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Cabral BVB, Monte GLA, Vasconcelos MN, Maranhão TA, Sousa GJB, Pereira MLD. Spatial patterns and factors associated with the incidence of tuberculosis-diabetes in Brazil. Public Health 2024; 233:149-156. [PMID: 38897067 DOI: 10.1016/j.puhe.2024.05.023] [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: 11/27/2023] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES The aim of this study was to analyse the spatial patterns and factors associated with the incidence of tuberculosis-diabetes (TB-DM) in Brazil, from 2001 to 2019. STUDY DESIGN Ecological study. METHODS Brazilian municipalities were used as the units of analysis. The local empirical Bayesian rate and the spatial autocorrelation test were calculated. Moran and Getis-Ord Gi∗ were used to identify spatial clusters, and spatially weighted regression was conducted. RESULTS In total, 75,021 new cases of TB associated with DM were reported in Brazil during the study period. Most Brazilian municipalities had an average TB-DM incidence of 1.0-2.0/100,000 inhabitants. The regression showed that the Gini index (β = 0.85) and family health strategy coverage (β = -0.26) were the two indicators that had the most influence on TB-DM incidence in Brazil. CONCLUSIONS This study identified spatial clusters of TB-DM in Brazil. The results also indicated that social inequalities played a key role in the incidence of TB.
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Affiliation(s)
- B V B Cabral
- Health Sciences Centre, State University of Ceará, Fortaleza, Ceará, Brazil.
| | - G L A Monte
- Health Sciences Centre, State University of Ceará, Fortaleza, Ceará, Brazil
| | - M N Vasconcelos
- Health Sciences Centre, State University of Ceará, Fortaleza, Ceará, Brazil
| | - T A Maranhão
- State University of Piauí, Teresina, Piauí, Brazil
| | | | - M L D Pereira
- Health Sciences Centre, State University of Ceará, Fortaleza, Ceará, Brazil
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Lai P, Cai W, Qu L, Hong C, Lin K, Tan W, Zhao Z. Pulmonary Tuberculosis Notification Rate Within Shenzhen, China, 2010-2019: Spatial-Temporal Analysis. JMIR Public Health Surveill 2024; 10:e57209. [PMID: 38875687 PMCID: PMC11214025 DOI: 10.2196/57209] [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: 02/08/2024] [Revised: 03/05/2024] [Accepted: 05/07/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Pulmonary tuberculosis (PTB) is a chronic communicable disease of major public health and social concern. Although spatial-temporal analysis has been widely used to describe distribution characteristics and transmission patterns, few studies have revealed the changes in the small-scale clustering of PTB at the street level. OBJECTIVE The aim of this study was to analyze the temporal and spatial distribution characteristics and clusters of PTB at the street level in the Shenzhen municipality of China to provide a reference for PTB prevention and control. METHODS Data of reported PTB cases in Shenzhen from January 2010 to December 2019 were extracted from the China Information System for Disease Control and Prevention to describe the epidemiological characteristics. Time-series, spatial-autocorrelation, and spatial-temporal scanning analyses were performed to identify the spatial and temporal patterns and high-risk areas at the street level. RESULTS A total of 58,122 PTB cases from 2010 to 2019 were notified in Shenzhen. The annual notification rate of PTB decreased significantly from 64.97 per 100,000 population in 2010 to 43.43 per 100,000 population in 2019. PTB cases exhibited seasonal variations with peaks in late spring and summer each year. The PTB notification rate was nonrandomly distributed and spatially clustered with a Moran I value of 0.134 (P=.02). One most-likely cluster and 10 secondary clusters were detected, and the most-likely clustering area was centered at Nanshan Street of Nanshan District covering 6 streets, with the clustering time spanning from January 2010 to November 2012. CONCLUSIONS This study identified seasonal patterns and spatial-temporal clusters of PTB cases at the street level in the Shenzhen municipality of China. Resources should be prioritized to the identified high-risk areas for PTB prevention and control.
