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

Goodarz Kolifarhood; Davoud Khorasani-Zavareh; Shaker Salarilak; Alireza Shoghli; Nasim Khosravi

doi:10.1016/j.jegh.2014.11.001

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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 Kolifarhood^a^,Gfarhood@gmail.com, Davoud Khorasani-Zavareh^b^{, c}^{, *}^,Davoud.khorasani@gmail.com, Shaker Salarilak^d^,Salarilak@yahoo.com, Alireza Shoghli^e^,Shoghli@zums.ac.ir, Nasim Khosravi^f^,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.2014.11.001 How 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.
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.2014.11.001 How to use a DOI?
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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ris enw bib

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  -

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