMID: 35703673 PMCID: PMC9262441 DOI: 10.36416/1806-3756/e20220099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sónia Silva Guerra
- . Serviço de Pneumologia, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Eduarda Seixas
- . Serviço de Pneumologia, Centro Hospitalar Baixo-Vouga, Aveiro, Portugal
| | - Ana Isabel Ribeiro
- . EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- . Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional, Porto, Portugal
- . Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Raquel Duarte
- . EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
- . ICBAS-UP - Instituto de Ciências Biomédicas de Abel Salazar, Universidade do Porto, Porto, Portugal
- . Serviço de Pneumologia, Centro Hospitalar de Vila Nova de Gaia, Vila Nova de Gaia, Portugal
- . Unidade de Investigação Clínica, Administração Regional de Saúde do Norte, Porto, Portugal
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24
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Khundi M, Carpenter JR, Corbett EL, Feasey HRA, Soko RN, Nliwasa M, Twabi H, Chiume L, Burke RM, Horton KC, Dodd PJ, Cohen T, MacPherson P. Neighbourhood prevalence-to-notification ratios for adult bacteriologically-confirmed tuberculosis reveals hotspots of underdiagnosis in Blantyre, Malawi. PLoS One 2022; 17:e0268749. [PMID: 35605004 PMCID: PMC9126376 DOI: 10.1371/journal.pone.0268749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 05/06/2022] [Indexed: 11/21/2022] Open
Abstract
Local information is needed to guide targeted interventions for respiratory infections such as tuberculosis (TB). Case notification rates (CNRs) are readily available, but systematically underestimate true disease burden in neighbourhoods with high diagnostic access barriers. We explored a novel approach, adjusting CNRs for under-notification (P:N ratio) using neighbourhood-level predictors of TB prevalence-to-notification ratios. We analysed data from 1) a citywide routine TB surveillance system including geolocation, confirmatory mycobacteriology, and clinical and demographic characteristics of all registering TB patients in Blantyre, Malawi during 2015-19, and 2) an adult TB prevalence survey done in 2019. In the prevalence survey, consenting adults from randomly selected households in 72 neighbourhoods had symptom-plus-chest X-ray screening, confirmed with sputum smear microscopy, Xpert MTB/Rif and culture. Bayesian multilevel models were used to estimate adjusted neighbourhood prevalence-to-notification ratios, based on summarised posterior draws from fitted adult bacteriologically-confirmed TB CNRs and prevalence. From 2015-19, adult bacteriologically-confirmed CNRs were 131 (479/371,834), 134 (539/415,226), 114 (519/463,707), 56 (283/517,860) and 46 (258/578,377) per 100,000 adults per annum, and 2019 bacteriologically-confirmed prevalence was 215 (29/13,490) per 100,000 adults. Lower educational achievement by household head and neighbourhood distance to TB clinic was negatively associated with CNRs. The mean neighbourhood P:N ratio was 4.49 (95% credible interval [CrI]: 0.98-11.91), consistent with underdiagnosis of TB, and was most pronounced in informal peri-urban neighbourhoods. Here we have demonstrated a method for the identification of neighbourhoods with high levels of under-diagnosis of TB without the requirement for a prevalence survey; this is important since prevalence surveys are expensive and logistically challenging. If confirmed, this approach may support more efficient and effective targeting of intensified TB and HIV case-finding interventions aiming to accelerate elimination of urban TB.
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Affiliation(s)
- McEwen Khundi
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - James R. Carpenter
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Elizabeth L. Corbett
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Helena R. A. Feasey
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rebecca Nzawa Soko
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Marriott Nliwasa
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Helse Nord TB Initiative, College of Medicine, University of Malawi, Zomba, Malawi
| | - Hussein Twabi
- Helse Nord TB Initiative, College of Medicine, University of Malawi, Zomba, Malawi
| | - Lingstone Chiume
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Rachael M. Burke
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Peter J. Dodd
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Ted Cohen
- Yale School of Public Health, New Haven, CT, United States of America
| | - Peter MacPherson
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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25
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Jiang H, Sun X, Hua Z, Liu H, Cao Y, Ren D, Qi X, Zhang T, Zhang S. Distribution of bacteriologically positive and bacteriologically negative pulmonary tuberculosis in Northwest China: spatiotemporal analysis. Sci Rep 2022; 12:6895. [PMID: 35477716 PMCID: PMC9046232 DOI: 10.1038/s41598-022-10675-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/04/2022] [Indexed: 11/09/2022] Open
Abstract
Pulmonary tuberculosis (PTB) is a major health issue in Northwest China. Most previous studies on the spatiotemporal patterns of PTB considered all PTB cases as a whole; they did not distinguish notified bacteriologically positive PTB (BP-PTB) and notified bacteriologically negative PTB (BN-PTB). Thus, the spatiotemporal characteristics of notified BP-PTB and BN-PTB are still unclear. A retrospective county-level spatial epidemiological study (2011-2018) was conducted in Shaanxi, Northwest China. In total, 44,894 BP-PTB cases were notified, with an average annual incidence rate of 14.80 per 100,000 persons between 2011 and 2018. Global Moran's I values for notified BP-PTB ranged from 0.19 to 0.49 (P < 0.001). Anselin's local Moran's I analysis showed that the high-high (HH) cluster for notified BP-PTB incidence was mainly located in the southernmost region. The primary spatiotemporal cluster for notified BP-PTB (LLR = 612.52, RR = 1.77, P < 0.001) occurred in the central region of the Guanzhong Plain in 2011. In total, 116,447 BN-PTB cases were notified, with an average annual incidence rate of 38.38 per 100,000 persons between 2011 and 2018. Global Moran's I values for notified BN-PTB ranged from 0.39 to 0.69 (P < 0.001). The HH clusters of notified BN-PTB were mainly located in the north between 2011 and 2014 and in the south after 2015. The primary spatiotemporal cluster for notified BN-PTB (LLR = 1084.59, RR = 1.85, P < 0.001) occurred in the mountainous areas of the southernmost region from 2014 to 2017. Spatiotemporal clustering of BP-PTB and BN-PTB was detected in the poverty-stricken mountainous areas of Shaanxi, Northwest China. Our study provides evidence for intensifying PTB control activities in these geographical clusters.
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Affiliation(s)
- Hualin Jiang
- Health Science Centre, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Xiaolu Sun
- Shaanxi Provincial Institute for Tuberculosis Control and Prevention, Xi'an, 710048, China
| | - Zhongqiu Hua
- Wuxi Early Intervention Centre for Children With Special Needs, Wuxi, 214000, China
| | - Haini Liu
- Shangluo University, Shangluo, 726000, China
| | - Yi Cao
- Health Science Centre, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Dan Ren
- Health Science Centre, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Xin Qi
- Health Science Centre, Xi'an Jiaotong University, Xi'an, 710061, China.
| | - Tianhua Zhang
- Shaanxi Provincial Institute for Tuberculosis Control and Prevention, Xi'an, 710048, China.
| | - Shaoru Zhang
- Health Science Centre, Xi'an Jiaotong University, Xi'an, 710061, China.
