Spatial and non-spatial determinants of successful tuberculosis treatment outcomes: An implication of Geographical Information Systems in health policy-making in a developing country (original) (raw)
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Geographical Distribution and Surveillance of Tuberculosis (TB) Using Spatial Statistics
International Journal of Applied Geospatial Research, 2013
Socio-demographic and health indices vary across the administrative units in a country. Thus, reported morbidity and mortality figures vary and inter/intra state comparison becomes a challenge. To handle such issues and administer a centralized health management system, identifying disease clusters and providing services to high risk population become important. Exploring a small part of the immense potential of geographic information systems (GIS) in centralized health management, this study presents a method of generating effective information for proper health management at local level. Such information is important for infectious diseases like tuberculosis (TB). The present paper discusses quarterly GIS mapping and assessment of TB in 1,965 villages of Almora district, Uttarakhand, India from 2003 to 2008. The values for Morbidity Rate (MBR) are depicted in risk maps for each quarter. Moran's I indices were used to estimate the global spatial autocorrelation between the morbidity rates. Local Moran's I (LISA) was used to detect spatial clusters and outliers, and for the prediction of hotspots of the disease. The result of this study has the potential to reflect a realistic assessment of the disease situation at the local level. Future work on this study can be utilized for planning and policy framework related to TB and other diseases.
International Journal of Computer Applications
Analyzing the spatiotemporal distribution of tuberculosis (TB) is a very important way to understand its epidemiology thereby helping to identify geographic regions at higher risk and to enable proper control and resource allocation. This study was undertaken to ascertain the spatiotemporal distribution of TB cases and treatment outcomes in the Birim Central Municipality (BCM) in the Eastern Region (E/R) of Ghana for the period 2012-2016 and to recommend appropriate preventive measures. In this retrospective study, the locations of the total of 268 TB cases identified from 2012-2016 were geocoded on the BCM digital maps. Spatial visualization using choropleth maps, network analysis, and service area analysis of ArcGIS10.2 was used to identify the geographic concentration of cases and the various treatment outcomes as well as proximity of patient community to health facility. A questionnaire was also used to collect primary data from TB patients diagnosed in year 2017. This data was analyzed using SPSS version 21. The study identified five main communities as hot spots of TB in the municipality with variations in other communities. It was also found that other non-spatial factors such as socioeconomic factors and stigmatization highly influence treatment outcome. Reducing stigmatization, regular sensitization of health staff who are not directly involved in tuberculosis care, and using a formerly cured TB patient as a peer educator were some of the best ways identified to help improve positive treatment outcomes in the municipality.
Investigating Barriers to Tuberculosis Evaluation in Uganda Using Geographic Information Systems
American Journal of Tropical Medicine and Hygiene, 2015
Reducing geographic barriers to tuberculosis (TB) care is a priority in high-burden countries where patients frequently initiate, but do not complete, the multi-day TB evaluation process. Using routine cross-sectional study from six primary-health clinics in rural Uganda from 2009 to 2012, we explored whether geographic barriers affect completion of TB evaluation among adults with unexplained chronic cough. We measured distance from home parish to health center and calculated individual travel time using a geographic information systems technique incorporating roads, land cover, and slope, and measured its association with completion of TB evaluation. In 264,511 patient encounters, 4,640 adults (1.8%) had sputum smear microscopy ordered; 2,783 (60%) completed TB evaluation. Median travel time was 68 minutes for patients with TB examination ordered compared with 60 minutes without (P < 0.010). Travel time differed between those who did and did not complete TB evaluation at only one of six clinics, whereas distance to care did not differ at any of them. Neither distance nor travel time predicted completion of TB evaluation in rural Uganda, although limited detail in road and village maps restricted full implementation of these mapping techniques. Better data are needed on geographic barriers to access clinics offering TB services to improve TB diagnosis.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 1996
To determine the geographical distribution of tuberculosis in the two Western Cape suburbs with the highest reported incidence of tuberculosis. Descriptive illustrative study. Two adjacent Western Cape suburbs covering 2.42 km2 with a population of 34,294 and a reported tuberculosis incidence of > 1,000/100,000. All patients notified as having tuberculosis over a 10-year period (1985-1994). None The geographical distribution of the cases was determined using a geographical information system (GIS) and the National Population Census (1991). One thousand eight hundred and thirty-five of the 5,345 dwelling units (34.3%) housed at least 1 case of tuberculosis during the past decade and in 483 houses 3 or more cases occurred. These cases were distributed unevenly through the community, with the tuberculosis incidence per enumerator subdistrict (ESD) varying from 78 to 3,150/100,000 population. In a small area with a high incidence of tuberculosis, the cases are spread unevenly through...