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Affiliation(s)
- Peixuan Lai
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Weicong Cai
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Lin Qu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chuangyue Hong
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Kaihao Lin
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Weiguo Tan
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Zhiguang Zhao
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
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Ribeiro LM, Figueira JNR, de Abreu AM, Araújo AVEC, de Brito PV, Sousa GJB, Maranhão TA, Pereira MLD. [Temporal pattern, spatial distribution, and factors associated with the incidence of HIV/AIDS among young people in BrazilPatrón temporal, distribución espacial y factores asociados a la incidencia de la infección por el VIH/sida en jóvenes en Brasil]. Rev Panam Salud Publica 2024; 48:e52. [PMID: 38859811 PMCID: PMC11164240 DOI: 10.26633/rpsp.2024.52] [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: 10/30/2023] [Accepted: 03/01/2024] [Indexed: 06/12/2024] Open
Abstract
Objective To describe temporal and spatial patterns and identify the factors associated with the incidence of HIV/AIDS among young people in Brazil. Method Ecological study of young Brazilians aged 15-24 years with reported HIV/AIDS, from 2001 to 2021. The Joinpoint method was used for the temporal analysis. Spatial clusters were detected using Bayesian methods, spatial autocorrelation, Getis-Ord Gi*, and scan techniques. Four non-spatial and spatial regression models were used to identify factors associated with the result. All statistical analyses considered p < 0.05. Results In Brazil, the average incidence was 12.29 per 100 000 inhabitants, with an annual increase of 7.3% in the period 2007-2014 and a subsequent 3.4% decrease in 2014-2021. A high-high pattern and hotspots were observed, mainly in municipalities in the South, Southeast, Central-West, and North regions. The primary cluster was located in 572 municipalities in Rio Grande do Sul and Santa Catarina, with the highest relative risks in Manaus (Amazonas) and Rondonópolis (Mato Grosso). The illiteracy rate (β = -0.08), GINI Index (β = -3.74) and Family Health Strategy coverage (β = -0.70) were negatively associated with the result. In contrast, the Firjan Municipal Development Index (β = 2.37), Social Vulnerability Index (β = 6.30), percentage of Bolsa Família recipients (β = 0.04), and per capita income (β = 0.008) showed a positive association. Conclusion There was an upward trend in the incidence of HIV/AIDS until 2014, followed by a decline until 2021. High-rate clusters were concentrated in municipalities in the North, South, Southeast and Central-West regions in particular. Indicators of socioeconomic vulnerability had positive or negative effects on the result, depending on the territory investigated.
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Affiliation(s)
- Leonardo Miranda Ribeiro
- Universidade Estadual do CearáFortalezaCEBrasilUniversidade Estadual do Ceará, Fortaleza, CE, Brasil
| | | | - Aline Miranda de Abreu
- Universidade Estadual do PiauíParnaíbaPIBrasilUniversidade Estadual do Piauí, Parnaíba, PI, Brasil
| | | | - Poliana Veras de Brito
- Universidade Estadual do PiauíParnaíbaPIBrasilUniversidade Estadual do Piauí, Parnaíba, PI, Brasil
| | - George Jó Bezerra Sousa
- Universidade Estadual do CearáFortalezaCEBrasilUniversidade Estadual do Ceará, Fortaleza, CE, Brasil
| | - Thatiana Araújo Maranhão
- Universidade Estadual do PiauíParnaíbaPIBrasilUniversidade Estadual do Piauí, Parnaíba, PI, Brasil
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Alves YM, Berra TZ, Tavares RBV, Popolin MAP, da Costa FBP, de Jezus SV, Ferezin LP, Tártaro AF, Serrano-Gallardo MDP, Pinto IC, Maciel ELN, Arcêncio RA. International Migration, Refugees, and Spread of Tuberculosis in Brazil: Analysis of Clusters, Trends, and Associated Factors (2010-2021). Trop Med Infect Dis 2024; 9:82. [PMID: 38668543 PMCID: PMC11053982 DOI: 10.3390/tropicalmed9040082] [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: 03/07/2024] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND International migration is a global phenomenon with significant implications on the health-disease process due to exposures along transit routes and local/destination epidemiological indicators. We aimed to analyze the transmission and spread of tuberculosis among international migrants and refugees from a spatiotemporal perspective and the associated factors. METHOD This was an ecological study of cases of tuberculosis in international migrants in Brazil, between 2010 and 2021. Annual incidence rates were calculated and spatiotemporal scan techniques were used to identify municipalities at risk. Multiple logistic regression was used to identify factors associated with tuberculosis in international migrants. RESULTS A total of 4037 cases of tuberculosis were reported in Brazil in international migrants. Municipalities at risk for this event were identified using the spatiotemporal scan technique, and a cluster was identified with ITT: +52.01% and ETT: +25.60%. A higher probability of TB infection was identified in municipalities with a TB incidence rate >14.40 cases/100 inhabitants, population >11,042 inhabitants, Gini index >0.49, and illiteracy rate >13.12%. A lower probability was found in municipalities with average per capita household income >BRL 456.43. CONCLUSIONS It is recommended that health authorities implement monitoring and rigorous follow-up in affected areas to ensure proper diagnosis and treatment completion for international migrants, preventing disease spread to other communities.
