A multidisciplinary method to map potential tuberculosis transmission 'hot spots' in high-burden communities.
BACKGROUND
Global control of the tuberculosis (TB) epidemic remains poor, especially in high-burden settings where ongoing transmission sustains the epidemic. In such settings, a significant amount of transmission takes place outside the household, and practical approaches to understanding transmission at community level are needed.


OBJECTIVE
To identify and map potential TB transmission 'hot spots' across high-burden communities.


METHODS
Our method draws on data that qualitatively describe a high-burden community in Cape Town, South Africa. Established transmission principles are applied to grade the potential TB transmission risk posed by congregate settings in the community. Geographic information systems (GIS) technology then creates a visual map, locating potential transmission 'hot spots' in the community.


RESULTS
Drinking places (shebeens), clinics and churches (often gatherings in confined homes) emerge as gathering places that potentially pose a high transmission risk, particularly if located in overcrowded and impoverished areas of the community.


CONCLUSIONS
This proof-of-concept study demonstrates that combining qualitative techniques with GIS mapping may improve our understanding of potential TB transmission within a community and guide public health interventions to enhance TB control efforts.
Murray
E J
EJ
Faculty of Health Sciences, Stellenbosch University, South Africa. emmajanes.murray@gmail.com
Marais
B J
BJ
Mans
G
G
Beyers
N
N
Ayles
H
H
Godfrey-Faussett
P
P
Wallman
S
S
Bond
V
V
D003140:Communicable Disease Control / Q000379:methods*; D017281:Cost of Illness; D003906:Developing Countries; D040362:Geographic Information Systems; D006801:Humans; D033183:Interdisciplinary Communication; D011159:Population Surveillance; D036301:Qualitative Research; D013019:South Africa; D014376:Tuberculosis / Q000635:transmission*