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26
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Szarka N, Biljecki F. Population estimation beyond counts-Inferring demographic characteristics. PLoS One 2022; 17:e0266484. [PMID: 35381028 PMCID: PMC8982831 DOI: 10.1371/journal.pone.0266484] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 03/21/2022] [Indexed: 11/18/2022] Open
Abstract
Mapping population distribution at a fine spatial scale is essential for urban studies and planning. Numerous studies, mainly supported by geospatial and statistical methods, have focused primarily on predicting population counts. However, estimating their socio-economic characteristics beyond population counts, such as average age, income, and gender ratio, remains unattended. We enhance traditional population estimation by predicting not only the number of residents in an area, but also their demographic characteristics: average age and the proportion of seniors. By implementing and comparing different machine learning techniques (Random Forest, Support Vector Machines, and Linear Regression) in administrative areas in Singapore, we investigate the use of point of interest (POI) and real estate data for this purpose. The developed regression model predicts the average age of residents in a neighbourhood with a mean error of about 1.5 years (the range of average resident age across Singaporean districts spans approx. 14 years). The results reveal that age patterns of residents can be predicted using real estate information rather than with amenities, which is in contrast to estimating population counts. Another contribution of our work in population estimation is the use of previously unexploited POI and real estate datasets for it, such as property transactions, year of construction, and flat types (number of rooms). Advancing the domain of population estimation, this study reveals the prospects of a small set of detailed and strong predictors that might have the potential of estimating other demographic characteristics such as income.
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Affiliation(s)
- Noée Szarka
- School of GeoSciences, University of Edinburgh, Edinburgh, United Kingdom
- Department of Architecture, National University of Singapore, Singapore, Singapore
| | - Filip Biljecki
- Department of Architecture, National University of Singapore, Singapore, Singapore
- Department of Real Estate, National University of Singapore, Singapore, Singapore
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27
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Intra-urban variation in tuberculosis and community socioeconomic deprivation in Lisbon metropolitan area: a Bayesian approach. Infect Dis Poverty 2022; 11:24. [PMID: 35321758 PMCID: PMC8942608 DOI: 10.1186/s40249-022-00949-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background Multidrug resistant tuberculosis (MDR-TB) is a recognized threat to global efforts to TB control and remains a priority of the National Tuberculosis Programs. Additionally, social determinants and socioeconomic deprivation have since long been associated with worse health and perceived as important risk factors for TB. This study aimed to analyze the spatial distribution of non-MDR-TB and MDR-TB across parishes of the Lisbon metropolitan area of Portugal and to estimate the association between non-MDR-TB and MDR-TB and socioeconomic deprivation. Methods In this study, we used hierarchical Bayesian spatial models to analyze the spatial distribution of notification of non-MDR-TB and MDR-TB cases for the period from 2000 to 2016 across 127 parishes of the seven municipalities of the Lisbon metropolitan area (Almada, Amadora, Lisboa, Loures, Odivelas, Oeiras, Sintra), using the Portuguese TB Surveillance System (SVIG-TB). In order to characterise the populations, we used the European Deprivation Index for Portugal (EDI-PT) as an indicator of poverty and estimated the association between non-MDR-TB and MDR-TB and socioeconomic deprivation. Results The notification rates per 10,000 population of non-MDR TB ranged from 18.95 to 217.49 notifications and that of MDR TB ranged from 0.83 to 3.70. We identified 54 high-risk areas for non-MDR-TB and 13 high-risk areas for MDR-TB. Parishes in the third [relative risk (RR) = 1.281, 95% credible interval (CrI): 1.021–1.606], fourth (RR = 1.786, 95% CrI: 1.420–2.241) and fifth (RR = 1.935, 95% CrI: 1.536–2.438) quintile of socioeconomic deprivation presented higher non-MDR-TB notifications rates. Parishes in the fourth (RR = 2.246, 95% CrI: 1.374–3.684) and fifth (RR = 1.828, 95% CrI: 1.049–3.155) quintile of socioeconomic deprivation also presented higher MDR-TB notifications rates. Conclusions We demonstrated significant heterogeneity in the spatial distribution of both non-MDR-TB and MDR-TB at the parish level and we found that socioeconomically disadvantaged parishes are disproportionally affected by both non-MDR-TB and MDR-TB. Our findings suggest that the emergence of MDR-TB and transmission are specific from each location and often different from the non-MDR-TB settings. We identified priority areas for intervention for a more efficient plan of control and prevention of non-MDR-TB and MDR-TB. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-022-00949-1.
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28
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Ramìrez-Aldana R, Gomez-Verjan JC, Bello-Chavolla OY, Naranjo L. A spatio-temporal study of state-wide case-fatality risks during the first wave of the COVID-19 pandemic in Mexico. GEOSPATIAL HEALTH 2022; 17. [PMID: 35352540 DOI: 10.4081/gh.2022.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/10/2022] [Indexed: 06/14/2023]
Abstract
spatio-temporal analysis of the first wave of the coronavirus (COVID-19) pandemic in Mexico (April to September 2020) was performed by state. Descriptive analyses through diagrams, mapping, animations and time series representations were carried out. Greater risks were observed at certain times in specific regions. Various trends and clusters were observed and analysed by fitting linear mixed models and time series clustering. The association of co-morbidities and other variables were studied by fitting a spatial panel data linear model (SPLM). On average, the greatest risks were observed in Baja California Norte, Chiapas and Sonora, while some other densely populated states, e.g., Mexico City, had lower values. The trends varied by state and a four-order polynomial, including fixed and random effects, was necessary to model them. The most common risk development was observed in states belonging to two clusters and consisted of an initial increase followed by a decrease. Some states presented cluster configurations with a retarded risk increase before the decrease, while the risk increased throughout the time of study in others. A cyclic behaviour with a second increasing trend was also observed in some states. The SPLM approach revealed a positive significant association with respect to case fatality risk between certain groups, such as males and individuals aged 50 years and more, and the prevalence of chronic kidney disease, cardiovascular disease, asthma and hypertension. The analysis may provide valuable insight into COVID-19 dynamics applicable in future outbreaks, as well as identify determinants signifying certain trends at the state level. The combination of spatial and temporal information may provide a better understanding of the fatalities due to COVID-19.
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Affiliation(s)
| | | | | | - Lizbeth Naranjo
- 2Department of Mathematics, Faculty of Sciences, National Autonomous University of Mexico, Mexico City.
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29
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Liu K, Chen S, Zhang Y, Li T, Xie B, Wang W, Wang F, Peng Y, Ai L, Chen B, Wang X, Jiang J. Tuberculosis burden caused by migrant population in Eastern China: evidence from notification records in Zhejiang Province during 2013-2017. BMC Infect Dis 2022; 22:109. [PMID: 35100983 PMCID: PMC8805310 DOI: 10.1186/s12879-022-07071-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/17/2022] [Indexed: 01/04/2023] Open
Abstract
Background Internal migrants have an enormous impact on tuberculosis (TB) epidemic in China. Zhejiang Province, as one of the developed areas, also had a heavy burden caused by TB. Methods In this study, we collected all cases in Zhejiang Province through the TB Management Information System from 2013 to 2017. Description analysis and Spatio-temporal analysis using R software and ArcGIS were performed to identify the epidemiological characteristics and clusterings, respectively. Results 48,756 individuals in total were notified with TB among the migrant population (TBMP), accounting for one-third of all cases identified. The primary sources of TB from migrants outside the province were from Guizhou, Sichuan, and Anhui. Wenzhou, Taizhou, and Lishui were the three mainly outflowing cities among the intra-provincial TBMP and Hangzhou as the primarily inflowing city. Also, results implied that the inconsistency of the TBMP in spatial analysis and the border area of Quzhou and Lishui city had the highest risk of TB occurrence among the migrants. Additionally, one most likely cluster and four secondary clusters were identified by the spatial–temporal analysis. Conclusion The effective control of TB in extra-provincial MP was critical to lowering the TB burden of MP in Zhejiang Province. Also, it is suggested that active TB screening for migrant employees outflowed from high epidemic regions should be strengthened, and further traceability analysis needs to be investigated to clarify the mechanism of TB transmission in clustered areas. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07071-5.