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Affiliation(s)
- Yan Mathias Alves
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | - Thaís Zamboni Berra
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | - Reginaldo Bazon Vaz Tavares
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | - Marcela Antunes Paschoal Popolin
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
- Nursing Department, Federal University of Tocantins, Palmas 77001-090, Brazil
| | - Fernanda Bruzadelli Paulino da Costa
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | - Sonia Vivian de Jezus
- Instituto de Ciências da Saúde, Federal University of Mato Grosso, Sinop 78550-728, Brazil
| | - Letícia Perticarrara Ferezin
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | - Ariela Fehr Tártaro
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | | | - Ione Carvalho Pinto
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
| | - Ethel Leonor Noia Maciel
- Ministry of Health, Secretary of Health Surveillance and Environment, Brasília 70058-900, Brazil;
| | - Ricardo Alexandre Arcêncio
- Ribeirão Preto College of Nursing, University of São Paulo, São Paulo 14040-902, Brazil; (T.Z.B.); (R.B.V.T.); (M.A.P.P.); (F.B.P.d.C.); (L.P.F.); (A.F.T.); (R.A.A.)
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de Lima RS, da Silva RN, André SR, Pinheiro AKC, Sousa AI, da Silva IFS, dos Santos J, Nogueira LMV, Zeitoune RCG. Mycobacterium tuberculosis latent infection in healthcare students: systematic review of prevalence. Rev Esc Enferm USP 2024; 58:e20230238. [PMID: 38488508 PMCID: PMC10941757 DOI: 10.1590/1980-220x-reeusp-2023-0238en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/12/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE The aim of this study was to synthesize the evidence on the prevalence of latent Mycobacterium tuberculosis infection (LTBI) among undergraduate health care students. METHODS A systematic review of prevalence with meta-analysis was conducted. Prospective and retrospective cohorts and cross-sectional studies involving probable exposure to M. tuberculosis during undergraduate education, along with the tuberculin skin test (TST) or interferon-γ release assay (IGRA) for investigation of latent tuberculosis were searched. Searches were conducted in MEDLINE, CINAHL, EMBASE, LILACS, Scopus, and Web of Science databases. Independent reviewers were responsible for the selection and inclusion of studies. Data were extracted, critically appraised, and synthesized using the JBI approach. PRISMA was used to report the study. RESULTS Twenty-two studies were analyzed. The overall prevalence in healthcare undergraduate students was 12.53%. CONCLUSION The prevalence of LTBI in undergraduate health students was high for such a highly educated population. Screening with TST and/or IGRA and chemoprophylaxis, when necessary, should be provided to undergraduate health students when in contact with respiratory symptomatic patients.
