Abstract
Background and Purpose:Tuberculosis (TB) poses a serious threat to public health throughout the world but disproportionately afflicts low-income nations. The aim of this study is to identify the high-risk areas in Mazandaran province (North of Iran) in helping the heath programmer for the best intervention.Materials and Methods:This is an ecological study conducted from 1999 through 2008. The sample included 2444 Tuberculosis (TB) patients. The variables were age, gender, type of disease and residential location, analyzed by descriptive statistical methods and spatial analysis to identify cluster of disease incidence. Geographical information system software applied to map of smooth rate of TB.Results:Of 2444 registered patients, 1283 (52.5%) were male. The data showed 61% urban and 96.4% of them with the Iranian nationality. There was insignificant difference between genders, but the main difference was observed between locations that are the incidence rate in the Tonekabon and Behshahr cities were 30% higher than mean incidence rate of Mazandaran province (P-value<0.05). The comprising chance of acquiring infection between urban and rural was 1.46 with confidence interval of 95% (1.35, 1.59).Conclusion:Geostatistical method showed spatial variability of TB incidence rate in all districts and identifying high-risk area (core areas). The most important core of TB incidence has been noticed in the eastern boundary of Mazandaran in the city of Behshahr which is due to proximity to Golestan Province. The incidence rate of TB in Behshahr city is about two times more than the number observed in Mazandaran province. Lower TB incidence rate has been observed in Golestan province is because there is usually a delay in the diagnosis of the disease especially in the positive smear patients.
Highlights
TB remains one of the most dangerous infectious diseases with more than 9 million cases annually and with more than 1.7 million mortalities per year (Cerf, 1994; Hannu, GianLuca, & Olesen, n.d.)
There was insignificant difference between genders, but the main difference was observed between locations that are the incidence rate in the Tonekabon and Behshahr cities were 30% higher than mean incidence rate of Mazandaran province (P-value
The most important core of TB incidence has been noticed in the eastern boundary of Mazandaran in the city of Behshahr which is due to proximity to Golestan Province
Summary
TB remains one of the most dangerous infectious diseases with more than 9 million cases annually and with more than 1.7 million mortalities per year (Cerf, 1994; Hannu, GianLuca, & Olesen, n.d.). Over 95% of TB deaths occur in low- and middle-income countries, and it is among the top three causes of death for women aged 15 to 44 (WHO, 2014). A Spatial cluster might be defined as an overload of events or of values in geographic area (Li et al, 2011). Spatial cluster analysis plays an important role in quantifying geographic variation patterns. It is commonly used in disease surveillance, spatial epidemiology, population genetics, landscape ecology, crime analysis and many other fields, but the underlying principles are the same (Jacquez, 2008). Tuberculosis (TB) poses a serious threat to public health throughout the world but disproportionately afflicts low-income nations. The aim of this study is to identify the high-risk areas in Mazandaran province (North of Iran) in helping the heath programmer for the best intervention
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