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Affiliation(s)
- Kui Liu
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.,Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Songhua Chen
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Yu Zhang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Tao Li
- National Center for Tuberculosis Control and Prevention, China CDC, Beijing, People's Republic of China
| | - Bo Xie
- School of Urban Design, Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Wei Wang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Fei Wang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Ying Peng
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Liyun Ai
- Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Bin Chen
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China. .,Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
| | - Xiaomeng Wang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
| | - Jianmin Jiang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China. .,Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
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30
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TB Hackathon: Development and Comparison of Five Models to Predict Subnational Tuberculosis Prevalence in Pakistan. Trop Med Infect Dis 2022; 7:tropicalmed7010013. [PMID: 35051129 PMCID: PMC8780063 DOI: 10.3390/tropicalmed7010013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 12/04/2022] Open
Abstract
Pakistan's national tuberculosis control programme (NTP) is among the many programmes worldwide that value the importance of subnational tuberculosis (TB) burden estimates to support disease control efforts, but do not have reliable estimates. A hackathon was thus organised to solicit the development and comparison of several models for small area estimation of TB. The TB hackathon was launched in April 2019. Participating teams were requested to produce district-level estimates of bacteriologically positive TB prevalence among adults (over 15 years of age) for 2018. The NTP provided case-based data from their 2010-2011 TB prevalence survey, along with data relating to TB screening, testing and treatment for the period between 2010-2011 and 2018. Five teams submitted district-level TB prevalence estimates, methodological details and programming code. Although the geographical distribution of TB prevalence varied considerably across models, we identified several districts with consistently low notification-to-prevalence ratios. The hackathon highlighted the challenges of generating granular spatiotemporal TB prevalence forecasts based on a cross-sectional prevalence survey data and other data sources. Nevertheless, it provided a range of approaches to subnational disease modelling. The NTP's use and plans for these outputs shows that, limitations notwithstanding, they can be valuable for programme planning.
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31
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Brooks MB, Jenkins HE, Puma D, Tzelios C, Millones AK, Jimenez J, Galea JT, Lecca L, Becerra MC, Keshavjee S, Yuen CM. A role for community-level socioeconomic indicators in targeting tuberculosis screening interventions. Sci Rep 2022; 12:781. [PMID: 35039612 PMCID: PMC8764089 DOI: 10.1038/s41598-022-04834-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 12/30/2021] [Indexed: 11/29/2022] Open
Abstract
Tuberculosis screening programs commonly target areas with high case notification rates. However, this may exacerbate disparities by excluding areas that already face barriers to accessing diagnostic services. We compared historic case notification rates, demographic, and socioeconomic indicators as predictors of neighborhood-level tuberculosis screening yield during a mobile screening program in 74 neighborhoods in Lima, Peru. We used logistic regression and Classification and Regression Tree (CART) analysis to identify predictors of screening yield. During February 7, 2019-February 6, 2020, the program screened 29,619 people and diagnosed 147 tuberculosis cases. Historic case notification rate was not associated with screening yield in any analysis. In regression analysis, screening yield decreased as the percent of vehicle ownership increased (odds ratio [OR]: 0.76 per 10% increase in vehicle ownership; 95% confidence interval [CI]: 0.58-0.99). CART analysis identified the percent of blender ownership (≤ 83.1% vs > 83.1%; OR: 1.7; 95% CI: 1.2-2.6) and the percent of TB patients with a prior tuberculosis episode (> 10.6% vs ≤ 10.6%; OR: 3.6; 95% CI: 1.0-12.7) as optimal predictors of screening yield. Overall, socioeconomic indicators were better predictors of tuberculosis screening yield than historic case notification rates. Considering community-level socioeconomic characteristics could help identify high-yield locations for screening interventions.
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Affiliation(s)
- Meredith B Brooks
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA.
- Harvard Medical School Center for Global Health Delivery, Boston, MA, USA.
| | - Helen E Jenkins
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | | | - Christine Tzelios
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
- Socios En Salud Sucursal Peru, Lima, Peru
| | | | | | - Jerome T Galea
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
- School of Social Work, University of South Florida, Tampa, FL, USA
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Leonid Lecca
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
- Socios En Salud Sucursal Peru, Lima, Peru
| | - Mercedes C Becerra
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
- Harvard Medical School Center for Global Health Delivery, Boston, MA, USA
| | - Salmaan Keshavjee
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
- Harvard Medical School Center for Global Health Delivery, Boston, MA, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA
| | - Courtney M Yuen
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA
- Harvard Medical School Center for Global Health Delivery, Boston, MA, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA
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Ali ZA, Al-Obaidi MJ, Sameer FO, Mankhi AA, Misha'al KI, Jassim IA, Taqi EA, Ad'hiah AH. Epidemiological profile of tuberculosis in Iraq during 2011-2018. Indian J Tuberc 2022; 69:27-34. [PMID: 35074147 DOI: 10.1016/j.ijtb.2021.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/10/2020] [Accepted: 01/14/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Tuberculosis (TB) is one of the most progressive infectious diseases caused by Mycobacterium tuberculosis. The pathogen is the first cause of mortality linked to a single pathogen worldwide, especially in poor and developing countries. METHODS A cross-sectional descriptive study was conducted to estimate incidence rate (IR) of TB in Iraq during a period of eight years (2011-2018). TB data were extracted from the computer system of the National Specialized Center for Chest and Respiratory Diseases in Baghdad. RESULTS During 2011-2018, 65,102 confirmed TB cases were reported in Iraq; 39,640 pulmonary TB (PTB) and 25,462 extra-pulmonary TB (EPTB). The average IR (case/100,000 inhabitants) of TB was 23.4 (14.2 for PTB and 9.1 for EPTB). Annual rate of TB cases showed a gradual decline over years (from 29.2 in 2011 to 18.6 in 2018). The decline in IR was more pronounced in PTB than EPTB. However PTB/EPTB ratio showed a gradual decreasing over years (from 2.04 in 2011 to 1.56 in 2018). GIS-mapping revealed that PTB and EPTB IRs show variations between the 18 governorates of Iraq. Most of the recorded PTB cases were new (average: 90.5%), followed by relapse cases (average: 7.9%). Among the reported PTB cases, percentage of males was greater than females (average: 52.1 vs. 47.9%), whereas an opposite trend was observed in EPTB (42.9 vs. 57.1%). The frequency distribution of PTB and EPTB varied between age groups, and lowest average frequency was recorded in age groups 1-4 and 5-14 year. CONCLUSIONS TB is still a public health threat, and although a declining trend in incidence was depicted over the years 2011-2018, the disease is still out of control in Iraq, and more investments of resource are necessitated to eliminate the disease. In this context, EPTB and PTB relapse need a recognized attention.
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Affiliation(s)
- Zainab A Ali
- Biotechnology Department, College of Science, University of Baghdad, Baghdad, Iraq
| | - Mohammed J Al-Obaidi
- Tropical-Biological Research Unit, College of Science, University of Baghdad, Baghdad, Iraq
| | - Fadhaa O Sameer
- Tropical-Biological Research Unit, College of Science, University of Baghdad, Baghdad, Iraq
| | - Ahmed A Mankhi
- National Specialized Center for Chest and Respiratory Diseases, Ministry of Health and Environment, Baghdad, Iraq
| | - Khawla I Misha'al
- Tropical-Biological Research Unit, College of Science, University of Baghdad, Baghdad, Iraq
| | - Iftikhar A Jassim
- Tropical-Biological Research Unit, College of Science, University of Baghdad, Baghdad, Iraq
| | - Estabraq A Taqi
- Tropical-Biological Research Unit, College of Science, University of Baghdad, Baghdad, Iraq
| | - Ali H Ad'hiah
- Tropical-Biological Research Unit, College of Science, University of Baghdad, Baghdad, Iraq.
