{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T02:46:32Z","timestamp":1746326792721,"version":"3.37.3"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T00:00:00Z","timestamp":1601337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","award":["PTDC\/SAU-PUB\/31346\/2017"],"award-info":[{"award-number":["PTDC\/SAU-PUB\/31346\/2017"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Tuberculosis (TB) causes pressure on healthcare resources, especially in terms of hospital admissions, despite being considered an ambulatory care-sensitive condition for which timely and effective care in ambulatory setting could prevent the need for hospitalization. Our objectives were to describe the spatial and temporal variation in pulmonary tuberculosis (PTB) hospitalizations, identify critical geographic areas at municipality level and characterize clusters of PTB hospitalizations to help the development of tailored disease management strategies that could improve TB control.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Ecologic study using sociodemographic, geographical and clinical information of PTB hospitalization cases from continental Portuguese public hospitals, between 2002 and 2016. Descriptive statistics, spatiotemporal cluster analysis and temporal trends were conducted.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The space\u2013time analysis identified five clusters of higher rates of PTB hospitalizations (2002\u201316), including the two major cities in the country (Lisboa and Porto). Globally, we observed a \u22127.2% mean annual percentage change in rate with only one of the identified clusters (out of six) with a positive trend (+4.34%). In the more recent period (2011\u201316) was obtained a mean annual percentage change in rate of \u22128.12% with only one cluster identified with an increase trend (+9.53%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our results show that space\u2013time clustering and temporal trends analysis can be an invaluable resource to monitor the dynamic of the disease and contribute to the design of more effective, focused interventions. Interventions such as enhancing the detection of active and latent infection, improving monitoring and evaluation of treatment outcomes or adjusting the network of healthcare providers should be tailored to the specific needs of the critical areas identified.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurpub\/ckaa161","type":"journal-article","created":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T19:21:48Z","timestamp":1597087308000},"page":"57-62","source":"Crossref","is-referenced-by-count":6,"title":["Space\u2013time clustering and temporal trends of hospitalizations due to pulmonary tuberculosis: potential strategy for assessing health care policies"],"prefix":"10.1093","volume":"31","author":[{"given":"Jo\u00e3o Almeida","family":"Santos","sequence":"first","affiliation":[{"name":"NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal\u00a0"},{"name":"Instituto Nacional de Sa\u00fade Dr. Ricardo Jorge, Lisboa, Lisboa, Portugal"},{"name":"NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal"}]},{"given":"Danielle T","family":"Santos","sequence":"additional","affiliation":[{"name":"NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal\u00a0"},{"name":"Escola de Enfermagem de Ribeir\u00e3o Preto, Universidade de S\u00e3o Paulo, Sao Paulo, Brasil"}]},{"given":"Ricardo A","family":"Arcencio","sequence":"additional","affiliation":[{"name":"Escola de Enfermagem de Ribeir\u00e3o Preto, Universidade de S\u00e3o Paulo, Sao Paulo, Brasil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4562-1057","authenticated-orcid":false,"given":"Carla","family":"Nunes","sequence":"additional","affiliation":[{"name":"NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal\u00a0"},{"name":"NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal"}]}],"member":"286","published-online":{"date-parts":[[2020,9,29]]},"reference":[{"year":"2019","key":"2021020212060402600_ckaa161-B1"},{"key":"2021020212060402600_ckaa161-B2"},{"key":"2021020212060402600_ckaa161-B3","doi-asserted-by":"crossref","DOI":"10.1186\/1741-7015-9-127","article-title":"Control of tuberculosis in large cities in developed countries: an organizational problem","volume":"9","author":"Cayl\u00e0","year":"2011","journal-title":"BMC Med"},{"key":"2021020212060402600_ckaa161-B4","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1093\/trstmh\/trw004","article-title":"A world of cities and the end of TB","volume":"110","author":"Prasad","year":"2016","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"2021020212060402600_ckaa161-B5","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.ijid.2016.12.025","article-title":"Tackling TB in low-incidence countries: improving diagnosis and management in vulnerable populations","volume":"56","author":"Heuvelings","year":"2017","journal-title":"Int J Infect Dis"},{"key":"2021020212060402600_ckaa161-B6","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1183\/13993003.00749-2016","article-title":"Tuberculosis in London: the convergence of clinical and social complexity","volume":"48","author":"Anderson","year":"2016","journal-title":"Eur Respir J"},{"key":"2021020212060402600_ckaa161-B7","doi-asserted-by":"crossref","first-page":"3211","DOI":"10.1017\/S0950268815001089","article-title":"Pulmonary tuberculosis space\u2013time clustering and spatial variation in temporal trends in Portugal, 2000\u20132010: an updated analysis","volume":"143","author":"Areias","year":"2015","journal-title":"Epidemiol Infect"},{"year":"2016","key":"2021020212060402600_ckaa161-B8"},{"key":"2021020212060402600_ckaa161-B9","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.puhe.2008.11.001","article-title":"Ambulatory care sensitive conditions: terminology and disease coding need to be more specific to aid policy makers and clinicians","volume":"123","author":"Purdy","year":"2009","journal-title":"Public Health"},{"key":"2021020212060402600_ckaa161-B10","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1093\/eurpub\/14.3.246","article-title":"The role of primary care in preventing ambulatory care sensitive conditions","volume":"14","author":"Caminal","year":"2004","journal-title":"Eur J Public Health"},{"year":"2012","author":"Tian","key":"2021020212060402600_ckaa161-B11"},{"key":"2021020212060402600_ckaa161-B12","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1016\/j.healthpol.2015.08.007","article-title":"Which hospitalisations are ambulatory care-sensitive, to what degree, and how could the rates be reduced? 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