Space–time clustering and temporal trends of hospitalizations due to pulmonary tuberculosis: potential strategy for assessing health care policies

Abstract

Background Tuberculosis (TB) causes pressure on healthcare resources, especially in terms of hospital admissions, despite being considered an ambulatory care-sensitive condition for which timely and effective care in ambulatory setting could prevent the need for hospitalization. Our objectives were to describe the spatial and temporal variation in pulmonary tuberculosis (PTB) hospitalizations, identify critical geographic areas at municipality level and characterize clusters of PTB hospitalizations to help the development of tailored disease management strategies that could improve TB control. Methods Ecologic study using sociodemographic, geographical and clinical information of PTB hospitalization cases from continental Portuguese public hospitals, between 2002 and 2016. Descriptive statistics, spatiotemporal cluster analysis and temporal trends were conducted. Results The space–time analysis identified five clusters of higher rates of PTB hospitalizations (2002–16), including the two major cities in the country (Lisboa and Porto). Globally, we observed a −7.2% mean annual percentage change in rate with only one of the identified clusters (out of six) with a positive trend (+4.34%). In the more recent period (2011–16) was obtained a mean annual percentage change in rate of −8.12% with only one cluster identified with an increase trend (+9.53%). Conclusions Our results show that space–time clustering and temporal trends analysis can be an invaluable resource to monitor the dynamic of the disease and contribute to the design of more effective, focused interventions. Interventions such as enhancing the detection of active and latent infection, improving monitoring and evaluation of treatment outcomes or adjusting the network of healthcare providers should be tailored to the specific needs of the critical areas identified.

Risk-prone territories for spreading tuberculosis, temporal trends and their determinants in a high burden city from São Paulo State, Brazil

“…Over the years with the evolution of technology, several studies have sought to understand the behavior of tuberculosis in space in Brazil [ 21 – 24 ], but few studies used temporal [ 25 , 26 ] or Spatio-temporal [ 27 , 28 ] approaches, and the numbers of studies that combined both techniques are even smaller [ 29 , 30 ]. Therefore, we encourage new studies to be carried out using spatial and temporal processes.…”

Spatiotemporal Patterns of Adverse Pregnancy Outcomes in Rural Areas of Henan, China

“…The Gini coefficient was used to select the optimal set of clusters to report when secondary spatial clusters were taken into account [ 31 ]. Following the methods outlined by Moura [ 32 ] and Santos [ 33 ], this spatial statistical analysis method involves the development of a circular window that scans the entire study. Finally, a correlation matrix plot was conducted for total and separate incidences of APOs to understand the relationship between different APOs, i.e., to what degree they were spatiotemporally similar.…”

Development and evaluation of an early rehabilitation nursing program for patients with pulmonary tuberculosis

“…[40,41] Researchers in different countries generally believe that the choice of the nursing method directly affects the rehabilitation efficiency and long-term prognosis of patients with pulmonary tuberculosis. [42][43][44] Some scholars believe that early rehabilitation nursing can promote rehabilitation of pulmonary function through timely and comprehensive rehabilitation means. [45] Greening et al [46] reported that, a series of rehabilitation training measures included in an early pulmonary rehabilitation program improved the recovery speed of patients, shortened their hospital stay, and reduced their economic burden.…”