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Addressing context dependence in ecology. Trends Ecol Evol 2021; 37:158-170. [PMID: 34756764 DOI: 10.1016/j.tree.2021.09.007] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/05/2021] [Accepted: 09/21/2021] [Indexed: 12/26/2022]
Abstract
Context dependence is widely invoked to explain disparate results in ecology. It arises when the magnitude or sign of a relationship varies due to the conditions under which it is observed. Such variation, especially when unexplained, can lead to spurious or seemingly contradictory conclusions, which can limit understanding and our ability to transfer findings across studies, space, and time. Using examples from biological invasions, we identify two types of context dependence resulting from four sources: mechanistic context dependence arises from interaction effects; and apparent context dependence can arise from the presence of confounding factors, problems of statistical inference, and methodological differences among studies. Addressing context dependence is a critical challenge in ecology, essential for increased understanding and prediction.
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Im C, Kim Y. Spatial pattern of tuberculosis (TB) and related socio-environmental factors in South Korea, 2008-2016. PLoS One 2021; 16:e0255727. [PMID: 34352032 PMCID: PMC8341643 DOI: 10.1371/journal.pone.0255727] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 07/23/2021] [Indexed: 11/24/2022] Open
Abstract
Tuberculosis (TB) incidence and corresponding mortality rates in S. Korea are unusual and unique compared to other economically developed countries. Korea has the highest TB incidence rate in Organization for Economic Co-operation and Development (OECD) countries. TB is known as a disease reflecting socio-economic and environmental conditions of a society. Besides, TB is an infectious disease spread through the air, naturally forming spatial dependence of its incidence. This study investigates TB incidences in Korea in socio-economic and environmental perspectives. Eigenvector spatial filtering applied accounts for spatial autocorrelation in the TB incidence, and Getis-Ord Gi* statistic tracks the changes of TB clusters at given time. The results show that population composition ratio, population growth rate, health insurance payment, and public health variables are significant throughout the study period. Environmental variables make minor effects on TB incidence. This study argues that unique demographic features of Korea are a potential threat to TB control in the future.
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Affiliation(s)
- Changmin Im
- Department of Geography, Graduate School, Korea University, Seoul, South Korea
| | - Youngho Kim
- Department of Geography & Geography Education, Korea University, Seoul, South Korea
- * E-mail:
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Khundi M, Carpenter JR, Nliwasa M, Cohen T, Corbett EL, MacPherson P. Effectiveness of spatially targeted interventions for control of HIV, tuberculosis, leprosy and malaria: a systematic review. BMJ Open 2021; 11:e044715. [PMID: 34257091 PMCID: PMC8278879 DOI: 10.1136/bmjopen-2020-044715] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 06/15/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND As infectious diseases approach global elimination targets, spatial targeting is increasingly important to identify community hotspots of transmission and effectively target interventions. We aimed to synthesise relevant evidence to define best practice approaches and identify policy and research gaps. OBJECTIVE To systematically appraise evidence for the effectiveness of spatially targeted community public health interventions for HIV, tuberculosis (TB), leprosy and malaria. DESIGN Systematic review. DATA SOURCES We searched Medline, Embase, Global Health, Web of Science and Cochrane Database of Systematic Reviews between 1 January 1993 and 22 March 2021. STUDY SELECTION The studies had to include HIV or TB or leprosy or malaria and spatial hotspot definition, and community interventions. DATA EXTRACTION AND SYNTHESIS A data extraction tool was used. For each study, we summarised approaches to identifying hotpots, intervention design and effectiveness of the intervention. RESULTS Ten studies, including one cluster randomised trial and nine with alternative designs (before-after, comparator area), satisfied our inclusion criteria. Spatially targeted interventions for HIV (one USA study), TB (three USA) and leprosy (two Brazil, one Federated States of Micronesia) each used household location and disease density to define hotspots followed by community-based screening. Malaria studies (one each from India, Indonesia and Kenya) used household location and disease density for hotspot identification followed by complex interventions typically combining community screening, larviciding of stagnant water bodies, indoor residual spraying and mass drug administration. Evidence of effect was mixed. CONCLUSIONS Studies investigating spatially targeted interventions were few in number, and mostly underpowered or otherwise limited methodologically, affecting interpretation of intervention impact. Applying advanced epidemiological methodologies supporting more robust hotspot identification and larger or more intensive interventions would strengthen the evidence-base for this increasingly important approach. PROSPERO REGISTRATION NUMBER CRD42019130133.
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Affiliation(s)
- McEwen Khundi
- Public Health, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - James R Carpenter
- Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
- MRC Clinical Trials Unit, University College London, London, UK
| | - Marriott Nliwasa
- Helse Nord Tuberculosis Initiative, University of Malawi College of Medicine, Blantyre, Malawi
| | - Ted Cohen
- School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Elizabeth L Corbett
- Public Health, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Peter MacPherson
- Public Health, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
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Dismer AM, Charles M, Dear N, Louis-Jean JM, Barthelemy N, Richard M, Morose W, Fitter DL. Identification of TB space-time clusters and hotspots in Ouest département, Haiti, 2011-2016. Public Health Action 2021; 11:101-107. [PMID: 34159071 DOI: 10.5588/pha.20.0085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Haiti has the highest incidence rate of TB in the Western Hemisphere, with an estimated 170 cases per 100,000 in 2019. Since 2010, control efforts have focused on targeted case-finding activities in urban areas, implementation of rapid molecular diagnostics at high-volume TB centers, and improved reporting. TB analyses are rarely focused on lower geographic units; thus, the major goal was to determine if there were focal areas of TB transmission from 2011 to 2016 at operational geographic levels useful for the National TB Control Program (PNLT). METHODS We created a geocoder to locate TB cases at the smallest geographic level. Kulldorff's space-time permutation scan, Anselin Moran's I, and Getis-Ord Gi* statistics were used to determine the spatial distribution and clusters of TB. RESULTS With 91% of cases linked using the geocoder, TB clusters were identified each year. Getis-Ord Gi* analysis revealed 14 distinct spatial clusters of high incidences in the Port-au-Prince metropolitan area. One hundred retrospective space-time clusters were detected. CONCLUSION Our study confirms the presence of TB hotspots in the Ouest département, with most clusters in the Port-au-Prince metropolitan area. Results will help the PNLT and its partners better design case-finding strategies for these areas.
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Affiliation(s)
- A M Dismer
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | | | - N Dear
- CDC, Port-au-Prince, Haiti
| | - J M Louis-Jean
- Programme National de Lutte contre la Tuberculose, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - N Barthelemy
- Directorate of Epidemiology, Laboratory, and Research, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - M Richard
- Programme National de Lutte contre la Tuberculose, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - W Morose
- Programme National de Lutte contre la Tuberculose, Ministère de la Santé Publique et de la Population, Port-au-Prince, Haiti
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Shaweno D, Trauer JM, Doan TN, Denholm JT, McBryde ES. Geospatial clustering and modelling provide policy guidance to distribute funding for active TB case finding in Ethiopia. Epidemics 2021; 36:100470. [PMID: 34052666 DOI: 10.1016/j.epidem.2021.100470] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 01/27/2020] [Accepted: 05/17/2021] [Indexed: 10/21/2022] Open
Abstract
Tuberculosis (TB) exhibits considerable spatial heterogeneity, occurring in clusters that may act as hubs of community transmission. We evaluated the impact of an intervention targeting spatial TB hotspots in a rural region of Ethiopia. To evaluate the impact of targeted active case finding (ACF), we used a spatially structured mathematical model that has previously been described. From model equilibrium, we simulated the impact of a hotspot-targeted strategy (HTS) on TB incidence ten years from intervention commencement and the associated cost-effectiveness. HTS was also compared with an untargeted strategy (UTS). We used logistic cost-coverage analysis to estimate cost-effectiveness of interventions. At a community screening coverage level of 95 % in a hotspot region, which corresponds to screening 20 % of the total population, HTS would reduce overall TB incidence by 52 % compared with baseline. For UTS to achieve an equivalent effect, it would be necessary to screen more than 80 % of the total population. Compared to the existing passive case detection strategy, the HTS at a CDR of 75 percent in hotspot regions is expected to avert 1,023 new TB cases over ten years saving USD 170 per averted case. Similarly, at the same CDR, the UTS will detect 1316 cases over the same period saving USD 3 per averted TB case. The incremental-cost effectiveness-ratio (ICER) of UTS compared with HTS is USD 582 per averted case corresponding to 293 more TB cases averted at an additional cost of USD 170,700. Where regional TB program spending was capped at current levels, maximum gains in incidence reduction were seen when the regional budget was shared between hotspots and non-hotspot regions in the ratio of 40% : 60%. Our analysis suggests that a spatially targeted strategy is efficient and cost-saving, with the potential for significant reduction in overall TB burden.
