Journal of Epidemiology and Global Health

Volume 5, Issue 3, September 2015, Pages 221 - 230

Spatial and non-spatial determinants of successful tuberculosis treatment outcomes: An implication of Geographical Information Systems in health policy-making in a developing country

Authors
Goodarz Kolifarhooda, Gfarhood@gmail.com, Davoud Khorasani-Zavarehb, c, *, Davoud.khorasani@gmail.com, Shaker Salarilakd, Salarilak@yahoo.com, Alireza Shoghlie, Shoghli@zums.ac.ir, Nasim Khosravif, Nasimkhosravi.khosravi3@gmail.com
aDepartment of Epidemiology and Biostatistics, School of Medicine, Zanjan University of Medical Sciences, Iran
bSocial Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
cDepartment of Clinical Science and Education, Karolinska Institute, Stockholm, Södersjukhuset, Sweden
dIslamic Azad University, Tabriz branch, Medical faculty, Tabriz, Iran
eDepartment of Social Medicine, School of Medicine, Zanjan University of Medical Sciences, Iran
fDepartment of Community Health Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Iran
*Corresponding author at: Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran.
Corresponding Author
Davoud Khorasani-ZavarehDavoud.khorasani@gmail.com
Received 27 July 2014, Revised 13 November 2014, Accepted 18 November 2014, Available Online 12 January 2015.
DOI
10.1016/j.jegh.2014.11.001How to use a DOI?
Keywords
Tuberculosis; Adverse treatment outcome; Health policy-making; Geographical Information System
Abstract

This retrospective study aimed to address whether or to what extent spatial and non-spatial factors with a focus on a healthcare delivery system would influence successful tuberculosis (TB) treatment outcomes in Urmia, Iran. In this cross-sectional study, data of 452 new TB cases were extracted from Urmia TB Management Center during a 5-year period. Using the Geographical Information System (GIS), health centers and study subjects’ locations were geocoded on digital maps. To identify the statistically significant geographical clusters, Average Nearest Neighbor (ANN) index was used. Logistic regression analysis was employed to determine the association of spatial and non-spatial variables on the occurrence of adverse treatment outcomes. The spatial clusters of TB cases were concentrated in older, impoverished and outskirts areas. Although there was a tendency toward higher odds of adverse treatment outcomes among urban TB cases, this finding after adjusting for distance from a given TB healthcare center did not reach statistically significant. This article highlights effects of spatial and non-spatial determinants on the TB adverse treatment outcomes, particularly in what way the policies of healthcare services are made. Accordingly, non-spatial determinants in terms of low socio-economic factors need more attention by public health policy makers, and then more focus should be placed on the health delivery system, in particular men’s health.

Copyright
© 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd.
Open Access
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Journal
Journal of Epidemiology and Global Health
Volume-Issue
5 - 3
Pages
221 - 230
Publication Date
2015/01/12
ISSN (Online)
2210-6014
ISSN (Print)
2210-6006
DOI
10.1016/j.jegh.2014.11.001How to use a DOI?
Copyright
© 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd.
Open Access
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Cite this article

TY  - JOUR
AU  - Goodarz Kolifarhood
AU  - Davoud Khorasani-Zavareh
AU  - Shaker Salarilak
AU  - Alireza Shoghli
AU  - Nasim Khosravi
PY  - 2015
DA  - 2015/01/12
TI  - Spatial and non-spatial determinants of successful tuberculosis treatment outcomes: An implication of Geographical Information Systems in health policy-making in a developing country
JO  - Journal of Epidemiology and Global Health
SP  - 221
EP  - 230
VL  - 5
IS  - 3
SN  - 2210-6014
UR  - https://doi.org/10.1016/j.jegh.2014.11.001
DO  - 10.1016/j.jegh.2014.11.001
ID  - Kolifarhood2015
ER  -