Spatio-Temporal Dynamics of Tuberculosis Clusters in Indonesia

Area of Science:

• Public Health
• Epidemiology
• Spatial Analysis

Background:

• Social determinants, particularly socioeconomic status, contribute to the formation of spatio-temporal tuberculosis (TB) clusters.
• Understanding the dynamics and social characteristics of these TB clusters is crucial for effective public health interventions.
• Previous research has focused on identifying TB clusters but often overlooks their dynamic nature and associated social factors.

Purpose of the Study:

• To investigate the spatio-temporal dynamics of tuberculosis (TB) clusters in Bandar Lampung, Indonesia, between 2015 and 2016.
• To identify the specific characteristics of population density and poverty within these identified TB clusters.

Main Methods:

• A cross-sectional study design was employed, analyzing data from 705 TB patients in 2015 and 1134 in 2016.
• Geographical coordinates of patient residences were collected using GPS, alongside secondary data on population density and poverty.
• Space-time permutation models, utilizing SaTScan software, were applied for spatio-temporal cluster analysis.

Main Results:

• Significant spatio-temporal TB clusters were identified in both 2015 and 2016, detailing their number, case distribution, locations, and sizes.
• Consistent social determinant characteristics were observed across all identified clusters.
• These characteristics included medium-high population density and a low-to-medium percentage of poverty.

Conclusions:

• TB control programs in high-burden, low-socioeconomic determinant settings should integrate spatio-temporal cluster dynamics.
• Understanding the interplay between TB clusters and social determinants is vital for developing more effective interventions.
• This study highlights the need for geographically and socioeconomically informed strategies to combat tuberculosis.