Finding gaps in TB notifications: spatial analysis of geographical patterns of TB notifications, associations with TB program efforts and social determinants of TB risk in Bangladesh, Nepal and Pakistan
Finding gaps in TB notifications: spatial analysis of geographical patterns of TB notifications, associations with TB program efforts and social determinants of TB risk in Bangladesh, Nepal and Pakistan
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DOI：
10.1186/s12879-020-05207-z
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发表时间：
2020-07-10
影响因子：
3.7
通讯作者：
Bakker, Mirjam Irene
中科院分区：
文献类型：
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作者：
van Gurp, Margo;Rood, Ente;Bakker, Mirjam Irene
为了有效地防治结核病，诊断和治疗结核病的资源应有效地分配给需要它们的地区和人群。虽然经常收集大量的国家以下各级结核病数据以支持地方规划，但这些数据往往没有得到充分利用。因此，本研究使用空间分析技术和分析来了解和确定孟加拉国、尼泊尔和巴基斯坦结核病例报告率（CNR）空间变化的潜在因素，以更好地进行结核病规划。（N=64，2015），尼泊尔（N=75，2014）和巴基斯坦（N=142，2015）。进行了多变量线性回归分析，以评估国家以下各级CNR与结核病负担相关的人口和健康指标以及结核病规划工作指标之间的关系。为了校正观察结果的空间依赖性，对多变量模型的残差进行了无法解释的空间自相关检验。残差之间的空间自相关进行了调整，通过拟合同步自回归模型（SAR）。在孟加拉国，发现TB CNR与检测率显着相关（0.06%，p
BackgroundIn order to effectively combat Tuberculosis, resources to diagnose and treat TB should be allocated effectively to the areas and population that need them. Although a wealth of subnational data on TB is routinely collected to support local planning, it is often underutilized. Therefore, this study uses spatial analytical techniques and profiling to understand and identify factors underlying spatial variation in TB case notification rates (CNR) in Bangladesh, Nepal and Pakistan for better TB program planning.MethodsSpatial analytical techniques and profiling was used to identify subnational patterns of TB CNRs at the district level in Bangladesh (N=64, 2015), Nepal (N=75, 2014) and Pakistan (N=142, 2015). A multivariable linear regression analysis was performed to assess the association between subnational CNR and demographic and health indicators associated with TB burden and indicators of TB programme efforts. To correct for spatial dependencies of the observations, the residuals of the multivariable models were tested for unexplained spatial autocorrelation. Spatial autocorrelation among the residuals was adjusted for by fitting a simultaneous autoregressive model (SAR).ResultsSpatial clustering of TB CNRs was observed in all three countries. In Bangladesh, TB CNR were found significantly associated with testing rate (0.06%, p