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Affiliation(s)
- Debebe Shaweno
- Department of Medicine, University of Melbourne, 300 Grattan Street, Melbourne, Victoria, 3050, Australia; Victorian Tuberculosis Program at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, 3000, Victoria, Australia; Department of Health Economics and Decision Science, School of Health and Related Research, The University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, United Kingdom.
| | - James M Trauer
- Victorian Tuberculosis Program at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, 3000, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia
| | - Tan N Doan
- Department of Medicine, University of Melbourne, 300 Grattan Street, Melbourne, Victoria, 3050, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Douglas, Townsville, QLD, 4814, Australia
| | - Justin T Denholm
- Victorian Tuberculosis Program at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth Street, Melbourne, 3000, Victoria, Australia; Department of Microbiology and Immunology, University of Melbourne792 Elizabeth Street, Melbourne, 3000, Victoria, Australia
| | - Emma S McBryde
- Department of Medicine, University of Melbourne, 300 Grattan Street, Melbourne, Victoria, 3050, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Douglas, Townsville, QLD, 4814, Australia
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Fasona MJ, Okolie CJ, Otitoloju AA. Spatial drivers of COVID-19 vulnerability in Nigeria. Pan Afr Med J 2021; 39:19. [PMID: 34394810 PMCID: PMC8348361 DOI: 10.11604/pamj.2021.39.19.25791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 03/29/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION the spread and diffusion of COVID-19 undoubtedly shows strong spatial connotations and alignment with the physical indices of civilization and globalization. Several spatial risk factors have possible influence on its dispersal trajectory. Understanding their influence is critical for mobilization, sensitization and managing non-pharmaceutical interventions at the appropriate spatial-administrative units. METHODS on 01 April 2020, we constructed a rapid spatial diagnostics and generated vulnerability map for COVID-19 infection spread at state level using 12 core spatial drivers. The risk factors used include established COVID-19 cases (as at 01 April 2020), population, proximity to the airports, inter-state road traffic, intra-state road traffic, intra city traffic, international road traffic, possible influx of elites from abroad, preponderance of high risk political elite, likelihood of religious gathering, likelihood of other social gatherings, and proximity to existing COVID-19 test centers. These were also tested as predictors of COVID-19 spread using multiple regression analysis. RESULTS the results show that 6 States - Lagos, Kano, Katsina, Kaduna, Oyo and Rivers - and the Federal Capital Territory have very high vulnerability, 17 states have high vulnerability and 13 states have medium vulnerability to COVID-19 transmission. Several drivers show a strong association with COVID-19 with the coefficient of correlation ranging from 0.983 - 0.995. The regression analysis indicates that between 96.6 and 99.0 percent of the total variation in the COVID-19 infections across Nigeria can be explained by the predictors. CONCLUSION the spatial pattern of infection across the states are substantially consistent with the predicted pattern of vulnerability.
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Affiliation(s)
- Mayowa Johnson Fasona
- Department of Geography, Faculty of Social Sciences, University of Lagos, Lagos, Nigeria
| | - Chukwuma John Okolie
- Department of Surveying and Geoinformatics, Faculty of Engineering, University of Lagos, Lagos, Nigeria
| | - Adebayo Akeem Otitoloju
- Department of Zoology, Ecotoxicology and Conservation Unit, Faculty of Science, University of Lagos, Lagos, Nigeria
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Shrestha S, Reja M, Gomes I, Baik Y, Pennington J, Islam S, Jamil Faisel A, Cordon O, Roy T, Suarez PG, Hussain H, Dowdy DW. Quantifying geographic heterogeneity in TB incidence and the potential impact of geographically targeted interventions in South and North City Corporations of Dhaka, Bangladesh: a model-based study. Epidemiol Infect 2021; 149:e106. [PMID: 33866998 PMCID: PMC8161375 DOI: 10.1017/s0950268821000832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/16/2021] [Accepted: 03/30/2021] [Indexed: 11/22/2022] Open
Abstract
In rapidly growing and high-burden urban centres, identifying tuberculosis (TB) transmission hotspots and understanding the potential impact of interventions can inform future control and prevention strategies. Using data on local demography, TB reports and patient reporting patterns in Dhaka South City Corporation (DSCC) and Dhaka North City Corporation (DNCC), Bangladesh, between 2010 and 2017, we developed maps of TB reporting rates across wards in DSCC and DNCC and identified wards with high rates of reported TB (i.e. 'hotspots') in DSCC and DNCC. We developed ward-level transmission models and estimated the potential epidemiological impact of three TB interventions: active case finding (ACF), mass preventive therapy (PT) and a combination of ACF and PT, implemented either citywide or targeted to high-incidence hotspots. There was substantial geographic heterogeneity in the estimated TB incidence in both DSCC and DNCC: incidence in the highest-incidence wards was over ten times higher than in the lowest-incidence wards in each city corporation. ACF, PT and combined ACF plus PT delivered to 10% of the population reduced TB incidence by a projected 7%-9%, 13%-15% and 19%-23% over five years, respectively. Targeting TB hotspots increased the projected reduction in TB incidence achieved by each intervention 1.4- to 1.8-fold. The geographical pattern of TB notifications suggests high levels of ongoing TB transmission in DSCC and DNCC, with substantial heterogeneity at the ward level. Interventions that reduce transmission are likely to be highly effective and incorporating notification data at the local level can further improve intervention efficiency.
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Affiliation(s)
- Sourya Shrestha
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mehdi Reja
- Challenge TB Project, Interactive Research & Development (IRD), Dhaka, Bangladesh
- Interactive Research & Development (IRD), Dhaka, Bangladesh
| | - Isabella Gomes
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yeonsoo Baik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jeffrey Pennington
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shamiul Islam
- National Tuberculosis Control Program (NTP), Dhaka, Bangladesh
| | - Abu Jamil Faisel
- Challenge TB Project, Interactive Research & Development (IRD), Dhaka, Bangladesh
- Interactive Research & Development (IRD), Dhaka, Bangladesh
| | - Oscar Cordon
- Challenge TB Project, Interactive Research & Development (IRD), Dhaka, Bangladesh
- Challenge TB Project, Management Sciences for Health, Dhaka, Bangladesh
| | - Tapash Roy
- Interactive Research & Development (IRD), Dhaka, Bangladesh
| | | | - Hamidah Hussain
- Interactive Research & Development (IRD) Global, Singapore, Singapore
| | - David W. Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Gwitira I, Karumazondo N, Shekede MD, Sandy C, Siziba N, Chirenda J. Spatial patterns of pulmonary tuberculosis (TB) cases in Zimbabwe from 2015 to 2018. PLoS One 2021; 16:e0249523. [PMID: 33831058 PMCID: PMC8031317 DOI: 10.1371/journal.pone.0249523] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 03/21/2021] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Accurate mapping of spatial heterogeneity in tuberculosis (TB) cases is critical for achieving high impact control as well as guide resource allocation in most developing countries. The main aim of this study was to explore the spatial patterns of TB occurrence at district level in Zimbabwe from 2015 to 2018 using GIS and spatial statistics as a preamble to identifying areas with elevated risk for prioritisation of control and intervention measures. METHODS In this study Getis-Ord Gi* statistics together with SaTscan were used to characterise TB hotspots and clusters in Zimbabwe at district level from 2015 to 2018. GIS software was used to map and visualise the results of cluster analysis. RESULTS Results show that TB occurrence exhibits spatial heterogeneity across the country. The TB hotspots were detected in the central, western and southern part of the country. These areas are characterised by artisanal mining activities as well as high poverty levels. CONCLUSIONS AND RECOMMENDATIONS Results of this study are useful to guide TB control programs and design effective strategies which are important in achieving the United Nations Sustainable Development goals (UNSDGs).
