Spatial Patterns of Tuberculosis and Diabetes Mellitus in Los Angeles County, California

Abstract

Background Tuberculosis remains a public health problem that disproportionately affects vulnerable populations. The objective of the study was to apply Geographic Information Systems (GIS) methods to identify statistically significant hot spots of tuberculosis (TB) and diabetes mellitus (DM) and identify areas and populations that are disproportionately burdened by TB and DM.Methods Verified cases of TB reported in Los Angeles County (LAC), California between 01/01/2015 and 06/30/2017 were identified from the LAC TB Control Program Surveillance Registry. The addresses for patients residing in LAC at the time of TB diagnosis were geocoded and mapped. Hot spot analyses were performed utilizing the Getis-Ord Gi* statistic to identify statistically significant hot spots of TB and DM.Results Among 389 TB cases with DM, 43% were Hispanic and 50% were Asian. Geographic variations for Hispanic and Asian TB cases were found (p<0.05). Hot spots of TB and DM were identified among Asians residing in the southwestern and southern regions of LAC and among Hispanics residing in south central and northwestern LAC.Conclusions GIS methods are important epidemiological tools for identifying and assessing geographic variations in disease morbidity. These findings highlight opportunities for public health interventions aimed at reducing health disparities in underserved communities.

Acceptability and Feasibility of a Nurse-Led, Community Health Worker Partnered Latent Tuberculosis Medication Adherence Model for Homeless Adults

“…In the United States (US), as compared to the general population, homeless persons have a 10-fold increase in TB incidence [3]. In Los Angeles County, approximately 7.6% of TB cases occur among those experiencing homelessness [4]. Prior to a TB diagnosis, over 5% of individuals report being homeless within the last year [5].…”