Methods used in the spatial analysis of tuberculosis epidemiology: a systematic review

Published on Dec 1, 2018in BMC Medicine8.285
· DOI :10.1186/s12916-018-1178-4
Debebe Shaweno7
Estimated H-index: 7
(University of Melbourne),
Malancha Karmakar3
Estimated H-index: 3
(University of Melbourne)
+ 5 AuthorsEmma S. McBryde29
Estimated H-index: 29
(University of Melbourne)
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 settings (n = 3) and the household (n = 2) on TB transmission. Molecular techniques combined with geospatial methods were used by 25 studies to compare the role of transmission to reactivation as a driver of TB spatial distribution, finding that geospatial hotspots are not necessarily areas of recent transmission. Almost all studies used notification data for spatial analysis (161 of 168), although none accounted for undetected cases. The most common data visualisation technique was notification rate mapping, and the use of smoothing techniques was uncommon. Spatial clusters were identified using a range of methods, with the most commonly employed being Kulldorff’s spatial scan statistic followed by local Moran’s I and Getis and Ord’s local Gi(d) tests. In the 11 papers that compared two such methods using a single dataset, the clustering patterns identified were often inconsistent. Classical regression models that did not account for spatial dependence were commonly used to predict spatial TB risk. In all included studies, TB showed a heterogeneous spatial pattern at each geographic resolution level examined. A range of spatial analysis methodologies has been employed in divergent contexts, with all studies demonstrating significant heterogeneity in spatial TB distribution. Future studies are needed to define the optimal method for each context and should account for unreported cases when using notification data where possible. Future studies combining genotypic and geospatial techniques with epidemiologically linked cases have the potential to provide further insights and improve TB control.
  • References (194)
  • Citations (4)
ABSTRACT Acute poisoning with isoniazid causes generalized convulsions which should be treated with intravenous pyridoxine and a rapidly-acting anticonvulsant. The purpose of this study was to determine the correlation between the distribution of tuberculosis (as a proxy for isoniazid use) and acute care hospital supplies of intravenous pyridoxine (the antidote for isoniazid overdose). The distribution of tuberculosis was based on Ontario public health regions. The study was descriptive using si...
4 CitationsSource
#1Debebe Shaweno (University of Melbourne)H-Index: 7
#2James M. Trauer (Monash University)H-Index: 13
Last. Emma S. McBryde (University of Melbourne)H-Index: 29
view all 4 authors...
Reported tuberculosis (TB) incidence globally continues to be heavily influenced by expert opinion of case detection rates and ecological estimates of disease duration. Both approaches are recognised as having substantial variability and inaccuracy, leading to uncertainty in true TB incidence and other such derived statistics. We developed Bayesian binomial mixture geospatial models to estimate TB incidence and case detection rate (CDR) in Ethiopia. In these models the underlying true incidence ...
5 CitationsSource
#1Benjamin Patterson (Columbia University)H-Index: 2
#2Carl Morrow (UCT: University of Cape Town)H-Index: 17
Last. Robin Wood (UCT: University of Cape Town)H-Index: 82
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Abstract Background Tuberculosis remains a major public health problem in poverty-stricken areas of the world. Communal gathering places account for the majority of TB transmission in high burden settings. Objective To investigate the social behaviour patterns of individuals who have developed TB disease and adolescents at risk of infection. To develop a cheap and effective method to locate transmission hot spots in high burden communities. Design Portable, combined CO 2 /GIS monitors and locati...
8 CitationsSource
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#1Kefyalew Addis Alene (University of Gondar)H-Index: 23
#2Kerri Viney (ANU: Australian National University)H-Index: 12
Last. Archie C. A. Clements (ANU: Australian National University)H-Index: 44
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Background Understanding the geographical distribution of multidrug-resistant tuberculosis (MDR-TB) in high TB burden countries such as Ethiopia is crucial for effective control of TB epidemics in these countries, and thus globally. We present the first spatial analysis of multidrug resistant tuberculosis, and its relationship to socio-economic, demographic and household factors in northwest Ethiopia. Methods An ecological study was conducted using data on patients diagnosed with MDR-TB at the U...
12 CitationsSource
#1Russell S. Kirby (USF: University of South Florida)H-Index: 55
#2Eric Delmelle (UNCC: University of North Carolina at Charlotte)H-Index: 20
Last. Jan M. Eberth (USC: University of South Carolina)H-Index: 14
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Abstract The field of spatial epidemiology has evolved rapidly in the past 2 decades. This study serves as a brief introduction to spatial epidemiology and the use of geographic information systems in applied research in epidemiology. We highlight technical developments and highlight opportunities to apply spatial analytic methods in epidemiologic research, focusing on methodologies involving geocoding, distance estimation, residential mobility, record linkage and data integration, spatial and s...
32 CitationsSource
#1Debebe Shaweno (University of Melbourne)H-Index: 7
#2T. Shaweno (JU: Jimma University)H-Index: 1
Last. Emma S. McBryde (JCU: James Cook University)H-Index: 29
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Objective: To describe the distribution of tuberculosis (TB) and its drivers in Sheka Zone, a geographically remote region of Ethiopia. Methods: We collected data on TB patients treated from 2010 to 2014 in the Sheka Zone. Predictors of TB incidence were determined using a multivariate generalised linear regression model. Results: We found significant spatial autocorrelation of TB incidence by kebele (the smallest administrative geographical subdivision in Ethiopia) (Moran's I = 0.3, P < 0.001)....
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#1Hua-Xiang Rao (Shanxi Medical University)H-Index: 1
#2Xi Zhang (IUPUI: Indiana University – Purdue University Indianapolis)H-Index: 1
Last. Lixia Qiu (Shanxi Medical University)H-Index: 3
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#1Wang Wei (XMU: Xinjiang Medical University)H-Index: 2
#2Jin Yuan-Yuan (XMU: Xinjiang Medical University)H-Index: 1
Last. Cao Ming-qin (XMU: Xinjiang Medical University)H-Index: 2
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#2Cláudia Di Lorenzo Oliveira (UFSJ: Universidade Federal de São João del-Rei)H-Index: 9
Last. Paulo A. M. Camargos (UFSJ: Universidade Federal de São João del-Rei)H-Index: 4
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Background Tuberculosis (TB) remains a major public health problem in many developing countries. Exploratory spatial analysis is a powerful instrument in spatial health research by virtue of its capacity to map disease distribution and associated risk factors at the population level. The aim of the present study was to describe the epidemiologic characteristics and spatial distribution of new cases of TB reported during the period 2002–2012 in Divinopolis, a midsized city located in the state of...
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Cited By4
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#1Shari Laliberte (RMIT: RMIT University)
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In this article, we explore challenges and opportunities in research oriented to understanding the relations among elements of socio-economic life and mental health (MH) and the development and evaluation of mental health promotion (HP) initiatives. We review the population health intervention research (PHIR) literature and respond to recommendations regarding social determinants of health and health inequities-focused research. We discuss three inter-related issue areas: first, the continued do...
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#1Gabriel Carrasco-Escobar (UCSD: University of California, San Diego)H-Index: 8
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#2John Bwalya Muma (UNZA: University of Zambia)H-Index: 22
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#1Basavaraj Poojar (Manipal University)H-Index: 1
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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-T...
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