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Affiliation(s)
- Renata Silva de Lima
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna
Nery, Rio de Janeiro, RJ, Brazil
| | | | - Suzana Rosa André
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna
Nery, Rio de Janeiro, RJ, Brazil
| | | | - Ana Inês Sousa
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna
Nery, Rio de Janeiro, RJ, Brazil
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Rocha MIF, Maranhão TA, da Frota MMC, de Araujo TKA, Veras e Silva WWS, Sousa GJB, Duarte Pereira ML, de Araujo Filho ACA. [Mortality from neglected tropical ciseases in Brazil in the 21st Century: Analysis of spatial and temporal trends and associated factorsMortalidad por enfermedades tropicales desatendidas en Brasil en el siglo XXI: análisis de tendencias espaciales y temporales y factores asociados]. Rev Panam Salud Publica 2023; 47:e146. [PMID: 37881800 PMCID: PMC10597395 DOI: 10.26633/rpsp.2023.146] [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: 03/07/2023] [Accepted: 07/11/2023] [Indexed: 10/27/2023] Open
Abstract
Objective To analyze the spatial-temporal distribution and factors associated with mortality from neglected tropical diseases (NTDs) in Brazil from 2000 to 2019. Method We performed an ecological study to analyze NTD-related deaths recorded in the Ministry of Health Mortality Information System (SIM). For the temporal analysis, the joinpoint method was used. Spatial dependence was analyzed using global Moran and local Getis-Ord Gi* indices. Four non-spatial and spatial regression models were used to identify factors associated with mortality. Results The mean mortality rate from NTDs in Brazil during the study period was 3.32 deaths per 100 000 inhabitants, with the highest rate (8.68 deaths per 100 000 inhabitants) recorded in the Midwest. The most prevalent causes of death were Chagas disease (n = 94 781; 74.9%) and schistosomiasis (n = 10 271; 8.1%). There was a 1.24% reduction (95%CI = -1.6; -0.9; P < 0.001) in NTD-related mortality in Brazil per year. A high/high spatial distribution pattern and hotspots were observed in municipalities in the states of Goiás, Minas Gerais, Bahia, Tocantins, and Piauí. The indicators "population in households with density > 2 people per bedroom" (β = -0.07; P = 0.00) and "municipal human development index" (β = -3.36; P = 0.08) were negatively associated with the outcome, while the "index of social vulnerability" (β = 2.74; P = 0.05) was positively associated with the outcome. Conclusion Lower human development and higher social vulnerability are associated with higher mortality from NTDs, which should guide NTD prevention and control efforts.
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Affiliation(s)
- Maria Izabel Félix Rocha
- Universidade Estadual do Piauí (UESPI)Curso de EnfermagemParnaíba (PI)BrasilUniversidade Estadual do Piauí (UESPI), Curso de Enfermagem, Parnaíba (PI), Brasil.
| | - Thatiana Araujo Maranhão
- Universidade Estadual do Piauí (UESPI)Curso de EnfermagemParnaíba (PI)BrasilUniversidade Estadual do Piauí (UESPI), Curso de Enfermagem, Parnaíba (PI), Brasil.
| | - Maria Madalena Cardoso da Frota
- Universidade Estadual do Piauí (UESPI)Curso de EnfermagemParnaíba (PI)BrasilUniversidade Estadual do Piauí (UESPI), Curso de Enfermagem, Parnaíba (PI), Brasil.
| | - Thalis Kennedy Azevedo de Araujo
- Universidade Estadual do Piauí (UESPI)Curso de EnfermagemParnaíba (PI)BrasilUniversidade Estadual do Piauí (UESPI), Curso de Enfermagem, Parnaíba (PI), Brasil.
| | - Wady Wendler Soares Veras e Silva
- Universidade Estadual do Piauí (UESPI)Curso de EnfermagemParnaíba (PI)BrasilUniversidade Estadual do Piauí (UESPI), Curso de Enfermagem, Parnaíba (PI), Brasil.
| | - George Jó Bezerra Sousa
- Secretaria de Saúde do estado do CearáFortaleza (CE)BrasilSecretaria de Saúde do estado do Ceará, Fortaleza (CE), Brasil.
| | - Maria Lúcia Duarte Pereira
- Universidade Estadual do Ceará (UECE)Programa de Pós-Graduação Cuidados Clínicos em Enfermagem e SaúdeFortaleza (CE)BrasilUniversidade Estadual do Ceará (UECE), Programa de Pós-Graduação Cuidados Clínicos em Enfermagem e Saúde, Fortaleza (CE), Brasil.
| | - Augusto Cezar Antunes de Araujo Filho
- Universidade Estadual do Piauí (UESPI)Curso de EnfermagemFloriano (PI)BrasilUniversidade Estadual do Piauí (UESPI), Curso de Enfermagem, Floriano (PI), Brasil.
