Identification of TB space-time clusters and hotspots in Ouest département, Haiti, 2011-2016

• Published in: Public health action 2021-06, Vol.11 (2), p.101-107
• Main Authors: Dismer, A. M., Charles, M., Dear, N., Louis-Jean, J. M., Barthelemy, N., Richard, M., Morose, W., Fitter, D. L.
• Format: Article
• Language: English
• Subjects: Anselin Moran's I; Geocoder; Getis-Ord Gi; Orignal; Space-Time Scan
• ISSN: 2220-8372; 2220-8372
• DOI: 10.5588/pha.20.0085

BACKGROUND: Haiti has the highest incidence rate of TB in the Western Hemisphere, with an estimated 170 cases per 100,000 in 2019. Since 2010, control efforts have focused on targeted case-finding activities in urban areas, implementation of rapid molecular diagnostics at high-volume TB centers, and improved reporting. TB analyses are rarely focused on lower geographic units; thus, the major goal was to determine if there were focal areas of TB transmission from 2011 to 2016 at operational geographic levels useful for the National TB Control Program (PNLT).METHODS: We created a geocoder to locate TB cases at the smallest geographic level. Kulldorff's space-time permutation scan, Anselin Moran's I, and Getis-Ord Gi* statistics were used to determine the spatial distribution and clusters of TB.RESULTS: With 91% of cases linked using the geocoder, TB clusters were identified each year. Getis-Ord Gi* analysis revealed 14 distinct spatial clusters of high incidences in the Port-au-Prince metropolitan area. One hundred retrospective space-time clusters were detected.CONCLUSION: Our study confirms the presence of TB hotspots in the Ouest département, with most clusters in the Port-au-Prince metropolitan area. Results will help the PNLT and its partners better design case-finding strategies for these areas.