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Affiliation(s)
- Isaiah Gwitira
- Department of Geography Geospatial Sciences and Earth Observation, Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
| | - Norbert Karumazondo
- Department of Geography Geospatial Sciences and Earth Observation, Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
| | - Munyaradzi Davis Shekede
- Department of Geography Geospatial Sciences and Earth Observation, Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
| | - Charles Sandy
- National TB Control Program, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Nicolas Siziba
- National TB Control Program, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Joconiah Chirenda
- Department of Community Medicine, Faculty of Medicine and Health Sciences, Parirenyatwa Hospital, University of Zimbabwe, Harare, Zimbabwe
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Bui DP, Chandran SS, Oren E, Brown HE, Harris RB, Knight GM, Grandjean L. Community transmission of multidrug-resistant tuberculosis is associated with activity space overlap in Lima, Peru. BMC Infect Dis 2021; 21:275. [PMID: 33736597 PMCID: PMC7977184 DOI: 10.1186/s12879-021-05953-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Transmission of multidrug-resistant tuberculosis (MDRTB) requires spatial proximity between infectious cases and susceptible persons. We assess activity space overlap among MDRTB cases and community controls to identify potential areas of transmission. Methods We enrolled 35 MDRTB cases and 64 TB-free community controls in Lima, Peru. Cases were whole genome sequenced and strain clustering was used as a proxy for transmission. GPS data were gathered from participants over seven days. Kernel density estimation methods were used to construct activity spaces from GPS locations and the utilization distribution overlap index (UDOI) was used to quantify activity space overlap. Results Activity spaces of controls (median = 35.6 km2, IQR = 25.1–54) were larger than cases (median = 21.3 km2, IQR = 17.9–48.6) (P = 0.02). Activity space overlap was greatest among genetically clustered cases (mean UDOI = 0.63, sd = 0.67) and lowest between cases and controls (mean UDOI = 0.13, sd = 0.28). UDOI was positively associated with genetic similarity of MDRTB strains between case pairs (P < 0.001). The odds of two cases being genetically clustered increased by 22% per 0.10 increase in UDOI (OR = 1.22, CI = 1.09–1.36, P < 0.001). Conclusions Activity space overlap is associated with MDRTB clustering. MDRTB transmission may be occurring in small, overlapping activity spaces in community settings. GPS studies may be useful in identifying new areas of MDRTB transmission. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-05953-8.
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Affiliation(s)
- David P Bui
- Department of Epidemiology and Biostatistics, The University of Arizona, Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave., Tucson, AZ, 85724, USA
| | - Shruthi S Chandran
- The London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Eyal Oren
- San Diego State University, School of Public Health, 5500 Campanile Drive, San Diego, California, 92182, USA
| | - Heidi E Brown
- Department of Epidemiology and Biostatistics, The University of Arizona, Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave., Tucson, AZ, 85724, USA
| | - Robin B Harris
- Department of Epidemiology and Biostatistics, The University of Arizona, Mel and Enid Zuckerman College of Public Health, 1295 N Martin Ave., Tucson, AZ, 85724, USA
| | - Gwenan M Knight
- The London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Louis Grandjean
- Universidad Peruana Cayetano Heredia, Lima, Peru. .,Institute of Child Health, University College London, 30 Guilford Street, London, UK.
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Using Bayesian spatial models to map and to identify geographical hotspots of multidrug-resistant tuberculosis in Portugal between 2000 and 2016. Sci Rep 2020; 10:16646. [PMID: 33024245 PMCID: PMC7538940 DOI: 10.1038/s41598-020-73759-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 09/11/2020] [Indexed: 11/21/2022] Open
Abstract
Multidrug-resistant tuberculosis (MDR-TB) is a major threat to the eradication of tuberculosis. TB control strategies need to be adapted to the necessities of different countries and adjusted in high-risk areas. In this study, we analysed the spatial distribution of the MDR- and non-MDR-TB cases across municipalities in Continental Portugal between 2000 and 2016. We used Bayesian spatial models to estimate age-standardized notification rates and standardized notification ratios in each area, and to delimitate high- and low-risk areas, those whose standardized notification ratio is significantly above or below the country’s average, respectively. The spatial distribution of MDR- and non-MDR-TB was not homogeneous across the country. Age-standardized notification rates of MDR-TB ranged from 0.08 to 1.20 and of non-MDR-TB ranged from 7.73 to 83.03 notifications per 100,000 population across the municipalities. We identified 36 high-risk areas for non-MDR-TB and 8 high-risk areas for MDR-TB, which were simultaneously high-risk areas for non-MDR-TB. We found a moderate correlation (ρ = 0.653; 95% CI 0.457–0.728) between MDR- and non-MDR-TB standardized notification ratios. We found heterogeneity in the spatial distribution of MDR-TB across municipalities and we identified priority areas for intervention against TB. We recommend including geographical criteria in the application of molecular drug resistance to provide early MDR-TB diagnosis, in high-risk areas.
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Trauer JM, Dodd PJ, Gomes MGM, Gomez GB, Houben RMGJ, McBryde ES, Melsew YA, Menzies NA, Arinaminpathy N, Shrestha S, Dowdy DW. The Importance of Heterogeneity to the Epidemiology of Tuberculosis. Clin Infect Dis 2020; 69:159-166. [PMID: 30383204 PMCID: PMC6579955 DOI: 10.1093/cid/ciy938] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/31/2018] [Indexed: 12/23/2022] Open
Abstract
Although less well-recognized than for other infectious diseases, heterogeneity is a defining feature of tuberculosis (TB) epidemiology. To advance toward TB elimination, this heterogeneity must be better understood and addressed. Drivers of heterogeneity in TB epidemiology act at the level of the infectious host, organism, susceptible host, environment, and distal determinants. These effects may be amplified by social mixing patterns, while the variable latent period between infection and disease may mask heterogeneity in transmission. Reliance on notified cases may lead to misidentification of the most affected groups, as case detection is often poorest where prevalence is highest. Assuming that average rates apply across diverse groups and ignoring the effects of cohort selection may result in misunderstanding of the epidemic and the anticipated effects of control measures. Given this substantial heterogeneity, interventions targeting high-risk groups based on location, social determinants, or comorbidities could improve efficiency, but raise ethical and equity considerations.
