Small-scale stable clusters of elevated tuberculosis incidence in Moscow, 2000–2015: Discovery and spatiotemporal analysis

•The micro spatial structure of the tuberculosis incidence in a metropolis is described.•Stable clusters of increased tuberculosis incidence are identified.•Population of clusters is a priority for tuberculosis screening. To find residential areas with high incidence rate of tuberculosis in Moscow u...

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Published in:International journal of infectious diseases Vol. 91; pp. 156 - 161
Main Authors: Romanyukha, Alexei A., Karkach, Arseny S., Borisov, Sergey E., Belilovsky, Evgeny M., Sannikova, Tatiana E., Krivorotko, Olga I.
Format: Journal Article
Language:English
Published: Canada Elsevier Ltd 01.02.2020
Elsevier
Subjects:
Diagnostic Tests, Routine
Epidemiology
GIS
Humans
Incidence
Local infection
Moscow - epidemiology
Resident population
Spatial analysis
Spatio-Temporal Analysis
Tuberculosis, Pulmonary - diagnosis
Tuberculosis, Pulmonary - epidemiology
Urban
Moscow
GIS
Spatial analysis
Urban
Resident population
Epidemiology
Local infection
ISSN:1201-9712, 1878-3511, 1878-3511
Online Access:Get full text
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Summary:•The micro spatial structure of the tuberculosis incidence in a metropolis is described.•Stable clusters of increased tuberculosis incidence are identified.•Population of clusters is a priority for tuberculosis screening. To find residential areas with high incidence rate of tuberculosis in Moscow using spatio-temporal analysis of incidence data. We analyzed the spatial patterns of residence locations of smear or culture positive patients with pulmonary tuberculosis in Moscow. To identify clusters with high local incidence rates, the neighborhoods of detected cases were studied. We assessed the spatial and temporal stability of clusters. For 19033 cases diagnosed with smear or culture positive pulmonary tuberculosis among residents of Moscow in 2000–2015 we identified 18 small-scale clusters of increased incidence rate responsible for 3% of all registered cases identified on a territory inhabited by only 1% of the population. Locations of clusters were sufficiently stable in space throughout the whole period. The local incidence rate inside clusters was significantly (3–4 times) higher than the city average during the whole observation period. The presence of clusters was associated with the incidence rate in the surrounding area. Socio-demographic characteristics of patients in clusters were not significantly different from the average characteristics of patients in the city. The detected small-scale clusters of increased incidence may be used to target active case finding for tuberculosis. The causes and mechanisms of cluster formation and stability need further study.
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ISSN:1201-9712
1878-3511
1878-3511
DOI:10.1016/j.ijid.2019.11.015