| Title |
Assessment of tuberculosis spatial hotspot areas in Antananarivo, Madagascar, by combining spatial analysis and genotyping
|
|---|---|
| Published in |
BMC Infectious Diseases, August 2017
|
| DOI | 10.1186/s12879-017-2653-9 |
| Pubmed ID | |
| Authors |
Noël Harijaona Ratovonirina, Niaina Rakotosamimanana, Solohery Lalaina Razafimahatratra, Mamy Serge Raherison, Guislaine Refrégier, Christophe Sola, Fanjasoa Rakotomanana, Voahangy Rasolofo Razanamparany |
| Abstract |
Tuberculosis (TB) remains a public health problem in Madagascar. A crucial element of TB control is the development of an easy and rapid method for the orientation of TB control strategies in the country. Our main objective was to develop a TB spatial hotspot identification method by combining spatial analysis and TB genotyping method in Antananarivo. Sputa of new pulmonary TB cases from 20 TB diagnosis and treatment centers (DTCs) in Antananarivo were collected from August 2013 to May 2014 for culture. Mycobacterium tuberculosis complex (MTBC) clinical isolates were typed by spoligotyping on a Luminex® 200 platform. All TB patients were respectively localized according to their neighborhood residence and the spatial distribution of all pulmonary TB patients and patients with genotypic clustered isolates were scanned respectively by the Kulldorff spatial scanning method for identification of significant spatial clustering. Areas exhibiting spatial clustering of patients with genotypic clustered isolates were considered as hotspot TB areas for transmission. Overall, 467 new cases were included in the study, and 394 spoligotypes were obtained (84.4%). New TB cases were distributed in 133 of the 192 Fokontany (administrative neighborhoods) of Antananarivo (1 to 15 clinical patients per Fokontany) and patients with genotypic clustered isolates were distributed in 127 of the 192 Fokontany (1 to 13 per Fokontany). A single spatial focal point of epidemics was detected when ignoring genotypic data (p = 0.039). One Fokontany of this focal point and three additional ones were detected to be spatially clustered when taking genotypes into account (p < 0.05). These four areas were declared potential TB transmission hotspots in Antananarivo and will be considered as priority targets for surveillance in the future. This method, combining spatial analysis and TB genotyping will now be used for further focused clinical and epidemiological studies in Madagascar and will allow better TB control strategies by public health authorities. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 83 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 83 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 18 | 22% |
| Researcher | 12 | 14% |
| Student > Ph. D. Student | 6 | 7% |
| Lecturer | 5 | 6% |
| Student > Bachelor | 4 | 5% |
| Other | 17 | 20% |
| Unknown | 21 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 15 | 18% |
| Nursing and Health Professions | 9 | 11% |
| Agricultural and Biological Sciences | 6 | 7% |
| Environmental Science | 4 | 5% |
| Unspecified | 4 | 5% |
| Other | 21 | 25% |
| Unknown | 24 | 29% |
Attention Score in Context
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#18,567,744
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Outputs from BMC Infectious Diseases
#5,652
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Outputs of similar age from BMC Infectious Diseases
#117
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