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. 2006 Aug 10:5:33.
doi: 10.1186/1476-072X-5-33.

Investigation of geo-spatial hotspots for the occurrence of tuberculosis in Almora district, India, using GIS and spatial scan statistic

Neeraj Tiwari  1 , C M S Adhikari, Ajoy Tewari, Vineeta Kandpal
Affiliations

Investigation of geo-spatial hotspots for the occurrence of tuberculosis in Almora district, India, using GIS and spatial scan statistic

Neeraj Tiwari et al. Int J Health Geogr. .

Abstract

Background: 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.

Results: Significant (p < 0.05 for primary clusters and p < 0.1 for secondary clusters) high rate spatial and space-time clusters were identified in three areas of the district.

Conclusion: There is sufficient evidence about the existence of statistically significant tuberculosis clusters in Almora district of Uttaranchal, India. The spatial scan statistics methodology used in this study has a potential use in surveillance of tuberculosis for detecting the true clusters of the disease.

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Figures

Figure 1
Figure 1
Spatial distribution of significant high rate tuberculosis clusters in Almora district, India. The three statistically significant clusters detected by the purely spatial and retrospective space-time analyses with a maximum cluster size of 25% of the total population have been presented in this map.
Figure 2
Figure 2
Significant purely spatial high rate tuberculosis clusters in Almora district, India with relevant database attached. In this map, the database given in Table 1 is attached to three statistically significant clusters detected by the purely spatial analysis with a maximum cluster size of 25% of the total population.
Figure 3
Figure 3
Significant space-time high rate tuberculosis clusters in Almora district, India with relevant database attached. In this map, the database given in Table 2 is attached to three statistically significant clusters detected by the retrospective space-time analysis with a maximum cluster size of 25% of the total population.
Figure 4
Figure 4
The thirteen microscopic centres (MC) in Almora district, India with relevant database attached. This map shows the area covered by the thirteen MCs of Almora district, which are taken as the geographical units of the district for our analyses. The database relevant to these thirteen MCs (Table 3 and Table 4) is also attached to this map.
See this image and copyright information in PMC

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