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Use of Activity Space in a Tuberculosis Outbreak: Bringing Homeless Persons Into Spatial Analyses
BACKGROUND: Tuberculosis (TB) causes significant morbidity and mortality in US cities, particularly in poor, transient populations. During a TB outbreak in Fulton County, Atlanta, GA, we aimed to determine whether local maps created from multiple locations of personal activity per case would differ...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414060/ https://www.ncbi.nlm.nih.gov/pubmed/28480272 http://dx.doi.org/10.1093/ofid/ofw280 |
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author | Worrell, Mary Claire Kramer, Michael Yamin, Aliya Ray, Susan M. Goswami, Neela D. |
author_facet | Worrell, Mary Claire Kramer, Michael Yamin, Aliya Ray, Susan M. Goswami, Neela D. |
author_sort | Worrell, Mary Claire |
collection | PubMed |
description | BACKGROUND: Tuberculosis (TB) causes significant morbidity and mortality in US cities, particularly in poor, transient populations. During a TB outbreak in Fulton County, Atlanta, GA, we aimed to determine whether local maps created from multiple locations of personal activity per case would differ significantly from traditional maps created from single residential address. METHODS: Data were abstracted for patients with TB disease diagnosed in 2008–2014 and receiving care at the Fulton County Health Department. Clinical and activity location data were abstracted from charts. Kernel density methods, activity space analysis, and overlay with homeless shelter locations were used to characterize case spatial distribution when using single versus multiple addresses. RESULTS: Data were collected for 198 TB cases, with over 30% homeless US-born cases included. Greater spatial dispersion of cases was found when utilizing multiple versus single addresses per case. Activity spaces of homeless and isoniazid (INH)-resistant cases were more spatially congruent with one another than non-homeless and INH-susceptible cases (P < .0001 and P < .0001, respectively). CONCLUSIONS: Innovative spatial methods allowed us to more comprehensively capture the geography of TB-infected homeless persons, who made up a large portion of the Fulton County outbreak. We demonstrate how activity space analysis, prominent in exposure science and chronic disease, supports that routine capture of multiple location TB data may facilitate spatially different public health interventions than traditional surveillance maps. |
format | Online Article Text |
id | pubmed-5414060 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-54140602017-05-05 Use of Activity Space in a Tuberculosis Outbreak: Bringing Homeless Persons Into Spatial Analyses Worrell, Mary Claire Kramer, Michael Yamin, Aliya Ray, Susan M. Goswami, Neela D. Open Forum Infect Dis Major Article BACKGROUND: Tuberculosis (TB) causes significant morbidity and mortality in US cities, particularly in poor, transient populations. During a TB outbreak in Fulton County, Atlanta, GA, we aimed to determine whether local maps created from multiple locations of personal activity per case would differ significantly from traditional maps created from single residential address. METHODS: Data were abstracted for patients with TB disease diagnosed in 2008–2014 and receiving care at the Fulton County Health Department. Clinical and activity location data were abstracted from charts. Kernel density methods, activity space analysis, and overlay with homeless shelter locations were used to characterize case spatial distribution when using single versus multiple addresses. RESULTS: Data were collected for 198 TB cases, with over 30% homeless US-born cases included. Greater spatial dispersion of cases was found when utilizing multiple versus single addresses per case. Activity spaces of homeless and isoniazid (INH)-resistant cases were more spatially congruent with one another than non-homeless and INH-susceptible cases (P < .0001 and P < .0001, respectively). CONCLUSIONS: Innovative spatial methods allowed us to more comprehensively capture the geography of TB-infected homeless persons, who made up a large portion of the Fulton County outbreak. We demonstrate how activity space analysis, prominent in exposure science and chronic disease, supports that routine capture of multiple location TB data may facilitate spatially different public health interventions than traditional surveillance maps. Oxford University Press 2017-01-09 /pmc/articles/PMC5414060/ /pubmed/28480272 http://dx.doi.org/10.1093/ofid/ofw280 Text en © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Major Article Worrell, Mary Claire Kramer, Michael Yamin, Aliya Ray, Susan M. Goswami, Neela D. Use of Activity Space in a Tuberculosis Outbreak: Bringing Homeless Persons Into Spatial Analyses |
title | Use of Activity Space in a Tuberculosis Outbreak: Bringing Homeless Persons Into Spatial Analyses |
title_full | Use of Activity Space in a Tuberculosis Outbreak: Bringing Homeless Persons Into Spatial Analyses |
title_fullStr | Use of Activity Space in a Tuberculosis Outbreak: Bringing Homeless Persons Into Spatial Analyses |
title_full_unstemmed | Use of Activity Space in a Tuberculosis Outbreak: Bringing Homeless Persons Into Spatial Analyses |
title_short | Use of Activity Space in a Tuberculosis Outbreak: Bringing Homeless Persons Into Spatial Analyses |
title_sort | use of activity space in a tuberculosis outbreak: bringing homeless persons into spatial analyses |
topic | Major Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414060/ https://www.ncbi.nlm.nih.gov/pubmed/28480272 http://dx.doi.org/10.1093/ofid/ofw280 |
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