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

© The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved..

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.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:31

Enthalten in:

European journal of public health - 31(2021), 1 vom: 01. Feb., Seite 57-62

Sprache:

Englisch

Beteiligte Personen:

Santos, João Almeida [VerfasserIn]
Santos, Danielle T [VerfasserIn]
Arcencio, Ricardo A [VerfasserIn]
Nunes, Carla [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 01.07.2021

Date Revised 01.07.2021

published: Print

Citation Status MEDLINE

doi:

10.1093/eurpub/ckaa161

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM315601256