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Preuc C, Humayun M, Yang Z. Varied trends of tuberculosis and HIV dual epidemics among different countries during 2000-2020: lessons from an ecological time-trend study of 9 countries. Infect Dis (Lond) 2023; 55:567-575. [PMID: 37345429 DOI: 10.1080/23744235.2023.2223272] [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: 05/02/2023] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND While Human Immunodeficiency Virus (HIV) infection is a well-established risk factor for tuberculosis (TB), the effect of HIV infection on TB incidence varies across countries given differences in local epidemiological factors and disparate progress with respect to TB elimination goals. METHODS In this descriptive epidemiological study, we explored the country-specific associations between HIV prevalence and TB incidence in nine countries representing four WHO regions using data between 2000 and 2020. For each of these countries, we (1) described the trends of TB incidence and HIV prevalence, and (2) examined country-level associations between TB incidence and HIV prevalence, using negative binomial regression. RESULTS The trends of TB incidence and HIV prevalence, and the country-level associations, varied across the study countries. Angola, Thailand and Zimbabwe showed parallel TB incidence and HIV prevalence trends while the two trends diverged in Brazil, Liberia and Indonesia during the study period. Additionally, the strength of association between HIV prevalence and TB incidence varied widely between countries, with the risk ratio ranging from 0.42 (95% CI: 0.36, 0.49) in Indonesia to 2.78 (95% CI: 2.57, 3.02) in Thailand. CONCLUSIONS The association of HIV infection with TB incidence varied across high burden settings, suggesting that HIV is not a ubiquitous driver of TB incidence. Without acknowledging the local drivers of TB epidemics across countries, the END TB Strategy cannot be adapted at the country level. The findings from this analysis can inform the design of future studies to identify country-specific drivers of TB using individual-level data.
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Affiliation(s)
- Chelsi Preuc
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Maheen Humayun
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Zhenhua Yang
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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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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Spatial-temporal analysis of pulmonary tuberculosis in Hubei Province, China, 2011-2021. PLoS One 2023; 18:e0281479. [PMID: 36749779 PMCID: PMC9904469 DOI: 10.1371/journal.pone.0281479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 01/24/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Pulmonary tuberculosis (PTB) is an infectious disease of major public health problem, China is one of the PTB high burden counties in the word. Hubei is one of the provinces having the highest notification rate of tuberculosis in China. This study analyzed the temporal and spatial distribution characteristics of PTB in Hubei province for targeted intervention on TB epidemics. METHODS The data on PTB cases were extracted from the National Tuberculosis Information Management System correspond to population in 103 counties of Hubei Province from 2011 to 2021. The effect of PTB control was measured by variation trend of bacteriologically confirmed PTB notification rate and total PTB notification rate. Time series, spatial autonomic correlation and spatial-temporal scanning methods were used to identify the temporal trends and spatial patterns at county level of Hubei. RESULTS A total of 436,955 cases were included in this study. The total PTB notification rate decreased significantly from 81.66 per 100,000 population in 2011 to 52.25 per 100,000 population in 2021. The peak of PTB notification occurred in late spring and early summer annually. This disease was spatially clustering with Global Moran's I values ranged from 0.34 to 0.63 (P< 0.01). Local spatial autocorrelation analysis indicated that the hot spots are mainly distributed in the southwest and southeast of Hubei Province. Using the SaTScan 10.0.2 software, results from the staged spatial-temporal analysis identified sixteen clusters. CONCLUSIONS This study identified seasonal patterns and spatial-temporal clusters of PTB cases in Hubei province. High-risk areas in southwestern Hubei still exist, and need to focus on and take targeted control and prevention measures.
