Department of Fundamental & Applied Sciences, Universiti Teknologi PETRONAS, Seri Iskandar 32610, Perak, Malaysia.
School of Mathematical and Computer Sciences, Heriot-Watt University Malaysia, Putrajaya 62200, Malaysia.
Int J Environ Res Public Health. 2020 Feb 21;17(4):1413. doi: 10.3390/ijerph17041413.
The number of tuberculosis (TB) cases in Pakistan ranks fifth in the world. The National TB Control Program (NTP) has recently reported more than 462,920 TB patients in Khyber Pakhtunkhwa province, Pakistan from 2002 to 2017. This study aims to identify spatial and space-time clusters of TB cases in Khyber Pakhtunkhwa province Pakistan during 2015-2019 to design effective interventions. The spatial and space-time cluster analyses were conducted at the district-level based on the reported TB cases from January 2015 to April 2019 using space-time scan statistics (SaTScan). The most likely spatial and space-time clusters were detected in the northern rural part of the province. Additionally, two districts in the west were detected as the secondary space-time clusters. The most likely space-time cluster shows a tendency of spread toward the neighboring districts in the central part, and the most likely spatial cluster shows a tendency of spread toward the neighboring districts in the south. Most of the space-time clusters were detected at the start of the study period 2015-2016. The potential TB clusters in the remote rural part might be associated to the dry-cool climate and lack of access to the healthcare centers in the remote areas.
巴基斯坦的肺结核（TB）病例数量位居世界第五。国家结核病控制项目（NTP）最近报告称，从 2002 年到 2017 年，巴基斯坦开伯尔-普赫图赫瓦省有超过 462920 名结核病患者。本研究旨在确定 2015-2019 年期间巴基斯坦开伯尔-普赫图赫瓦省结核病病例的空间和时空聚集，以设计有效的干预措施。根据 2015 年 1 月至 2019 年 4 月报告的结核病病例，在地区一级进行了空间和时空聚类分析，使用时空扫描统计（SaTScan）。在该省北部农村地区发现了最可能的空间和时空集群。此外，还在西部的两个区发现了次要的时空集群。最可能的时空集群显示出向中部邻近地区传播的趋势，最可能的空间集群显示出向南部邻近地区传播的趋势。大多数时空集群是在 2015-2016 年研究开始时检测到的。偏远农村地区的潜在结核病集群可能与干燥凉爽的气候以及偏远地区缺乏获得医疗保健中心的机会有关。
