Pulmonary tuberculosis and risk factors in Portugal: a spatial analysis

Abstract

Tuberculosis (TB) is a multidimensional disease, and interactions between individuals and groups are of extreme importance in its development. The aim of this study was to estimate the occurrence of pulmonary TB (PTB) to identify potential risk factors and to define high-risk areas in Portugal (2004-2006). The relevance of the common risk factors identified was evaluated at the national and local levels. Considering local public health at the municipality level, the main objective of this study was the support of local interventions, identifying local high-risk areas and the corresponding local risk factors. A complex statistical methodology based on correlation analysis, spatial clustering, risk maps and multivariate regression models was developed. The results showed that some areas were at higher risk of PTB than others due to high incidence of HIV/AIDS, incarceration, nonstandard (abnormal) and/or crowded accommodation, unemployment and immigrant populations. The majority of these areas showed increased TB incidence rates.

Distribution of pulmonary tuberculosis in Rio de Janeiro (Brazil): a spatial analysis

“…Some studies have evaluated tuberculosis (TB) distribution using spatial analysis tool [2][3][4][5][6][7] . In Portugal, the spatial distribution of TB incidence rates (2004)(2005)(2006) showed high values in large cities (Porto, Lisbon and Setúbal Peninsula), in north-eastern and in southern Portugal 8 . A Brazilian study (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)) detected strong spatial auto correlation of TB rates and remarked that these rates were notably higher in urban areas on the eastern seaboard and in the west of the country 9 .…”

Pentingnya Analisis Cluster Berbasis Spasial dalam Penanggulangan Tuberkulosis di Indonesia

“…Kedua distrik tersebut mempunyai lebih banyak populasi imigran, penduduk yang tidak bekerja dan lingkungan yang padat. 21 Penelitian di Vitoria, Brazil, juga menunjukkan bahwa terdapat clustering penderita TB di wilayah dengan determinan sosial rendah. 22…”

“…21 Informasi clustering TB pada penelitian di Brazil diharapkan dapat membantu program pengendalian TB dalam mengalokasikan sumber daya pada populasi di daerah clustering TB yang merupakan populasi berisiko. 22 Informasi clustering TB di Hermosillo, Mexico, diharapkan dapat menunjukkan populasi berisiko.…”

“…13,18,19 Walaupun analisis clustering TB sangat berpotensi menghasilkan informasi yang bermanfaat dalam penanggulangan TB, tetapi belum terdapat bahasan penerapan analisis tersebut dalam penanggulangan TB. 13,[18][19][20][21][22] Beberapa faktor menjadi kendala penerapan analisis cluster berbasis spasial dalam penanggulangan TB. Studi kasus penerapan infrastruktur berbasis Sistem Informasi Geografis (SIG) di New Jersey menunjukkan bahwa untuk proses implementasi sistem tersebut membutuhkan dana, staf yang terlatih, perangkat lunak, perangkat keras, pelatihan yang kontinu serta partisipasi dari semua wilayah yang terkait.…”

“…24 Di Brazil, Portugal, dan China, walaupun data koordinat geografis penderita TB belum dikumpulkan secara rutin, telah terdapat studi kontinu atau sensus selama beberapa tahun. 19,21,22 Di Indonesia, kegiatan program penanggulangan TB belum mencakup pengumpulan data geografis penderita TB. 25 …”