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TB control strategies need to be adapted to the necessities of different countries and adjusted in high-risk areas. In this study, we analysed the spatial distribution of the MDR- and non-MDR-TB cases across municipalities in Continental Portugal between 2000 and 2016. We used Bayesian spatial models to estimate age-standardized notification rates and standardized notification ratios in each area, and to delimitate high- and low-risk areas, those whose standardized notification ratio is significantly above or below the country\u2019s average, respectively. The spatial distribution of MDR- and non-MDR-TB was not homogeneous across the country. Age-standardized notification rates of MDR-TB ranged from 0.08 to 1.20 and of non-MDR-TB ranged from 7.73 to 83.03 notifications per 100,000 population across the municipalities. We identified 36 high-risk areas for non-MDR-TB and 8 high-risk areas for MDR-TB, which were simultaneously high-risk areas for non-MDR-TB. We found a moderate correlation (\u03c1\u2009=\u20090.653; 95% CI 0.457\u20130.728) between MDR- and non-MDR-TB standardized notification ratios. We found heterogeneity in the spatial distribution of MDR-TB across municipalities and we identified priority areas for intervention against TB. We recommend including geographical criteria in the application of molecular drug resistance to provide early MDR-TB diagnosis, in high-risk areas.<\/jats:p>","DOI":"10.1038\/s41598-020-73759-w","type":"journal-article","created":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T10:04:27Z","timestamp":1601978667000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Using Bayesian spatial models to map and to identify geographical hotspots of multidrug-resistant tuberculosis in Portugal between 2000 and 2016"],"prefix":"10.1038","volume":"10","author":[{"given":"Olena","family":"Oliveira","sequence":"first","affiliation":[]},{"given":"Ana Isabel","family":"Ribeiro","sequence":"additional","affiliation":[]},{"given":"Elias Teixeira","family":"Krainski","sequence":"additional","affiliation":[]},{"given":"Teresa","family":"Rito","sequence":"additional","affiliation":[]},{"given":"Raquel","family":"Duarte","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2202-5431","authenticated-orcid":false,"given":"Margarida","family":"Correia-Neves","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2020,10,6]]},"reference":[{"key":"73759_CR1","unstructured":"WHO Regional Office for Europe\/European Centre for Disease Prevention and Control. 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