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Affiliation(s)
- James M Trauer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter J Dodd
- Health Economic and Decision Science, University of Sheffield, United Kingdom
| | - M Gabriela M Gomes
- Liverpool School of Tropical Medicine, United Kingdom.,CIBIO-InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, Portugal
| | - Gabriela B Gomez
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Rein M G J Houben
- Tuberculosis Centre, London School of Hygiene and Tropical Medicine, United Kingdom.,Infectious Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Emma S McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland
| | - Yayehirad A Melsew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Nicolas A Menzies
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Nimalan Arinaminpathy
- Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, United Kingdom
| | - Sourya Shrestha
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - David W Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Robsky KO, Kitonsa PJ, Mukiibi J, Nakasolya O, Isooba D, Nalutaaya A, Salvatore PP, Kendall EA, Katamba A, Dowdy D. Spatial distribution of people diagnosed with tuberculosis through routine and active case finding: a community-based study in Kampala, Uganda. Infect Dis Poverty 2020; 9:73. [PMID: 32571435 PMCID: PMC7310105 DOI: 10.1186/s40249-020-00687-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 06/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Routine tuberculosis (TB) notifications are geographically heterogeneous, but their utility in predicting the location of undiagnosed TB cases is unclear. We aimed to identify small-scale geographic areas with high TB notification rates based on routinely collected data and to evaluate whether these areas have a correspondingly high rate of undiagnosed prevalent TB. METHODS We used routinely collected data to identify geographic areas with high TB notification rates and evaluated the extent to which these areas correlated with the location of undiagnosed cases during a subsequent community-wide active case finding intervention in Kampala, Uganda. We first enrolled all adults who lived within 35 contiguous zones and were diagnosed through routine care at four local TB Diagnosis and Treatment Units. We calculated average monthly TB notification rates in each zone and defined geographic areas of "high risk" as zones that constituted the 20% of the population with highest notification rates. We compared the observed proportion of TB notifications among residents of these high-risk zones to the expected proportion, using simulated estimates based on population size and random variation alone. We then evaluated the extent to which these high-risk zones identified areas with high burdens of undiagnosed TB during a subsequent community-based active case finding campaign using a chi-square test. RESULTS We enrolled 45 adults diagnosed with TB through routine practices and who lived within the study area (estimated population of 49 527). Eighteen zones reported no TB cases in the 9-month period; among the remaining zones, monthly TB notification rates ranged from 3.9 to 39.4 per 100 000 population. The five zones with the highest notification rates constituted 62% (95% CI: 47-75%) of TB cases and 22% of the population-significantly higher than would be expected if population size and random chance were the only determinants of zone-to-zone variation (48%, 95% simulation interval: 40-59%). These five high-risk zones accounted for 42% (95% CI: 34-51%) of the 128 cases detected during the subsequent community-based case finding intervention, which was significantly higher than the 22% expected by chance (P < 0.001) but lower than the 62% of cases notified from those zones during the pre-intervention period (P = 0.02). CONCLUSIONS There is substantial heterogeneity in routine TB notification rates at the zone level. Using facility-based TB notification rates to prioritize high-yield areas for active case finding could double the yield of such case-finding interventions.
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Affiliation(s)
- Katherine O Robsky
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. .,Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda.
| | - Peter J Kitonsa
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - James Mukiibi
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - Olga Nakasolya
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - David Isooba
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - Annet Nalutaaya
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - Phillip P Salvatore
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily A Kendall
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda.,Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Achilles Katamba
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda.,Department of Medicine, Clinical Epidemiology and Biostatistics Unit, Makerere University, College of Health Sciences, Kampala, Uganda
| | - David Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda.,Johns Hopkins School of Medicine, Baltimore, MD, USA
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Abstract
INTRODUCTION Tuberculosis (TB), a major public health concern in Ethiopia, is distributed heterogeneously across the country. Mapping TB prevalence at national and subnational levels can provide information for designing and implementing control strategies. Data for spatial analysis can be obtained through systematic review of the literature, and spatial prediction can be done by meta-analysis of published data (geospatial meta-analysis). Geospatial meta-analysis can increase the power of spatial analytic models by making use of all available data. It can also provide a means for spatial prediction where new survey data in a given area are sparse or not available. In this report, we present a protocol for a geospatial meta-analysis to investigate the spatial patterns of TB prevalence in Ethiopia. METHODS AND ANALYSIS To conduct this study, a national TB prevalence survey, supplemented with data from a systematic review of published reports, will be used as the source of TB prevalence data. Systematic searching will be conducted in PubMed, Scopus and Web of Science for studies published up to 15 April 2020 to identify all potential publications reporting TB prevalence in Ethiopia. Data for covariates for multivariable analysis will be obtained from different, readily available sources. Extracted TB survey and covariate data will be georeferenced to specific locations or the centroids of small administrative areas. A binomial logistic regression model will be fitted to TB prevalence data using both fixed covariate effects and random geostatistical effects based on the approach of model-based geostatistics. Markov Chain Monte Carlo simulation will be conducted to obtained posterior parameter estimations, including spatially predicted prevalence. ETHICS AND DISSEMINATION Ethical approval will not be required for this study as it will be based on deidentified, aggregate published data. The final report of this review will be disseminated through publication in a peer-reviewed scientific journal and will also be presented at relevant conferences.
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Affiliation(s)
- Kefyalew Addis Alene
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Zeleke Alebachew Wagaw
- National Tuberculosis Control Programme, Ghana Health Service, Accra, Greater Accra, Ghana
| | - Archie C A Clements
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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Chirenda J, Gwitira I, Warren RM, Sampson SL, Murwira A, Masimirembwa C, Mateveke KM, Duri C, Chonzi P, Rusakaniko S, Streicher EM. Spatial distribution of Mycobacterium Tuberculosis in metropolitan Harare, Zimbabwe. PLoS One 2020; 15:e0231637. [PMID: 32315335 PMCID: PMC7173793 DOI: 10.1371/journal.pone.0231637] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/29/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The contribution of high tuberculosis (TB) transmission pockets in propagating area-wide transmission has not been adequately described in Zimbabwe. This study aimed to describe the presence of hotspot transmission of TB cases in Harare city from 2011 to 2012 using geospatial techniques. METHODS Anonymised TB patient data stored in an electronic database at Harare City Health department was analysed using geospatial methods. Confirmed TB cases were mapped using geographic information system (GIS). Global Moran's I and Anselin Local Moran's I (LISA) were used to assess clustering and the local Getis-Ord Gi* was used to estimate hotspot phenomenon of TB cases in Harare City for the period between 2011 and 2012. RESULTS A total of 12,702 TB cases were accessed and mapped on the Harare City map. In both 2011 and 2012, ninety (90%) of cases were new and had a high human immunodeficiency virus (HIV)/TB co-infection rate of 72% across all suburbs. Tuberculosis prevalence was highest in the Southern district in both 2011 and 2012. There were pockets of spatial distribution of TB prevalence across West South West, Southern, Western, South Western and Eastern health districts. TB hot spot occurrence was restricted to the West South West, parts of South Western, Western health districts. West South West district had an increased peri-urban population with inadequate social services including health facilities. These conditions were conducive for increased intensity of TB occurrence, a probable indication of high transmission especially in the presence of high HIV co-infection. CONCLUSIONS AND RECOMMENDATIONS Increased TB transmission was limited to a health district with high informal internal migrants with limited health services in Harare City. To minimise spread of TB into greater Harare, there is need to improve access to TB services in the peri-urban areas.
