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Free Content A multidisciplinary method to map potential tuberculosis transmission ‘hot spots’ in high-burden communities

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Abstract:

BACKGROUND: Global control of the tuberculosis (TB) epidemic remains poor, especially in high-burden settings where ongoing transmission sustains the epidemic. In such settings, a significant amount of transmission takes place outside the household, and practical approaches to understanding transmission at community level are needed.

OBJECTIVE: To identify and map potential TB transmission ‘hot spots’ across high-burden communities.

SETTING AND DESIGN: Our method draws on data that qualitatively describe a high-burden community in Cape Town, South Africa. Established transmission principles are applied to grade the potential TB transmission risk posed by congregate settings in the community. Geographic information systems (GIS) technology then creates a visual map, locating potential transmission ‘hot spots’ in the community.

RESULTS: Drinking places (shebeens), clinics and churches (often gatherings in confined homes) emerge as gathering places that potentially pose a high transmission risk, particularly if located in overcrowded and impoverished areas of the community.

CONCLUSION: This proof-of-concept study demonstrates that combining qualitative techniques with GIS mapping may improve our understanding of potential TB transmission within a community and guide public health interventions to enhance TB control efforts.

Keywords: community; transmission; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Faculty of Health Sciences, Stellenbosch University, South Africa 2: Ukwanda Centre for Rural Health, Stellenbosch University, South Africa 3: Unit for Religion and Development Research, Stellenbosch University, South Africa 4: Desmond Tutu TB Centre, Stellenbosch University, South Africa 5: Clinical Research Unit, Department of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom; and ZAMBART Project, University of Zambia, Lusaka, Zambia 6: Clinical Research Unit, Department of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom 7: Anthropology Department, University College London, London, United Kingdom 8: ZAMBART Project, University of Zambia, Lusaka, Zambia; and Health Policy Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom

Publication date: June 1, 2009

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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