Int J Health Geogr - Using statistical methods and genotyping to detect tuberculosis outbreaks.

Tópicos

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Resumo

CKGROUND: Early identification of outbreaks remains a key component in continuing to reduce the burden of infectious disease in the United States. Previous studies have applied statistical methods to detect unexpected cases of disease in space or time. The objectives of our study were to assess the ability and timeliness of three spatio-temporal methods to detect known outbreaks of tuberculosis.METHODS: We used routinely available molecular and surveillance data to retrospectively assess the effectiveness of three statistical methods in detecting tuberculosis outbreaks: county-based log-likelihood ratio, cumulative sums, and a spatial scan statistic.RESULTS: Our methods identified 8 of the 9 outbreaks, and 6 outbreaks would have been identified 1-52 months (median=10 months) before local public health authorities identified them. Assuming no delays in data availability, 46 (59.7%) of the 77 patients in the 9 outbreaks were identified after our statistical methods would have detected the outbreak but before local public health authorities became aware of the problem.CONCLUSIONS: Statistical methods, when applied retrospectively to routinely collected tuberculosis data, can successfully detect known outbreaks, potentially months before local public health authorities become aware of the problem. The three methods showed similar results; no single method was clearly superior to the other two. Further study to elucidate the performance of these methods in detecting tuberculosis outbreaks will be done in a prospective analysis.

Resumo Limpo

ckground earli identif outbreak remain key compon continu reduc burden infecti diseas unit state previous studi appli statist method detect unexpect case diseas space time object studi assess abil timeli three spatiotempor method detect known outbreak tuberculosismethod use routin avail molecular surveil data retrospect assess effect three statist method detect tuberculosi outbreak countybas loglikelihood ratio cumul sum spatial scan statisticresult method identifi outbreak outbreak identifi month median month local public health author identifi assum delay data avail patient outbreak identifi statist method detect outbreak local public health author becam awar problemconclus statist method appli retrospect routin collect tuberculosi data can success detect known outbreak potenti month local public health author becom awar problem three method show similar result singl method clear superior two studi elucid perform method detect tuberculosi outbreak will done prospect analysi

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