Spatial distribution of Mycobacterium Tuberculosis in metropolitan Harare, Zimbabwe.
Adolescent
Adult
Child
Child, Preschool
Disease Transmission, Infectious
Female
Geographic Information Systems
HIV
/ pathogenicity
HIV Infections
/ complications
Health Services Accessibility
Humans
Male
Middle Aged
Mycobacterium tuberculosis
/ pathogenicity
Spatial Analysis
Tuberculosis
/ complications
Urban Population
Young Adult
Zimbabwe
/ epidemiology
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
29
11
2019
accepted:
29
03
2020
entrez:
22
4
2020
pubmed:
22
4
2020
medline:
18
7
2020
Statut:
epublish
Résumé
The contribution of high tuberculosis (TB) transmission pockets in propagating area-wide transmission has not been adequately described in Zimbabwe. This study aimed to describe the presence of hotspot transmission of TB cases in Harare city from 2011 to 2012 using geospatial techniques. Anonymised TB patient data stored in an electronic database at Harare City Health department was analysed using geospatial methods. Confirmed TB cases were mapped using geographic information system (GIS). Global Moran's I and Anselin Local Moran's I (LISA) were used to assess clustering and the local Getis-Ord Gi* was used to estimate hotspot phenomenon of TB cases in Harare City for the period between 2011 and 2012. A total of 12,702 TB cases were accessed and mapped on the Harare City map. In both 2011 and 2012, ninety (90%) of cases were new and had a high human immunodeficiency virus (HIV)/TB co-infection rate of 72% across all suburbs. Tuberculosis prevalence was highest in the Southern district in both 2011 and 2012. There were pockets of spatial distribution of TB prevalence across West South West, Southern, Western, South Western and Eastern health districts. TB hot spot occurrence was restricted to the West South West, parts of South Western, Western health districts. West South West district had an increased peri-urban population with inadequate social services including health facilities. These conditions were conducive for increased intensity of TB occurrence, a probable indication of high transmission especially in the presence of high HIV co-infection. Increased TB transmission was limited to a health district with high informal internal migrants with limited health services in Harare City. To minimise spread of TB into greater Harare, there is need to improve access to TB services in the peri-urban areas.
Identifiants
pubmed: 32315335
doi: 10.1371/journal.pone.0231637
pii: PONE-D-19-33115
pmc: PMC7173793
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0231637Subventions
Organisme : Wellcome Trust
ID : WT087537MA
Pays : United Kingdom
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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