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Spatial Co-Clustering of Tuberculosis and HIV in Ethiopia. Diseases 2022; 10:diseases10040106. [PMID: 36412600 PMCID: PMC9680430 DOI: 10.3390/diseases10040106] [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: 08/08/2022] [Revised: 11/05/2022] [Accepted: 11/08/2022] [Indexed: 11/19/2022] Open
Abstract
Background: Tuberculosis (TB) and HIV are epidemiologically associated, and their co-dynamics suggest that the two diseases are directly related at the population level and within the host. However, there is no or little information on the joint spatial patterns of the two diseases in Ethiopia. The main objective of the current study was to assess the spatial co-clustering of TB and HIV cases simultaneously in Ethiopia at the district level. Methods: District-level aggregated data collected from the national Health Management Information System (HMIS) for the years 2015 to 2018 on the number of TB cases enrolled in directly observed therapy, short course (DOTS) who were tested for HIV and the number of HIV patients enrolled in HIV care who were screened for TB during their last visit to health care facilities were used in this study. The univariate and bivariate global and local Moran’s I indices were applied to assess the spatial clustering of TB and HIV separately and jointly. Results: The results of this study show that the two diseases were significantly (p-value <0.001) spatially autocorrelated at the district level with minimum and maximum global Moran’s I values of 0.407 and 0.432 for TB, 0.102 and 0.247 for HIV, and 0.152 and 0.251 for joint TB/HIV. The district-level TB/HIV spatial co-clustering patterns in Ethiopia in most cases overlapped with the hot spots of TB and HIV. The TB/HIV hot-spot clusters may appear due to the observed high TB and HIV prevalence rates in the hot-spot districts. Our results also show that there were low-low TB/HIV co-clusters or cold spots in most of the Afar and Somali regions, which consistently appeared for the period 2015−2018. This may be due to very low notifications of both diseases in the regions. Conclusions: This study expanded knowledge about TB and HIV co-clustering in Ethiopia at the district level. The findings provide information to health policymakers in the country to plan geographically targeted and integrated interventions to jointly control TB and HIV.
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Berra TZ, Ramos ACV, Arroyo LH, Delpino FM, de Almeida Crispim J, Alves YM, dos Santos FL, da Costa FBP, dos Santos MS, Alves LS, Fiorati RC, Monroe AA, Gomes D, Arcêncio RA. Risk-prone territories for spreading tuberculosis, temporal trends and their determinants in a high burden city from São Paulo State, Brazil. BMC Infect Dis 2022; 22:515. [PMID: 35655177 PMCID: PMC9161466 DOI: 10.1186/s12879-022-07500-5] [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: 05/31/2021] [Accepted: 05/25/2022] [Indexed: 11/12/2022] Open
Abstract
Objectives To identify risk-prone areas for the spread of tuberculosis, analyze spatial variation and temporal trends of the disease in these areas and identify their determinants in a high burden city. Methods An ecological study was carried out in Ribeirão Preto, São Paulo, Brazil. The population was composed of pulmonary tuberculosis cases reported in the Tuberculosis Patient Control System between 2006 and 2017. Seasonal Trend Decomposition using the Loess decomposition method was used. Spatial and spatiotemporal scanning statistics were applied to identify risk areas. Spatial Variation in Temporal Trends (SVTT) was used to detect risk-prone territories with changes in the temporal trend. Finally, Pearson's Chi-square test was performed to identify factors associated with the epidemiological situation in the municipality. Results Between 2006 and 2017, 1760 cases of pulmonary tuberculosis were reported in the municipality. With spatial scanning, four groups of clusters were identified with relative risks (RR) from 0.19 to 0.52, 1.73, 2.07, and 2.68 to 2.72. With the space–time scan, four clusters were also identified with RR of 0.13 (2008–2013), 1.94 (2010–2015), 2.34 (2006 to 2011), and 2.84 (2014–2017). With the SVTT, a cluster was identified with RR 0.11, an internal time trend of growth (+ 0.09%/year), and an external time trend of decrease (− 0.06%/year). Finally, three risk factors and three protective factors that are associated with the epidemiological situation in the municipality were identified, being: race/brown color (OR: 1.26), without education (OR: 1.71), retired (OR: 1.35), 15 years or more of study (OR: 0.73), not having HIV (OR: 0.55) and not having diabetes (OR: 0.35). Conclusion The importance of using spatial analysis tools in identifying areas that should be prioritized for TB control is highlighted, and greater attention is necessary for individuals who fit the profile indicated as “at risk” for the disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07500-5.
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