Evidence shows that multiple factors, such as socioeconomic status and access to health care facilities, affect tuberculosis (TB) incidence. However, there is limited literature available with respect to the correlation between socio-economic/health facility factors and tuberculosis incidence. This study aimed to explore the relationship between TB incidence and socio-economic/health service predictors in the study settings. A retrospective spatial regression analysis was carried out based on new sputum smear-positive pulmonary TB cases in Beijing districts. Global Moran's I analysis was adopted to detect the spatial dependency followed by spatial regression models (spatial lag model, and spatial error model) along with the ordinary least square model were applied to examine the correlation between TB incidence and predictors. A high incidence of TB was seen in densely populated districts in Beijing, e.g., Haidian, Mentougou, and Xicheng. After comparing the R 2 , log-likelihood, and Akaike information criterion (AIC) values among three models, the spatial error model (R 2 = 0.413; Log Likelihood = −591; AIC = 1199.76) identified the best model fit for the spatial regression model. The study showed that the number of beds in health institutes (p < 0.001) and per capita gross domestic product (GDP) (p = 0.025) had a positive effect on TB incidence, whereas population density (p < 0.001) and migrated population (p < 0.001) had an adverse impact on TB incidence in the study settings. High TB incidence districts were detected in urban and densely populated districts in Beijing. Our findings suggested that socioeconomic predictors influence TB incidence. These findings may help to guide TB control programs and promote targeted intervention.
Using GIS technology to identify areas of tuberculosis transmission and incidence
International Journal of Health Geographics, 2004
Background: Currently in the U.S. it is recommended that tuberculosis screening and treatment programs be targeted at high-risk populations. While a strategy of targeted testing and treatment of persons most likely to develop tuberculosis is attractive, it is uncertain how best to accomplish this goal. In this study we seek to identify geographical areas where on-going tuberculosis transmission is occurring by linking Geographic Information Systems (GIS) technology with molecular surveillance.
Methods used in the spatial analysis of tuberculosis epidemiology: a systematic review
BMC medicine, 2018
Tuberculosis (TB) transmission often occurs within a household or community, leading to heterogeneous spatial patterns. However, apparent spatial clustering of TB could reflect ongoing transmission or co-location of risk factors and can vary considerably depending on the type of data available, the analysis methods employed and the dynamics of the underlying population. Thus, we aimed to review methodological approaches used in the spatial analysis of TB burden. We conducted a systematic literature search of spatial studies of TB published in English using Medline, Embase, PsycInfo, Scopus and Web of Science databases with no date restriction from inception to 15 February 2017. The protocol for this systematic review was prospectively registered with PROSPERO ( CRD42016036655 ). We identified 168 eligible studies with spatial methods used to describe the spatial distribution (n = 154), spatial clusters (n = 73), predictors of spatial patterns (n = 64), the role of congregate setting...
Local Spatial Knowledge for Eliciting Risk Factors and Disease Mapping of Tuberculosis Epidemics
Environment-Behaviour Proceedings Journal
Predicting risk areas of tuberculosis (TB) epidemics needs a proper understanding of the disease transmission process in identifying holistic risk factors. This study was performed to determine the causative factors triggering the epidemics in Shah Alam, Malaysia by utilising spatial analysis techniques and participation of local-expert knowledge or local spatial knowledge (LSK) approach. LSK approach was conducted to collect data on TB risk factors by combining experienced local experts' opinions, multi-criteria decision making (MCDM) analysis, and GIS mapping. The combination of experts participatory GIS and knowledge elicitation can generate a useful spatial knowledge framework for risk assessment of local epidemics. Keywords: Local spatial knowledge, MCDM method, experts participatory GIS, tuberculosis. eISSN: 2398-4287 © 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license...
International journal of environmental research and public health, 2015
Tuberculosis (TB) remains a major public health problem in China, and its incidence shows certain regional disparities. Systematic investigations of the social and environmental factors influencing TB are necessary for the prevention and control of the disease. Data on cases were obtained from the Chinese Center for Disease and Prevention. Social and environmental variables were tabulated to investigate the latent factor structure of the data using exploratory factor analysis (EFA). Partial least square path modeling (PLS-PM) was used to analyze the complex causal relationship and hysteresis effects between the factors and TB prevalence. A geographically weighted regression (GWR) model was used to explore the local association between factors and TB prevalence. EFA and PLS-PM indicated significant associations between TB prevalence and its latent factors. Altitude, longitude, climate, and education burden played an important role; primary industry employment, population density, air...
International journal of health geographics, 2006
The World Health Organization has declared tuberculosis a global emergency in 1993. It has been estimated that one third of the world population is infected with Mycobacterium tuberculosis, the causative agent of tuberculosis. The emergence of TB/HIV co-infection poses an additional challenge for the control of tuberculosis throughout the world. The World Health Organization is supporting many developing countries to eradicate tuberculosis. It is an agony that one fifth of the tuberculosis patients worldwide are in India. The eradication of tuberculosis is the greatest public health challenge for this developing country. The aim of the present population based study on Mycobacterium tuberculosis is to test a large set of tuberculosis cases for the presence of statistically significant geographical clusters. A spatial scan statistic is used to identify purely spatial and space-time clusters of tuberculosis. Significant (p < 0.05 for primary clusters and p < 0.1 for secondary cl...