Geographic analysis of latent tuberculosis screening: A health system approach

Novel approaches are required to better focus latent tuberculosis infection (LTBI) efforts in low-prevalence regions. Geographic information systems, used within large health systems, may provide one such approach. A retrospective, cross-sectional design was used to integrate US Census and Duke Heal...

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Bibliographic Details
Published in:	PloS one 2020-11, Vol.15 (11), p.e0242055-e0242055
Main Authors:	Bonnewell, John P, Farrow, Laura, Dicks, Kristen V, Cox, Gary M, Stout, Jason E
Format:	Article
Language:	eng
Subjects:	Census Censuses Computer and Information Sciences Cross-Sectional Studies Diagnosis Earth Sciences Endemic Diseases Ethnicity Geographic information systems Geography Geography, Medical Health risks Health screening Hispanic people Humans Immunization Infectious diseases Laboratories Latent Tuberculosis - diagnosis Latent Tuberculosis - epidemiology Medical screening Medicine Medicine and Health Sciences Methods Patients People and places Prevalence Regression analysis Remote sensing Research and Analysis Methods Retrospective Studies Risk Factors Statistical analysis Statistics Trends Tuberculosis
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Summary:	Novel approaches are required to better focus latent tuberculosis infection (LTBI) efforts in low-prevalence regions. Geographic information systems, used within large health systems, may provide one such approach. A retrospective, cross-sectional design was used to integrate US Census and Duke Health System data between January 1, 2010 and October 31, 2017 and examine the relationships between LTBI screening and population tuberculosis risk (assessed using the surrogate measure of proportion of persons born in tuberculosis-endemic regions) by census tract. The median proportion of Duke patients screened per census tract was 0.01 (range 0-0.1, interquartile range 0.01-0.03). The proportion of Duke patients screened within a census tract significantly but weakly correlated with the population risk. Furthermore, patients residing in census tracts with higher population tuberculosis risk were more likely to be screened with TST than with an IGRA (p
ISSN:	1932-6203 1932-6203