An Ecological Study of Tuberculosis Transmission in California

Myers, Ward P.; Westenhouse, Janice; Flood, Jennifer; Riley, Lee W.

doi:10.2105/ajph.2004.048132

Cited by 56 publications

(69 citation statements)

References 20 publications

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“…These results are compatible with previous ecological analyses from the literature [32][33][34] , confirming that TB continues to be a disease strongly related to the social characteristics of a population. Marais et al 35 cite 3 primary causes that deter-mine the role of poverty in the transmission of M. tuberculosis: I) its influence on living conditions, such as people living in overcrowded and poorly ventilated homes, II) prolonged diagnostic delay, and III) increased vulnerability due to malnutrition and/or HIV infection.…”

Section: Discussionsupporting

confidence: 91%

“…Marais et al 35 cite 3 primary causes that deter-mine the role of poverty in the transmission of M. tuberculosis: I) its influence on living conditions, such as people living in overcrowded and poorly ventilated homes, II) prolonged diagnostic delay, and III) increased vulnerability due to malnutrition and/or HIV infection. Ecological studies provide a means of examining TB within its social context 34 as the relationship between the disease and the conditions related to poverty and low socioeconomic status can be unclear in studies conducted at an individual level. Several studies have already addressed the spatio-temporal patterns of TB in Ribeirão Preto 36,37 , but these studies are limited because they only describe the place of residence of the individuals who developed TB and the regions with the largest concentration of cases of the disease without the use of regression models that formally link vulnerability and socioeconomic factors to the disease from a spatial perspective.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, several ecological studies have already investigated risk factors for TB in a spatial context 18,34,36,44,45 , but there is a need for new studies dealing simultaneously with the impacts of socio-economic status and health services. This would allow better understanding of the impact of the application of DOT strategy regimens and other strategies for health care provision in the incidence of TB.…”

Section: Discussionmentioning

confidence: 99%

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Spatio-temporal patterns of tuberculosis incidence in Ribeirão Preto, State of São Paulo, southeast Brazil, and their relationship with social vulnerability: a Bayesian analysis

Roza

Caccia-Bava

Martinez

2012

Rev. Soc. Bras. Med. Trop.

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Introduction:The purpose of this ecological study was to evaluate the urban spatial and temporal distribution of tuberculosis (TB) in Ribeirão Preto, State of São Paulo, southeast Brazil, between 2006 and 2009 and to evaluate its relationship with factors of social vulnerability such as income and education level. Methods: We evaluated data from TBWeb, an electronic notification system for TB cases. Measures of social vulnerability were obtained from the SEADE Foundation, and information about the number of inhabitants, education and income of the households were obtained from Brazilian Institute of Geography and Statistics. Statistical analyses were conducted by a Bayesian regression model assuming a Poisson distribution for the observed new cases of TB in each area. A conditional autoregressive structure was used for the spatial covariance structure. Results: The Bayesian model confirmed the spatial heterogeneity of TB distribution in Ribeirão Preto, identifying areas with elevated risk and the effects of social vulnerability on the disease. We demonstrated that the rate of TB was correlated with the measures of income, education and social vulnerability. However, we observed areas with low vulnerability and high education and income, but with high estimated TB rates. Conclusions: The study identified areas with different risks for TB, given that the public health system deals with the characteristics of each region individually and prioritizes those that present a higher propensity to risk of TB. Complex relationships may exist between TB incidence and a wide range of environmental and intrinsic factors, which need to be studied in future research.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Spatio-temporal patterns of tuberculosis incidence in Ribeirão Preto, State of São Paulo, southeast Brazil, and their relationship with social vulnerability: a Bayesian analysis

Roza

Caccia-Bava

Martinez

2012

Rev. Soc. Bras. Med. Trop.

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“…Using this method, the magnitude of the change in the incidence rate ratio for severe dengue cases was compared for each predictive variable 13,16 .…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, FHS teams are trained in early disease recognition, ensuring the referral of these patients to other care levels within the health system when necessary 15,16 .…”

Section: Roriz-cruz Et Almentioning

confidence: 99%

Occurrence of severe dengue in Rio de Janeiro: an ecological study

Gibson

Souza-Santos

Siqueira

et al. 2014

Rev. Soc. Bras. Med. Trop.

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Introduction:This study aimed to analyze the relationship between the incidence of severe dengue during the 2008 epidemic in Rio de Janeiro, Brazil, and socioeconomic indicators, as well as indicators of health service availability and previous circulation of the dengue virus serotype-3 (DENV-3). Methods: In this ecological study, the units of analysis were the districts of Rio de Janeiro. The data were incorporated into generalized linear models, and the incidence of severe dengue in each district was the outcome variable. Results: The districts with more cases of dengue fever in the 2001 epidemic and a higher percentage of residents who declared their skin color or race as black had higher incidence rates of severe dengue in the 2008 epidemic [incidence rate ratio (IRR)= 1.21; 95% confi dence interval ( 95% CI)= 1.05-1.40 and IRR= 1.34; 95% CI= 1.16-1.54, respectively]. In contrast, the districts with Family Health Strategy (FHS) clinics were more likely to have lower incidence rates of severe dengue in the 2008 epidemic (IRR= 0.81; 95% CI= 0.70-0.93). Conclusions: At the ecological level, our fi ndings suggest the persistence of health inequalities in this region of Brazil that are possibly due to greater social vulnerability among the selfdeclared black population. Additionally, the protective effect of FHS clinics may be due to the ease of access to other levels of care in the health system or to a reduced vulnerability to dengue transmission that is afforded by local practices to promote health.

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Factors Affecting Outcome of Tuberculosis in Children in Italy: An Ecological Study

Nicastro

Scotto

Cerullo

et al. 2016

Advances in Experimental Medicine and Biology

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An Ecological Study of Tuberculosis Transmission in California

Abstract: The techniques used in this work provide a way to examine a disease within its social context. The results confirmed that tuberculosis in California continues to be a disease of poverty and racial/ethnic minorities.

Cited by 56 publications

References 20 publications

Spatio-temporal patterns of tuberculosis incidence in Ribeirão Preto, State of São Paulo, southeast Brazil, and their relationship with social vulnerability: a Bayesian analysis

Spatio-temporal patterns of tuberculosis incidence in Ribeirão Preto, State of São Paulo, southeast Brazil, and their relationship with social vulnerability: a Bayesian analysis

Occurrence of severe dengue in Rio de Janeiro: an ecological study

Factors Affecting Outcome of Tuberculosis in Children in Italy: An Ecological Study

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