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Affiliation(s)
- Joconiah Chirenda
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
- Division of Molecular Biology and Human Genetics, NRF/DST Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Isaiah Gwitira
- Department of Geography and Environmental Science, University of Zimbabwe, Harare, Zimbabwe
| | - Robin M. Warren
- Division of Molecular Biology and Human Genetics, NRF/DST Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Samantha L. Sampson
- Division of Molecular Biology and Human Genetics, NRF/DST Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Amon Murwira
- Department of Geography and Environmental Science, University of Zimbabwe, Harare, Zimbabwe
| | - Collen Masimirembwa
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
- African Institute of Biomedical Science & Technology Wilkins Hospital, Cnr J.Tongogara and R. Tangwena, Harare, Zimbabwe
| | - Kudzanai M. Mateveke
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Cremence Duri
- Department of Health, Harare City Council, Harare, Zimbabwe
| | - Prosper Chonzi
- Department of Health, Harare City Council, Harare, Zimbabwe
| | - Simbarashe Rusakaniko
- Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Elizabeth M. Streicher
- Division of Molecular Biology and Human Genetics, NRF/DST Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Carrasco-Escobar G, Schwalb A, Tello-Lizarraga K, Vega-Guerovich P, Ugarte-Gil C. Spatio-temporal co-occurrence of hotspots of tuberculosis, poverty and air pollution in Lima, Peru. Infect Dis Poverty 2020; 9:32. [PMID: 32204735 PMCID: PMC7092495 DOI: 10.1186/s40249-020-00647-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 03/05/2020] [Indexed: 12/03/2022] Open
Abstract
Growing evidence suggests pollution and other environmental factors have a role in the development of tuberculosis (TB), however, such studies have never been conducted in Peru. Considering the association between air pollution and specific geographic areas, our objective was to determine the spatial distribution and clustering of TB incident cases in Lima and their co-occurrence with clusters of fine particulate matter (PM2.5) and poverty. We found co-occurrences of clusters of elevated concentrations of air pollutants such as PM2.5, high poverty indexes, and high TB incidence in Lima. These findings suggest an interplay of socio-economic and environmental in driving TB incidence.
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Affiliation(s)
- Gabriel Carrasco-Escobar
- Health Innovation Lab, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- Division of Infectious Diseases, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Alvaro Schwalb
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kelly Tello-Lizarraga
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Cesar Ugarte-Gil
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
- TB Centre, London School of Hygiene and Tropical Medicine, London, UK.
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Poojar B, Shenoy KA, Naik PR, Kamath A, Tripathy JP, Mithra PP, Chowta MN, Badarudeen MN, Nagalakshmi N, Sharma V, Shamanewadi AN, Thekkur P. Spatiotemporal analysis of drug-resistant TB patients registered in selected districts of Karnataka, South India: a cross-sectional study. Trop Med Health 2020; 48:15. [PMID: 32180685 PMCID: PMC7063724 DOI: 10.1186/s41182-020-00199-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 02/27/2020] [Indexed: 12/02/2022] Open
Abstract
Background Tuberculosis (TB) depicts heterogeneous spatial patterns with geographical aggregation of TB cases due to either ongoing person-to-person transmission or reactivation of latent infection in a community sharing risk factor. In this regard, we aimed to assess the spatiotemporal aggregation of drug-resistant TB (DR-TB) patients notified to the national TB program (NTP) from 2015 to 2018 in selected districts of Karnataka, South India. Methods This was a cross-sectional study among DR-TB patients notified from Dakshina Kannada, Udupi, and Chikamagalur districts of the state of Karnataka. Clinico-demographic details were extracted from treatment cards. The registered addresses of the patients were geocoded (latitude and longitude) using Google Earth. Using the QGIS software, spot map, heat maps and grid maps 25 km2 with more than the expected count of DR-TB patients were constructed. Results Of the total 507 patients studied, 376 (74%) were males and the mean (standard deviation) age of the study participants was 41.4 (13.9) years. From 2015 to 2018, the number of patients increased from 85 to 209 per year, the area of aggregation in square kilometers increased from 113.6 to 205.7, and the number of rectangular grids with more than the expected DR-TB patients (> 1) increased from 12 to 47. Conclusions The increase in the number of DR-TB patients, area of aggregation, and grids with more than the expected count is a cause for concern. The NTP can use routine programmatic data to develop maps to identify areas of aggregation of disease for targeted TB control activities.
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Affiliation(s)
- Basavaraj Poojar
- 1Department of Pharmacology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
| | - K Ashok Shenoy
- 1Department of Pharmacology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
| | - Poonam R Naik
- 2Department of Community Medicine, Yenepoya Medical College, Mangalore, Yenepoya (Deemed to be University), Mangalore, Karnataka India
| | - Ashwin Kamath
- 1Department of Pharmacology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
| | - Jaya Prasad Tripathy
- 3Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
| | - P Prasanna Mithra
- 4Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
| | - Mukta N Chowta
- 1Department of Pharmacology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
| | | | - Narasimhaswamy Nagalakshmi
- 6Department of Microbiology, Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, India.,7Department of Microbiology and Immunology, College of Medicine, American University of Antigua, St John's, Antigua and Barbuda
| | - Vivek Sharma
- Tuberculosis Health Action and Learning Initiative (THALI), JSI India, New Delhi, West Bengal India
| | - Amrita N Shamanewadi
- Department of Community Medicine, MVJ Medical College and Research Hospital (MVJ&MCRH) Hoskote, Bangalore, India
| | - Pruthu Thekkur
- 3Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
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Proud Tembo NF, Bwalya Muma J, Hang’ombe B, Munyeme M. Clustering and spatial heterogeneity of bovine tuberculosis at the livestock/wildlife interface areas in Namwala District of Zambia. Vet World 2020; 13:478-488. [PMID: 32367953 PMCID: PMC7183465 DOI: 10.14202/vetworld.2020.478-488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 01/29/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND AIM Bovine tuberculosis (bTB) remains a major public health issue in Zambia and has been exacerbated by human immunodeficiency virus prevalence and consumption of unpasteurized milk in the Southern Province of the country. The prevalence of bTB has been established to be linked to Kafue Lechwe, which act as reservoir hosts and share grazing fields with domestic cattle. No studies have so far used geographic information system (GIS) to investigate the relationship between the reservoir hosts (Kafue Lechwe) and domestic animals. This study, therefore, aimed to apply GIS to investigate the spatial distribution of bTB in Namwala District of the Southern Province of the country. MATERIALS AND METHODS To investigate the spatial distribution of bTB, geographical positioning system (GPS) coordinates representing 96 cattle herds across 20 independent villages were captured alongside risk factor data. The 96 herds were based on abattoir reports of condemned carcasses and a trace back. Positive herds were confirmed by cross-reference to purified protein derivative tests conducted by the District Veterinary Office. The GPS coordinates were transferred into ArcView 3.2 and laid on the map of Namwala District alongside physical features, including national parks, game management areas, and flood plains. Questionnaires were administered across 96 independent households to assess risk factors of bTB transmission. RESULTS The results revealed a "clustered" spatial distribution of the disease in cattle in Namwala District of Zambia, particularly significant in the eastern interface areas of the district (p=0.006 using Moran's I). Abattoir to production area trace back revealed a herd-level prevalence of 36.4% (95% CI=26.7-46.3%) among cattle herds in Namwala District, whereas individual animal prevalence ranged from 0% to 14% (95% CI=2.4-26.2%). Further, GPS data indicated that the majority of the positive herds were located at the livestock/wildlife interface area. Contacts with wildlife, coupled with sharing grazing, and watering points were found to be significant risk factors for bTB transmission. CONCLUSION This study demonstrated the presence of bTB in cattle and associated spatial risk factors. In particular, bTB was observed to be a function of animal location within the livestock/wildlife interface area. GIS is thus an applicable and important tool in studying disease distribution.
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Affiliation(s)
- Novan Fully Proud Tembo
- Department of Public Health, School of Health Sciences, University of Lusaka, Lusaka, Zambia
| | - John Bwalya Muma
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
| | - Bernard Hang’ombe
- Department of Paraclinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
| | - Musso Munyeme
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka 10101, Zambia
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Romanyukha AA, Karkach AS, Borisov SE, Belilovsky EM, Sannikova TE, Krivorotko OI. Small-scale stable clusters of elevated tuberculosis incidence in Moscow, 2000–2015: Discovery and spatiotemporal analysis. Int J Infect Dis 2020; 91:156-161. [DOI: 10.1016/j.ijid.2019.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/12/2019] [Accepted: 11/15/2019] [Indexed: 11/25/2022] Open
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